orangeblock

Sloppy administration hits broker hard

13 January 2009 | Compliance - Regulatory | FAIS Ombudsman | Gareth Stokes

More than five years after the implementation of the Financial Advisory and Intermediary Services (FAIS) Act 2002 financial services providers are still falling foul of the legislation due to poor administrative processes. This fact was again illustrated by the Deputy Ombudsman for Financial Services Providers’ determination against XXXX Brokers CC  and the company’s key individual, XXXX.

On 6 January 2009 Noluntu Bam determined that the respondents’ failure to comply with “an important provision of the General Code of Conduct for Authorised Financial Services Providers and Representatives (the Code) framed under the FAIS Act” had culminated in the complainant’s loss. She ordered the respondents to pay the complainant, Marlon van Dorsen, an amount of R113700 plus interest at 15.5 per cent per annum from 14 July 2007. This to compensate Van Dorsen for the loss of his 2003 Volkswagen Golf 4 which was written off following an accident on 13 July 2007.

Insurance broker got it wrong

So where did things go wrong? To find out we need to consider the events as they took place. From 1 June 2005, Van Dorsen’s vehicle was insured with Auto & General. Two years after the policy inception, A & G increased the premium and Van Dorsen contacted Y Barnard (a receptionist/administrative clerk at the respondent) to shop around for a better rate. Barnard obtained quotes from Santam and Quicksure, and Van Dorsen verbally accepted the Santam quote, dated 4 June 2007. This quote was sent to Van Dorsen again on the 20 June with the request: “should you wish to [accept] please [sign] and fax back to our office along with your updated banking details, copy of ID and drivers license.” A week later, after another reminder, Van Dorsen authorised Barnard to switch from A & G to Santam, informing her that the deduction could be made from his bank on the first day of each month. No problem as yet.

Less than an hour after Van Dorsen’s instruction, Barnard sent an email to Ansie van Tonder of C & F Outsource Management (an administrator for Santam) in which she says: “Herewith attached please find quotation for client Mr Van Dorsen. Please could you arrange for policy to be on cover as from the 1st of July 2007.” This correspondence was copied to the complaint and Bam believes the content of this email created the impression (certainly in Van Dorsen’s mind) that he was comprehensively insured from that date. Bear in mind that Van Dorsen had not provided the required documents (or signed quotation) at this stage. This was still the case when he reported the accident on 19 July 2007. By 31 July Van Dorsen was informed that his claim would not be entertained as he was not on cover.

Did the insurer make any noise?

In this case the insurer (through its administrator) had communicated the documentary requirements for insurance applications as recently as 29 May of that year. The correspondence read: “Please take note on all NEW POLICY APPLICATIONS we need the following:

  • Signed Proposal Form or Signed Quotation Form
  • Signed Debit Order Form
  • Registration Number – Vin Number – Engine Number
  • Correct Security on Premises and Vehicles
  • Vehicle Tracking System Certificate (to qualify for discount)
  • Valuation Certificates for Jewellery
  • Copy of ID of Insured.”

Thus the determination hinges on the failure by the brokerage (and its staff) to comply with Section 3 (1) of the Code. In her ruling Bam finds that the brokerage failed to communicate to Van Dorsen that he would enjoy no cover unless he complied with all the requirements of the insurer. According to Bam: “It is abundantly clear that the respondent through its registered provider, XXXX had a duty to clearly and unambiguously inform the complainant that he would not be insured until such time as all the requested information and documents were supplied.”

Bam also questioned why the complainant’s insurance with A & G was cancelled prior to confirmation that a new policy was in place. She concludes that Barnard must have believed the complainant was insured from the date of her email to C & F Outsource Management too!

Advice from appropriately qualified persons

Bam was also confused as to why all the correspondence in this matter was handled by  a member of staff who was not a registered provider in terms of the FAIS Act. “I should mention my grave concern at the fact that although certain correspondence (including the letter in terms of section 27(4) of the FAIS Act) was addressed to XXXX as the managing member and Key Individual of the respondent, all responses were received from Barnard, who, as I said earlier is a receptionist/administrative clerk of the respondent,” said Bam.

