MONEY
16/05/2018 10:29 SAST | Updated 16/05/2018 10:36 SAST

SA's 8 Worst Insurers When Responding To Complaints: Ombud

Nearly 15 South Africans a day report a "chargeable complaint" to the long-term insurance ombudsman. Here's how you can get yours investigated...

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Nedgroup Life — Nedbank's insurance company — has been revealed as the worst insurance-company responder by the Ombudsman for Long-Term Insurance (OLTI).

The offenders were exposed in the Ombud's 2017 Annual Report, which was released on Tuesday.

The OLTI provides an independent mediation service to policyholders who have a dispute with their insurers — a service that's free to consumers but not to insurers, who are made to pay a per-complaint fee.

Nedgroup Life, funeral insurers Nestlife Assurance, Safrican Insurance, 1Life Insurance, Alexander Forbes, the Liberty Group, Worker's Life Assurance and First Rand Life were all in the top eight worst offenders, receiving a number of reminders to respond to complaints raised with the ombudsman.

The office received 10,768 written requests for assistance in 2017, including 5,435 chargeable complaints. Half the complaints related to denied claims, followed by complaints of poor service from insurers, Ombudsman Ron McLaren revealed.

R193.3-million was recovered for complainants, and compensation of R531,429 was awarded to complainants in 150 complaints for poor service by insurers. Of the complaints received, 85 percent were finalised within six months, and 29 percent were resolved wholly or partially in favour of complainants.

You can also submit a complaint about a long-term insurer

The ombudsman can help you if you believe your long-term insurer unfairly denied you a claim. To submit a complaint about a long-term insurer, you can visit the OLTI's website.

OLTI gives insurers 21 working days to respond to a complaint once it has been raised with the ombud, and if no response is given, a reminder is sent for the insurer to respond within a week, explained deputy ombudsman Jennifer Preiss.

If OLTI still does not hear from the insurers, the case is deemed "incompetent" — and insurers are at risk of being charged a double fee.

Insurers will pay a triple fee if a third reminder needs to be sent.