The insurance ombuds put almost R400-milion back in the hands of consumers who complained in the past financial year.
In a joint 2021 annual report, the ombudsman for long-term insurance (OLTI) noted that R200-million was recovered for complainants while the ombudsman for short-term insurance (OSTI) said the monetary benefit for consumers amounted to R197 188 388.
Both offices made mention of the emotional strain experienced by staff who had to contend with the loss of relatives, friends and colleagues because of the Covid-19 pandemic. The Office of the OSTI said this was reflected in some key operational results.
Denise Gabriels, deputy ombud for long-term insurance, says the ravages of Covid-19 continued in 2021, with the third wave hitting particularly hard. Many employees contracted the virus, resulting in prolonged absences, and some lost close relatives.
The civil unrest in KwaZulu-Natal and Gauteng impacted on the national psyche, and in the Western Cape taxi violence prevented some employees in the Office of the OLTI from getting to work for several days. Loadshedding further exacerbated the situation.
“Against this backdrop, the reported results are remarkable, and for this all tribute must go to the staff, who displayed resilience and perseverance, despite the adversity,” Gabriels says.
The 17 379 written requests to the Office of the OLTI for assistance exceeded the record of 14 198 set in 2020, as did the 8 163 chargeable (to the insurer) complaints received. Including transfers closed, 7 533 cases were finalised, compared with 6 512 in 2020.
An amount of R200,7-million was recovered for complainants in lump sums and an additional R948 592 was awarded to complainants as compensation for poor service.
“The increase in the number of complaints can largely be ascribed to the effects of the Covid-19 pandemic, as insurers have widely reported on the increased number of claims.
“Our subscribing members also had to operate under challenging circumstances,” Gabriels says. “Many had staff working from home, which had its own challenges of accessing information and documentation.
“Combined with an inordinate rise in the number of claims, especially funeral and credit insurance claims, this gave rise to many service-related complaints.
“Despite pockets of service lapses and poor complaints handling, in general the insurers responded well to the challenges.”
Edite Teixeira-Mckinon, CEO of the office of the OSTI, says: “2021 was a year of struggles, continued resilience and hope for a brighter tomorrow. Going through two years of a harrowing pandemic has taught us that just surviving is not enough; we need to reshape ourselves for the future.”
The Office of the OSTI did not attain two operational targets that it set for itself in 2021, namely an average turnaround time (TAT) of 120 days and ensuring that the number of complaints outstanding for six months did not exceed 10% of the number of open complaints. It ended the year with an average TAT of 138 days, and with 332 complaints outstanding for six months instead of 300.
There were 11,7% fewer complaints were registered in 2021 compared to 2020. The office of the OSTI registered 9 797 new complaints of which 259 were Covid-19-linked complaints, 197 of these relating to business interruption and 62 about travel insurance.
The Covid-19-related complaints made up 2,6% of all the complaints registered by the office in 2021, compared to 2020, when Covid-19-related complaints comprised 7% of all the registered complaints.
Complaints resulting from the civil unrest, looting and damage to infrastructure that swept through the provinces of KwaZulu-Natal and Gauteng in July 2021 were specifically categorised as “SASRIA” complaints, and 31 were registered last year, with 23 relating to commercial lines and eight relating to personal lines insurance.
The office of the OSTI ended the year with 3 052 open complaints, compared to 4 210 in 2020, the difference being primarily due to the 7% increase in registered complaints in 2020 and the almost 12% decrease in registered complaints last year.
OSTI finalised 10 879 complaints, 0,7% more than in 2020, and from the complaints finalised it recorded a monetary benefit and value for consumers of R197 188 388. An overall customer experience rating of 76% out of a target of 80% was maintained, the same score as in 2020.