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Short-Term Ombudsman to recognise insurer excellence

11 September 2007 Gareth Stokes

The Ombudsman for Short-Term Insurance has a simple mission to resolve short-term insurance complaints fairly, efficiently and impartially. Each year the Ombudsman receives and rules on thousands of complaints directed at its member organisations. It is essential that these insurers cooperate with the Ombudsman to secure speedy claim resolution.

Tremendous progress has been made in recent years in obtaining buy-in from the 38 short-term insurance companies and organisations that are listed as members of the Ombudsman. An example of these successes is contained in the opening statement in the 2006 Annual Report in which the Ombudsman reveals: "Although this office has the power to make a binding ruling against an insurer (with no right of appeal), I am pleased to report that it was not necessary to make a single ruling this past year."

Cooperation between insurer and Ombudsman mean that even though the number of complaints and amounts awarded increase annually, insurers are more likely to accept and honour the Ombudsman's rulings.

Significant increases in case loads and recoveries

A quick look at the statistics included on the Ombudsman's website confirms the significant increase in complaints. Both the number of cases recorded and the money recovered on behalf of the complainants have soared over the last three years. Money recovered for insurance consumers increased from R22 million in 2003 to R67 million in 2006. And over the same period the number of formal complaints (arising out of rejected claims and other insurance related issues) increased from 4, 351 cases to 7, 187.

Despite the increased workload the Ombudsman has managed to reduce the time taken to process each complaint. From an average of 110 days in 2003, the office now closes a file in 87 days. This success can in part be attributed to improved cooperation from the various insurance companies involved. The more professional the relationship between insurance companies and the Ombudsman, the quicker the many check boxes can be ticked off and a file closed.

Working hand in hand with insurers

The Ombudsman has made huge steps in increasing cooperation in the industry's complaint resolution process. The 2006 Annual Report acknowledges this fact, stating that: "The insurance industry has certainly cooperated to resolve complaints in a reduced time period. Insurers can check out exactly what is the status of a particular claim at any time by visiting our website. The majority of insurers are equally anxious to resolve a complaint with the minimum of delay."

And the Ombudsman appears intent on improving things further. At a function held in Johannesburg on Tuesday, 11 September 2007, the Ombudsman for Short-Term Insurance announced a new award. The "OSTI Ukusizana Award" will be awarded annually to an insurance company that excels in a number of areas. Named for the Zulu word 'Ukusizana' which means "working hand in hand" the award will further the spirit of cooperation in the short-term insurance complaints resolution process.

The Ombudsmanhas devised this award to recognise and reward insurance companies for their commitment to fairness and equity. The aim is to enhance the spirit of cooperation between insurers and the Ombudsman and promote excellence in customer service across the industry.

Six measures of insurance excellence

Insurance companies will be judged on six criteria which relate to how they interact with the Ombudsman and their customers. The first of these criteria requires a commitment to service excellence.

The remaining criteria apply specifically to the complaint resolution process applied by the Ombudsman. The Ombudsman will judge insurers based on the speed and thoroughness of responses to queries, commitment to fairness and equity, the level of cooperation with the Ombudsman and the promptness of implementation of Ombudsman recommendations.

"By establishing the Office 17 years ago, the insurance industry has shown its commitment to resolving issues in an informal and quick manner without any cost to the insured. It is therefore only appropriate that we recognise these efforts by way of awarding the "Ukusizana" award on an annual basis to the insurer who meets the criteria and has shown the greatest commitment to the principles of the Ombudsmans office", said Brian Martin, Ombudsman for Short-Term Insurance.

First winner to be announced in 2008

Finalists for the 2007 award will be announced in January 2008 before the Ombudsman verifies and confirms results in February. The winner will be announced in March 2008 to coincide with the Office for the Ombudsman of Short-Term Insurance's 2007 Annual Report.

Speaking in her capacity as Chairperson of the Short-Term Insurance Ombudsman's Board, Isabel Jones said: "I congratulate our Ombudsman, Brian Martin on this initiative to recognise Insurers' commitment in giving consumers' speedy and efficient service. Without the back up of the industry, the endeavours of the Ombudsman and his team would not be as successful as they are. Let's recognise the industry members who go the individual mile to get speedier resolution of disputes and help to build up a greater consumer respect for the industry's integrity."

Editor's thoughts:
The Office for the Ombudsman of Short-Term Insurance is taking positive steps to encourage greater cooperation from stakeholders in the insurance industry. This innovation will hopefully lead to improved relationships between insurers and the Ombudsman, as well as more efficient complaint resolution. It seems though that the industry might need another award for the insurance company that troubles the Ombudsman the least. Should the Ombudsman also establish an award for the insurer that generates the least complaints in a given period? Send your comments to
gareth@fanews.co.za


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