Complaints Handling Policy & Procedure 2013
Contents 1. INTRODUCTION... 2 2. OBJECTIVE... 2 3. WHAT IS A COMPLAINT?... 3 4. GUIDING PRINCIPLES OF EFFECTIVE COMPLAINTS HANDLING... 3 5. PROCEDURES... 4 a) How a complaint may be made... 4 b) What information is required when making a complaint?... 4 c) Acknowledgement of complaints... 5 d) Complainant s rights during the complaint process... 5 e) Response to a complaint... 5 6. CREATION OF FILE FOR EVERY COMPLAINT... 8 7. COMMUNICATION WITH COMPLAINANT... 9 1
1. INTRODUCTION The Lawyer s Voice seeks to maintain its reputation as the Legal Insurance Broker by delivering high quality insurance services to its policyholders. The Lawyer s Voice is also committed to maintaining its responsiveness to the needs and concerns of our policyholders and other stakeholders. The Lawyer s Voice is committed to provide excellent and quality service to all its current and prospective policyholders. In order to achieve this objective we have taken steps to develop the Complaint Handling Policy and Procedure ( The Policy ) which will articulate steps and procedure which should be followed in the event of a complaint by our client. In preparing this Policy, The Lawyer s Voice has endeavoured to align our procedures with the relevant legal requirements and current best practice. The Policy is designed to provide guidance on the manner in which The Lawyer s Voice receives and handles complaints made against the company, its sales representatives, brokers, and its employees.. 2. OBJECTIVE The objective of the Policy is to assist the company, its Directors and employees in resolving complaints in an efficient, speedily, effective and professional manner. In order to establish fair complaint handling procedures and to standardize the management of complaints, the Lawyer s Voice has adopted this Policy and Procedure. It is applicable to all written and oral complaints received relative to insurance products or services distributed in all offices of the Lawyer s Voice in the Republic of South Africa. All complaints, not only those related to a potential violation or infringement of the laws and regulations, will be considered and thoroughly investigated and fairly addressed by the company. We are committed to delivering the best possible service to our policyholders, and have taken all necessary measures to inform all The Lawyer s Voice employees of our complaint handling procedures. 2
3. WHAT IS A COMPLAINT? The Policy is intended to address complaints made to The Lawyer s Voice directly. Under this Policy complaint is defined as follows: An expression of dissatisfaction made to The Lawyer s Voice, related to its services, or the complaints-handling process itself, where a response or resolution is explicitly or implicitly expected. Any person or organisation (the complainant) who is dissatisfied with our service, for any reason, may contact The Lawyer s Voice to lodge a complaint. A complaint may be oral or written. At times, complaints can be by way of negative feedback, which may not require a resolution or formal follow-up. While this type of feedback is valuable, the Policy does not apply to feedback of this nature. 4. GUIDING PRINCIPLES OF EFFECTIVE COMPLAINTS HANDLING Management and staff of The Lawyer s Voice must consider and apply the following guiding principles of effective complaints handling: i. Accessibility- Our Complaints Handling Policy is readily accessible to all directors, management and general employees and clients. The Policy is easy to understand and includes details on making and resolving complaints. ii. Responsiveness- Receipt of each complaint is acknowledged to the complainant immediately. Complaints will be handled in an efficient and effective manner. Complainants will be treated courteously and kept informed of the progress of their complaint throughout the complaint-handling process. iii. Objectivity- Each complaint is addressed in an equitable, objective and unbiased manner through the complaints-handling process. 3
iv. Confidentiality- Personally identifiable information concerning the complainant is actively protected from disclosure unless the complainant expressly consents to its disclosure. v. Customer focused approach- All managers and employees of The Lawyer s Voice, including the members of the Board, and the Managing Director are committed to efficient and fair resolution of complaints. We actively solicit feedback from our clients on a regular basis and acknowledge a client s right to complain. i. Accountability- All managers and employees accept responsibility for effective complaints handling. The Complaint s Officer will ensure that, where appropriate, issues raised in the complaints handling process are reflected in manager and employee performance evaluation. 5. PROCEDURES a) How a complaint may be made All complaints should be made in writing so that the details of the complaint are clear and complete. If the complainant is illiterate it is the duty of the responsible office manager to assist the complainant in writing a complaint. b) What information is required when making a complaint? When making a complaint, the policyholder or client must provide the following information: Complainant s full particulars and contact details. The nature of the complaint (including when the conduct giving rise to the complaint occurred). Details of The Lawyer s Voice employee involved (if applicable). Copies of any relevant documentation supporting the complaint. 4
c) Acknowledgement of complaints We are committed to acknowledging all complaints immediately upon receipt. Once a complaint has been received, we will undertake an initial review of the complaint. We will endeavour to resolve complaints within five (5) weeks of receiving the complaint, but this will not be possible on all occasions. Where our review exceeds four weeks, we will contact the complainant to inform him/her of the reasons for the delay, and indicate to you when we expect to be in a position to complete our review of the complaint. d) Complainant s rights during the complaint process The complainant has the right to enquire as to the status of his/her complaint by contacting the manager or employee who has been identified to handle the complaint. e) Response to a complaint Once we have reviewed the complaint, we will provide the complainant with a written response. If he/she is dissatisfied with our response, he/she has the right to ask for reconsideration of the response by the Complaint s Officer. Such a request should be made in writing and forwarded to the branch manager of the branch that handled the complaint. The following are the options available to a complainant in addressing reporting his/her complaint: Step 1: Contact Your Broker Generally, most issues can be resolved promptly with a simple explanation. The complainant who took our policy through a broker then it is advisable to first 5
