Share

Long-term insurance Ombudsman recovers R184.4m

Cape Town - As in 2014, claims declined by long-term insurers again made up most of the complaints (55%) received by the Ombudsman for Long-term Insurance in 2015.

The types of long-term insurance products most consumers complained about were funeral cover (35% of complaints) and life cover (31%). Complaints in the health category decreased for the third consecutive year to 14% as a result of fewer complaints about hospital cash plans.

Complaints about poor communication - usually the second largest category of complaints - however, showed an annual decrease this time.

The office of the Ombudsman for Long-term Insurance said on Tuesday that it recovered R184.4m in the form of lump sums for consumers from long-term insurance companies during 2015.

Complainants received more than R577 000 in compensation because of poor service. These amounts do not include income benefits, annuity payments and the value of non-monetary benefits.
 
At the release of its annual report for 2015, Long-term Insurance Ombudsman Ron McLaren said it had received 9 815 written requests for assistance in 2015, an increase of 6% on the previous year.

Of these, 5 018 were chargeable complaints, with 3 491 cases full cases finalised and 75% of cases finalised within six months of receiving them. Almost 30% of cases were resolved in favour of the complainant, slightly up on 2014’s 29.7%.

“It is promising that insurers seem to have worked hard to communicate more clearly with their clients about policy terms and conditions,” said McLaren. “Good progress has been made on complying with 'treating customers fairly' principles too.”

Unreasonable complaints
 
McLaren noted that there had been a steady increase in the number of unreasonable complainants and in the number of complex complaints against long-term insurers.
 
“This appears to be a worldwide phenomenon, with the reasons for unreasonable conduct including anger, frustration and an exaggerated sense of entitlement,” explained McLaren.

“Some complainants claim to be seeking ‘justice’ or ‘a moral outcome’, but tend to display unreasonable arguments, behaviour, demands and persistence as well as unwillingness to co-operate.”
 
There was also an increase in the number of complaints that were lodged directly with the office of the Ombudsman, rather than through insurers.

We live in a world where facts and fiction get blurred
Who we choose to trust can have a profound impact on our lives. Join thousands of devoted South Africans who look to News24 to bring them news they can trust every day. As we celebrate 25 years, become a News24 subscriber as we strive to keep you informed, inspired and empowered.
Join News24 today
heading
description
username
Show Comments ()
Rand - Dollar
18.89
+0.3%
Rand - Pound
23.87
+0.1%
Rand - Euro
20.38
+0.2%
Rand - Aus dollar
12.32
+0.1%
Rand - Yen
0.12
+0.2%
Platinum
908.05
0.0%
Palladium
1,014.94
0.0%
Gold
2,232.75
-0.0%
Silver
24.95
-0.1%
Brent Crude
87.00
+1.8%
Top 40
68,346
0.0%
All Share
74,536
0.0%
Resource 10
57,251
0.0%
Industrial 25
103,936
0.0%
Financial 15
16,502
0.0%
All JSE data delayed by at least 15 minutes Iress logo
Company Snapshot
Editorial feedback and complaints

Contact the public editor with feedback for our journalists, complaints, queries or suggestions about articles on News24.

LEARN MORE
Government tenders

Find public sector tender opportunities in South Africa here.

Government tenders
This portal provides access to information on all tenders made by all public sector organisations in all spheres of government.
Browse tenders