18 September 2014
Last year the Insurance & Savings Ombudsman Scheme resolved the largest number of complaints since 1998, with 3,215 complaint enquiries and 300 complaint investigations.
“More people are aware they can access our service if they are having issues with their insurance or financial service provider,” says Insurance & Savings Ombudsman Karen Stevens. “People have the right to complain, and our service is independent, impartial and entirely free for consumers.”
The ISO Scheme released its Annual Report today, which also shows a rise in membership from 47 ISO Scheme Participants in 2010 to 4,386 Participants as at 30 June 2014.
“Expanding our service to include all financial service providers in 2010 resulted in rapid growth, and we expect this growth to continue,” says Karen. “ISO Scheme Participants now include providers of insurance, investments, loans and credit, superannuation, financial advice and foreign exchange. However, it is interesting to note that very few complaint investigations relate to financial advisers.”
Karen says the greatest proportion of complaints to the ISO Scheme still relate to insurance, with 62% of complaints in the general insurance category. The most common complaints within this area relate to:
1. House insurance: Unresolved claims from the Canterbury earthquakes make up a significant portion of complaints, with over 1,450 earthquake-related complaint enquiries dealt with, and over 120 complaints investigated since the earthquakes.
2. Travel Insurance: Often a claim has been declined due to pre-existing conditions, policy exclusions, or a breach of the required duty of care.
3. Contents insurance: Common issues include proof of purchase, falsified information, or negotiating the settlement value.
4. Motor vehicle insurance: The most common complaint relates to the settlement amount for the ‘market value’ of a vehicle, or the cover provided in terms of ‘Mechanical Damage’ – wear and tear as opposed to accidental damage.
The second largest number of complaints related to ‘health, life and disability’ insurance, at 31%.
The most common complaints relate to:
1. Health insurance: Commonly disputed issues include pre-existing conditions and
non-disclosure of material information.
2. Life insurance: This includes trauma, terminal illness, and disability entitlements, policy definitions of terminal illnesses, or the ability to return to work.
3. Income Protection: The most common issues relate to the medical evidence of inability to work and proof of earnings.
The ISO Scheme Annual Report Summary and the full Annual Report are available from our website.