Since Dennis Jooste took over the management of the short-term insurance (STI) ombud’s office less than three years ago, it has received and resolved thousands of complaints by consumers.
Last year was the office’s busiest period with over 9 000 complaints lodged and resolved.
This is based on figures in the recently-published annual short-term insurance ombud’s report.
The report says these disputes occurred between aggrieved policy-holders and insurance or financial services companies.
Since the office was first established in 1989, it has successfully intervened in numerous small claims disputes involving products such as short-term insurance and loans.
The report reveals that the ombud finalised 30 450 formal disputes between Jooste’s appointment in 2011 and 2013 – out of which 9 368 were complaints filed last year alone.
The rand value for settled disputes in favour of consumers was R118 million – which is about R500 000 more than the R113 million finalised in 2012.
“The amount recovered refers to payments made to the policy-holders as a result of our involvement,” says Jooste.
Jooste supervises a team of senior and assistant ombudsmen who facilitate accessible, informal and speedy resolution processes to people who have disputes with the companies they are insured with.
His office assesses complaints involving house, car, livestock and business insurance claims from various policyholders.
Complaints vary from late settlements on submitted claims, “unfair” interest charges on loans and suspected fraud.
To lodge a complaint, consumers can download and submit the ombud’s online application form or call the toll-free number.
Important documents, for example policy schedules and letters of rejection from the service provider must be included in the application form.
“On receipt of a complaint, the case gets registered with our office. The complaint is then forwarded to the insurance company for a response,” says John van Rensburg, assistant ombudsman.
The insurance company’s response is then sent to the complainant for consideration and is then returned to the ombud’s office with his or her comments.
Once the cause of the disagreement is determined by the ombud, an investigation into the dispute begins.
The cost-free process takes between three to four months to complete.
Van Rensburg says his office liaises constantly with both insurance and loan companies and their clients to ensure that “impartial” outcomes are reached.
“Ombudsman Jooste receives excellent co-operation from consumers.
This is illustrated by the fact (that) he made only two formal rulings against insurance companies during 2013, to which those insurers complied with,” he says.
Previously, final decisions by the office were binding to all insurance companies, but not to consumers. However, in December 2013, the office launched an appeal mechanism that will allow insurers to appeal as well.
- Go to www.osti.co.za for more information