CR179 Delay – late notification of complaint

See too: CR, Delay,

CR179

Delay – late notification of complaint

Background
Occasionally the Ombudsman receives complaints where the act or omission giving rise to the complaint occurred many years before. In the majority of such cases prescription applies. In addition the Ombudsman’s Rules feature a qualifying time bar. Rule 2.3.3 reads:-

“The Ombudsman shall not consider a complaint if three years or more has elapsed from the date on which the complainant became aware or should reasonably have become aware that he or she had cause to complain to the Ombudsman, unless the failure so to complain within the said period was due to circumstances for which, in the opinion of the Ombudsman, the complainant could not be blamed.”

However, in cases where a complaint relates to events that occurred in the distant past, it must be borne in mind that the insurance company no longer has any record of the policy or any record of the transaction which has taken place.

This particular case is somewhat unusual in that the policies were effected in 1952 and 1963 and the event giving rise to the complaint was the alleged non-payment of maturity values which would have been due in the late 1960’s and early 1970’s.

The policies in question were non-profit endowment assurances effected under the aegis of industrial insurance when the complainant was a child. The complainant alleges that neither he nor his mother can recall any benefits ever being paid. Surprisingly the insurance company still had records of the contracts, including a copy of policy documents.

Result

As one copy policy bore an office stamp stating that the maturity value had been paid on 20 April 1967 the insurance company rejected the request for further payment. So far as the second policy is concerned, there was nothing to suggest that a maturity benefit had been paid and as the sum assured was relatively small the insurer, somewhat generously, agreed to pay the maturity benefit together with interest.

DM
November 2006

Download Attachments

Subscribe to our Newsletter