When can I submit a complaint to your office?
Must my complaint be in writing?
What is the process of lodging a complaint with your office?
Can I lodge my complaint in my own language?
Does it cost anything to lodge a complaint?
If the service is free, how is the office funded?
Do you limit the insured amount claimed for?
How long will my complaint take?
How long do you give the insurer to respond to my complaint?
What may one complain about?
- Where your claim has been declined;
- If you are dissatisfied with the policy performance and maturity values;
- Poor service;
- Lapsing of your policy;
- If you are dissatisfied with your surrender or paid-up values;
- Partial payment of claims;
- Credit Retrenchment insurance
What types of policies can I complain about?
- Life Insurance;
- Disability Insurance;
- Health Insurance;
- Funeral Insurance;
- Credit Life Insurance;
- Credit Disability Insurance;
- Hospital Plan Insurance;
- Dread disease Insurance.
Which complaints cannot be dealt with by your office?
- That are not against life insurers
- Financial advice or service by intermediaries
- Pension and provident funds, retirement annuities and preservation funds;
- Short-term insurance;
- Labour disputes;
- Medical Aid;
- Debt review, credit issues, ITC/blacklisting complaints.
Can I go to the press to complain while my complaint is under investigation with the Ombudsman?
Must I still deal with the insurer once my complaint has been lodged with your office?
Must all correspondence about my complaint be sent to your office once my complaint has been received by your office?
Should or can I stop paying premiums while my complaint is being investigated?
Can I submit more than one complaint?
How often will I get feedback regarding the status of my complaint?
Can I assist or act on behalf of a friend or family member with their complaint?
If you are the executor of an estate we need the letter of executorship.
Can your office give me financial advice?
What can I do if I am still not satisfied with the decision the Ombudsman's office has made?
If you are still not satisfied after a final determination you can apply for leave to appeal in terms of the Rules.
Who carries the cost of medical reports or consultations which the insurer needs to assess my claim?
If the insurer wants to rely on an exclusion clause in the policy, the cost for any additional medical reports has to be paid by the insurer.