2. Policyholder Protection Rules 2004
In terms of the rules, an insurer must inform the consumer, in writing, of a policy issued to them. The insurer must advise the consumer of any internal complaint resolution systems and procedures. This, as well as full particulars relating to the short-term and long-term insurance ombudsmen. No insurer may ask or induce a consumer to waive their rights in terms of the rules. If they do give any such waiver, it will be regarded as void. No insurer or intermediary may allow a consumer to sign a blank or partially completed form necessary for entering into a policy. If you feel like your insurance provider has not informed you of the above, you can contact the Ombudsman for Short Term Insurance (OSTI). It is recommended to first bring up the issue with your insurance provider, after which you may contact OSTI to resolve the issue.
OSTI Recommends Taking These Steps First:
- 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. Along with details such as, the date and time of your call and what was said. This may be required at a later stage.
- 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.
- 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.
- Attempt taking up the matter with a Senior Official at the Insurer.
- When you write a letter of complaint, set out the facts as clearly as possible.
- 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.
- Keep a copy of any letters between you and the Insurer.
What Happens If You Are Still Not Happy With The Insurer's Decision?
- Fill in and submit a complaint form to OSTI.
- Issue a summons out of the Small Claims Court (small cost involved) on the Insurance Company. The maximum amount that can be claimed in the Small Claims Court is R 15 000.
- Consult with an attorney to pursue the matter by means of further legal action.