Editor’s thoughts:
Hundreds of accidents occur in the first few days after policy inception. For this reason short-term insurance brokers should have administrative processes in place to ensure that all conditions for their clients’ cover are met. Do you believe the FAIS Ombudsman finding for the complainant in this case is correct – or should the insurer have taken a softer stance? Add your comments below, or send them to [email protected]

Comments

Added by Retha, 15 Jan 2009
Dis my mening dat die huidige ekonomiese toestande die oorsaak is waarom die eis nie uitbetaal is nie. Versekeraars probeer hulle self beskerm deur minder eise uit te betaal en dan die polisbewoording tot op die letter uit te voer en te vereis - iets wat hulle voorheen nie gedoen het nie en baie meer buigbaar was tov die vereistes, veral tov uitstaande dokumente (wat in elk geval bestaan maar wat kliënte versuim om in te stuur bloot omdat hulle vergeet en die makelaar, deur die buigbaarheid van die versekeraars, nie daarop aandring nie.). Versekeraars het dus volgens my ook 'n bydraende skuld aan hierdie situasie. Die skuld kan daarom nie net voor die deur van die makelaar gelê word nie. Ons het voorbeelde van dieselfde situasie: 1. Voor die huidige ekonomiese krisis is die eis uitbetaal (deur dieselfde versekeraar). 'n Gesteelde motor met uitstaande dokumentasie op die polis. 2. 'n Eis wat in November 2008 ontstaan het en wat nie uitbetaal is nie (deur dieselfde versekeraar). 'n Gesteelde motor met uitstaande dokumentasie.
Report Abuse
Added by Les, 15 Jan 2009
I've had situations where an existing short term client with personal short term insurance policy with a large insurer calls thru to our office 3 working days before Xmas to say he has traded his old vehicle in on another vehicle and is about to drive this (new) vehicle out of the showroom. The client wants us to arrange that the Insurer sends the motor car salesman a letter to confirm that the new vehicle is covered. The salesman is happy to release the vehicle once he receives this letter stating the "car will be held covered" on the Insurers letterhead. Here's the thing, if we compare the above scenario, technically speaking the increased premium for the new vehicle has not been received. Should this vehicle be involved in a massive accident and totally written off ...will the insurer pay? Would the broker have been negligent of due diligence and proper admin process? It would seem in cases like this the insurer is happy to take on the risk and the increased premium, but would look for reasons to repudiate the claim on technicalities when it suits them...... and the broker may still have the Ombud and client on his back demanding compensation.
Report Abuse
Added by Mark Cooper, 13 Jan 2009
Do I presume that the licence holder will be penalised/lose their licence for allowing a clerk to "give advice" when the clerk wasn't listed as fit and proper?
Report Abuse
Added by Jakes Jacobs, 13 Jan 2009
Without prejudice and without any ill content; I am of the opinion that u/w after having received the request for cover to commence w.e.f. 01/07 could have (a) send a request to broker for outstanding info, referring to the previous correspondence or (b) hold cover temporarily for say 7 days during which broker had to furnish required info and in failing doing so then would have led to termination of cover. Lately companies tend to change from old ways of operating and thus often we unintentionally may do wrong - the above was the easy way out. ( Normally insurars tend to take into consideration the wishes of the client / intentions of the client e.g. when client fax you a request to add something to his policy and you as broker haven't had time to forward this to insurer - they tend to accept that the agreement was in place to have the item insured ( once again the easy (cheap?) way out will be to say it is not covered because they did not receive the instructions as yet. ) Also taking into consideration that the admin lady may not be entitled to send such request through to insurer. What if she does send it and ask for insurer to hold on cover untill broker had time to send a official instruction? ) One tends to get a picture that it is easier to always just blame/kick the broker. (Quite often u/w's & admin houses gain financially if the claims ratios are lower.)
Report Abuse
Added by Quinten Knox, 13 Jan 2009
Mark: Any person rendering financial advice (which is defined in the Act) must meet the Fit and Proper requirements. Their title is irrelevant. Not complying with these requirements is a very very serious issue and you do not want to cross swords with the Regulator on this matter. You are punishable for non-compliance with the Fit and Proper requirements but whether you (the FSP) will loose your licence is something that is decided on a case by case basis. Regards, Quinten.
Report Abuse
Added by Nico, 13 Jan 2009
Ek wonder of slegs `n pro-rata premie gevorder sou word met ontvangs van ontbrekende dokumente en of die hele maand se premie verhaal sou word op 01/08.
Report Abuse

Comment on this Post

Name*

Email Address*

Comment*

Sloppy administration hits broker hard
quick poll
Question

If you had to hazard a guess, when do you reckon the COFI Bill will be signed into law?

Answer