contact his/her independent insurance broker first to discuss you concerns or complaint. Step 2: Contact Your Lawyer s Voice Branch Manager If there is no broker involved then the complaint must be lodged directly with the manager in charge of any of the closer Lawyer s Voice office. The complaint will then be handled by branch manager in the following manner (non-exhaustive list): Type of Complaint Premium payment queries Premium increases Policy declined Claim denied Coverage declined Cancellation of policy Staff member not returning calls Changes to driving records Poor service by assigned lawyer Misrepresentation by sales consultant Policy document not issued Unacceptable staff behaviour Fraud Department Responsible Accounting Claims Sales and Marketing Legal Department Sales and Marketing /underwriting Human Resources Accounting/ Legal Department It is the duty of the branch manager to refer the lodged complaint to the relevant department. The branch manager remains directly accountable for final resolution of the customer complaint. Of course, in some cases, depending on the type of complaint to be handled, the complaint may be directly handled by the branch manager without referring it to the relevant department if he/she feels that equity and fairness might not be achieved by referring the complaint to the relevant department. 6
Upon receipt of a complaint, a file will be opened and logged into our system. If the complainant s complaint is incomplete or we require further information from the complainant, the manager in charge of the branch will contact the complainant. If, upon receipt, a complaint cannot be resolved within five (5) business days, the branch manager will advise complainant by sending an acknowledgement of receipt. The purpose of the acknowledgement of receipt is to inform complainant about the following: the contact information of the company employee responsible for handling the complaint; and the estimated time required to respond to the complaint. The estimated time cannot exceed the maximum of three (3) weeks. If the complainant is not satisfied with the service she/he has received or the handling of his/her complaint by the frontline staff, he/she will be referred to the relevant department manager, who will review the complaint. Department managers should not take more than two (2) weeks to finalize complaints referred to them. Step 3: Contact the Johannesburg Head Office (Complaints Officer) If the complaint was not resolved at the branch level or the complainant is dissatisfied with the outcome of the complaint then the complaint must be referred to the company s complaint s officer (i.e. the Head of Legal Department) based in Johannesburg Head office. This officer will review the complaint and have it finalised within three weeks of its referral to him/her. Step 4: Contact the relevant Department at the Financial Service Board (FSB) If the complainant is not satisfied with the final written outcome reached by the Head of Legal (i.e. Complaint s Officer), the complainant may then approach FSB for intervention. FSB is an independent institution responsible for regulating and monitoring the conduct of Insurance companies in South Africa. The appropriate department at the FSB will contact our organization in an attempt to find a lasting and final solution. FSB is impartial in its approach in resolving the problem or complaint. 7
When the complaint is filled with the FSB: The complainant s complain is reviewed. The handling of complain is discussed with the appropriate personnel in the company, and A suggestion is made to resolve the issue in a fair and satisfactory manner. 6. CREATION OF FILE FOR EVERY COMPLAINT Generally speaking, to be receivable, a complaint should be in writing form (letter, email, fax or any other communication form that allows conservation, reporting and filling). If the complainant communicates his/her complaint by phone or in person, his/her complaint will be documented at all times by the employee who is handling it in order to keep track and ultimately for reporting purposes. All offices of the company will create a distinct file for every complaint and register it in a complaints log in order to transmit it in report form to the Complaint Officer. The company will document such information as: Client complaint. The date and time of all contacts with client and summarize discussions or correspondence, including times when our employee was unable to reach you. Whether the issue was resolved or not. Whether the client ultimately referred the complaint to FSB for intervention. Whether the complaint resulted in a civil action brought to court. Through the process and subsequent to, we will take all appropriate steps to ensure that the complainant s personal information is not disclosed or revealed without his/her written consent. 8
7. COMMUNICATION WITH COMPLAINANT If you the complainant is dissatisfied with the complaint review procedure or its outcome, we will inform him/her in writing and without delay, of his/her right to forward the complaint to the Financial Services Board as the relevant regulatory authority. Upon receipt of your request, we will forward the complainant s file which will include, but is not limited to, the following: The complaint made against the Company; The potential or actual prejudice; The corrective measure requested; The result of the complaint handling process (that is, the analysis realized by the Company s final response in written form (must include the rationale sustaining the conclusions). INITIATED: 20 JULY 2012 ADOPTED: 20 OCTOBER 2012 NEXT REVIEW: 20 OCTOBER 2014 9