How do I lodge a car insurance complaint with the Ombudsman?

How-do-I-lodge-a-car-insurance-complaint-with-the-OmbudsmanWe have previously raised this topic in 2 separate Blog posts titled:

I have found the process to be very effective and have personally experienced the favourable outcome of such a complaint to the Ombudsman. We have also found that it is worthwhile to take some time to find and follow the correct steps to follow in this process.

Many visitors to the Car Insurance Blog have searched for information on the procedures to follow when raising a complaint – and we would like to provide more clarity.

The Ombudsman provides a handy guide on the steps that every complainant should follow.

Before you raise a car insurance complaint

You must complain to the Insurance Company first, before we can look at your complaint. Remember that the Insurance Company must first respond on you claim before you can take this matter to the Ombudsman.

Attitude, Facts, Documentation and Records

Once you have submitted a car insurance claim, the car insurer could accept the claim and make payment, reject your claim or decide to make partial payment under the claim. It is at this stage where many consumers may become unhappy, agitated and seek further action.

Your attitude is most important and we would like to suggest keeping the following in mind:

  • Remain calm and give the insurer the benefit of doubt.
  • Accept that there is no intentional malice on the side of the insurer and person who has responded.
  • Accept that someone could have erred in having overlooked something in your claim.
  • There could be many reasons why the answer received does not meet your expectations.
  • It is important to focus on the facts – the law will look after itself!
  • Focus on collecting and gathering all the documentation needed for your complaint as well as all your communications with your insurer, your broker and parties to this claims process.

Complaining to the Car Insurance Company:

Here are some hints to help you complain effectively to the Insurer and details of what to do next if you are still unhappy with their decision.

  1. It is usually best to complain in writing. But if you phone, ask for the name of the person you speak to. Keep a note of this information, with details such as, the date and time of your call and what was said. This may be required at a later stage.
  2. Remain calm and polite, however emotional, angry or upset you may be. You are more likely to explain your complaint clearly and effectively if you can stay calm.
  3. Initially attempt contacting the person you originally dealt with. If they cannot help, indicate that the matter will be taken further. Seek details of the name or job title of the person who will be handling your complaint and for details of the Insurer’s complaints procedure.
  4. Make an attempt to take up the matter with a Senior Official at the Insurer.
  5. When you write a letter of complaint, set out the facts as clearly as possible.
  6. Write down the facts in a logical order and stick to what is relevant. Include important details like your claim number or your policy number.
  7. Keep a copy of all letters between you and the Insurer.

What to do after complaining to the Car Insurance Company:

If you are not happy with the Insurer’s decision you may:

  1. Issue a summons out of the Small Claims Court ( there is a small cost involved ) on the Insurance Company. The maximum amount that can be claimed in the Small Claims Court is R 7,000.00.
  2. Consult with an Attorney to pursue the matter by means of further legal action.
  3. Submit a complaint to the Ombudsman of Short Term Isurance.

There are 2 Options available for submitting a complaint to the Ombudsman

You can either complete the complaint form by hand and post or fax it or complete the complaint form online and post or fax it. Visit the website of the Ombudsman for Short Term Insurance for more information.

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