Presentation to Insurance Ireland’s Annual President’s

ConferenceBy

Ger DeeringFinancial Services Ombudsman

Effective Customer Complaint Handling

The Financial Services Ombudsman

Mediate Investigate Conduct Oral Hearings Adjudicate Award compensation up to €250k Direct rectification Publish complaint records Findings are legally binding, can only be appealed to the High Court

Complaints Received by Sector

Insurance Complaints

*Miscellaneous includes other categories such as marine, agriculture, computers mobile phones and pets

Insurance Findings & Settlements

Avoiding Disputes

Clear communication, in plain English, can avoid or resolve disputes and is particularly required when:

Selling the productProviding policy documents and warningsDealing with claimsDealing with complaints

Entering an insurance contract is a serious business and should be treated so by both parties

Can a Consumer know…

What non-disclosure is?What a material fact is?What would reasonably influence a prudent

insurer? What areas “are prone to storm”?

Should the insurer have predicted Barney?What “areas are prone to crime”?

Are there areas that are not?Whether material (the other “material”) is

incombustible?

Utmost Good FaithA contract of insurance is a contract of the utmost good faith on both sides

“The Office of the Financial Services Ombudsman may wish to consider the possibility that a

reasonably assertive claims policy may have strayed across the line into an unreasonably

avaricious claims policy which sought to dislodge a genuine claim on specious grounds under the ostensibly legitimising umbrella of uberrimae

fidei”Deirdre Earls –v- Financial Services Ombudsman & FBD Insurance plc

High Court Unreported, Barrett J., 09 July 2015 – Rec. No. 2014/506 MCA

Resolving Complaints

Complaints can be:An early (or not so early) warning systemA tool for measuring performance & customer satisfaction

Early Resolution of complaints can:Keep or win back customersMaintain or enhance reputationSave time and money

Early Resolution

We encourage parties to:Avoid causing complaints – good quality information resolve issues before coming to us

Encourage discussion and meaningful engagement Best outcome is resolution without the need for

adjudicationOur aim is to resolve disputes/complaints at the earliest

possible opportunityThis should be the aim of the service provider too

MediationWe recommend mediation as the first and best option to resolving complaints/disputes because it is: InformalConfidentialPotentially quickerVoluntaryOffers a better possible range of solutionsWhy then do so many providers reject this option?

Why are people so reluctant to engage?

Not sure what it achieves We have set out our final position – so no point Perception that it shows a weakness The need for the “Harp” or someone else to make the decision Creates an expectation of payment Fruitless unless we had money to offer Resource requirements

“The lack of practical experience of mediation would indicate that there are few “champions” for mediation within the financial services industry”

International Financial Dispute ResolutionAustralia

Telephone Conciliation Fast Track Conciliation (1 Hour)Conciliation Conference Workshops for Financial Service Providers

New ZealandFacilitation (mainly recorded telephone calls)Infrequent use of face-to-face conciliation

UK 9 out of 10 cases resolved through informal means -

mediation

Where the Irish FSO is going: Amalgamation of Financial & Pensions Ombudsman Strategic & Operational Review Implement the simplest, most efficient, proportionate and effective

complaint resolution processes Resolve disputes:

at the earliest possible stage as informally as possible as fast as possible

Only when necessary, proceed to formal investigation, oral hearings and adjudication

Achieving this will require the support and co-operation of providers

Reducing and Resolving Complaints Communicate clearly Provide plainly written documents highlighting the essential terms Provide clear warnings of the consequences of certain actions /omissions Respond, promptly proportionately and fairly to complaints Provide appropriate, proportionate dispute resolution Empower your people to engage in the FSO’s new dispute resolution processes

in a meaningful, productive and proportionate manner

Thank You