You are upset because the car insurance company you are dealing with has let you down regarding certain expectations, whether it is PMD or another car insurance company. This is also not the first time that you have complained. You now wish to complain further, but what is the best avenue? Is it HelloPeter?
HOW DO COMPLAINTS WITH INSURANCE COMPANIES EVOLVE?
Some clients start by contacting the insurance company directly, especially when the problem that needs solving is a small issue. On the other hand, some clients announce it through a channel like Hellopeter.com. Hellopeter.com has been used extensively for showing complaints made by many clients. It is a good idea to follow the complaints procedure that the company has in order to get the quickest responses from them, this is usually found on their website.
WHY DO MEDIA PLATFORMS LIKE HELLOPETER.COM AND OTHER SIMILAR PLATFORMS SEEM EFFECTIVE?
Compare Guru compared results of a survey regarding clients’ complaints and compliments concerning large and small insurance companies. With media platforms like Hellopeter.com, the type of complaining can be powerful because it exposes the different insurance companies performance for the whole world to see, whether legitimate or not. No company wishes to attract any negative publicity. Although, there is a chance that the company might not see the complaint if you just post it on a media platform and don’t go through their internal complaints channels.
It is possible that complaints made by clients on Hellopeter.com may have a noticeable effect on the performance of a company mentioned. The first thing any company that does not feature well in such a survey should possibly do is get to the root-cause of the complaints and determine whether they are legitimate or not. The company would presumably then try and respond and solve the legitimate complaints as soon as possible. The impact of a company’s efforts to mitigate the fall-out from client complaints should be monitored over time so that the company can ensure that their newly installed measures are effective.
PUBLISHING COMPLAINTS ABOUT INSURANCE COMPANIES FOSTERS ACCOUNTABILITY AND TRANSPARENCY, AND PROMOTES THE ESTABLISHMENT OF STANDARDS
Another avenue for clients of insurance companies to channel their complaints is via the relevant Ombudsman. The Ombudsman publishes surveys based on the data they get and the benefits of these surveys are that it publishes which companies received the most and the least complaints. Such surveys foster accountability and transparency by the various companies. Insurers that are serious about excelling in the market place will begin to learn from other insurance companies what makes them “tick,” and so standards are being established that will form a future pre-requisite for any insurance company to be attractive.
TO WHOM SHOULD YOU COMPLAIN FIRST?
- Every company has its own complaints procedures. This is usually available on their websites or on request. Following these procedures will likely give you the most efficient response.
- Some general tips would be to try and resolve the issue with the relevant contact person of the insurance company with which you have a complaint. Try to email or call a few times, if that is required, and record those events. Allow the company time to respond, remember that although your complaint is important a reasonable turn-around-time should be expected.
- When phoning the insurance company, write down who you spoke to, and briefly record what was said and when, as this information may well be required in the future. Some companies provide a reference number for a particular conversation. By recording information carefully will also protect you from straying away from the actual facts at hand.
- It is understandable that anything involving complaints can be an emotional issue, but if you want to be in a win-win situation, remember to remain courteous at all times with all your communications with the insurance company.
- There may be a point where there is nothing more that you can do and you still feel like your complaint has not been resolved, in those instances you can inform the company representative you are dealing with that you will escalate your matter further via the relevant Insurer or Ombudsman.
THE OFFICE OF THE OMBUDSMAN FOR SHORT-TERM INSURANCE
By way of introduction, the Office of the Ombudsman for Short-term Insurance came into being in 1989 for the specific purpose to resolve complaints between insurance companies and their clients. The advantage of using the Ombudsman route is that the Ombudsman is completely impartial and objective in the handling of complaints.
It has been proven to be helpful to go the route of the Ombudsman, because it provides an opportunity which can be successfully used when a stalemate has been reached regarding a client complaint against a certain insurance company. Decisions made by the Office are taken as final regarding the car insurance industry in South Africa. In addition, the service provided by this Office is free-of-charge.
HOW CAN YOU LODGE A COMPLAINT WITH THE OMBUDSMAN (LONG-TERM AND SHORT-TERM INSURANCE)?
The following steps outline the way to complain to the ombudsman:
- The complaint should be in writing. The letter must be neatly written or preferably typed, with help from the Ombudsman if need be. In the case of the Short-term Insurance Ombudsman, a specific complaint form needs to be completed, and returned to the Ombudsman. You can visit their website for the forms and information as well.
- It is understandable that one can get really upset about a particular issue, but please don’t shoot the messenger, the Ombudsman, especially if you feel you are being misunderstood. This also applies to writing down a complaint – stay courteous at all times.
- The Ombudsman needs information from you such as the name of the insurance company, the policy numbers involved, your contact details, and a brief description of the complaint itself.
- Provide the Ombudsman with any supporting documentation as well as any relevant communication held with the insurer.
- You can write / type the complaint in a language you prefer.
- It is vital that you keep a “paper trail” of all correspondence relevant to your complaint.
- Keep on contacting the Office of the Ombudsman so that you stay on top by finding out what progress has been made.
THE RESPONSE BY THE OMBUDSMAN
- The Ombudsman will acknowledge receipt of your letter and will advise you of the next steps.
- If the complaint is relevant to the ombudsman’s mandate, the Ombudsman will contact the insurer in writing, asking that the insurer investigates the complaint.
- The insurer has 6 weeks to respond. Once the insurer has responded in writing, the ombudsman will either write back to the complainant, or more information may be required from one or both parties.
- The service provided by the Ombudsman is free-of-charge.
ARE THERE ANY OTHER AVENUES FOR CHANNELLING YOUR COMPLAINT?
The Ombudsman cannot help you in every situation. It is good to note that the following are not covered by the Ombudsman:
- Any injury or death claims resulting from a car accident.
- Disputes that involve other insurance companies apart from your own.
- If legal action has already been taken against the insurer.
- If the car insurance had already been cancelled at the time the dispute arose.
- Free legal advice is not provided by the Ombudsman.
- The Ombudsman is not in a position to tell you how long the process will take. Generally, claims can take 3 – 12 months.
SENDING YOUR COMPLAINT TO THE SOUTH AFRICAN INSURANCE ASSOCIATION (SAIA)
It is important to remember that SAIA can only handle complaints that relate to the SAIA Code of Conduct. However, for short-term insurance complaints, you will still need to contact the Ombudsman for Short-term Insurance
Should you have a complaint against a particular insurance company, you can follow the procedure as prescribed by SAIA:
- On the SAIA website,10 you can establish whether your insurer is a registered member of SAIA.
- To complain against a specific insurance company, you need to fill in the SAIA complaints form, and return it to SAIA.
When dealing with PMD, you can contact us as soon as you are dissatisfied, and we will handle your complaint professionally and as soon as possible.
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