Agony Aunt: Burgled and still waiting for insurance
Dear Janine
Our home was burgled in early January and we still haven't reached a settlement or had the stolen goods replaced by our insurer. We have gone to great lengths to provide everything they have asked for including receipts, pictures and proof of ownership, but now they have gone quiet and we don't know where we stand.
How long do we wait before progressing to an internal complaint letter and a letter of deadlock? Our claim was lodged in early January. The insurer says they are looking into it, but we haven't been asked to provide anything since mid-March. When is it appropriate to start the dispute process?
ANSWER:
Ever heard the saying "do as I say, not as I do".
This is probably a good time to take heed. Guess how long I waited to submit a formal complaint to my insurer when a claim wasn't progressing? Four years.
That admission might even make you run a mile.Your letter certainly made me ponder my own failings.
As I read about your predicament there was a fleeting moment where I thought, for goodness sake, its only two-and-a-half months and you talked to them two weeks ago. Then I got a grip and realised I was behaving like an ex-Cantabrian; down trodden, overly obliging towards insurers work loads and too accepting of excuses.If your light-fingered foe took off with your television and lap-top, you certainly shouldn't be waiting two to three months to replace those items. If you didn't have the financial ability to fund these, this wait would be getting very painful.
Time delays are relative to the particular circumstances of the case.
I'll eat my hat if your insurer produces a letter of dead-lock on this one and I wouldn't predict for one second, they will let it get to the ombudsman. Insurers pride themselves in cleaning up their own messes and the Ombudsman prides herself in encouraging the parties to work it out before they become a statistic in her little black book.
I'm assuming this isn't a case where the insurer is suspicious or has doubts over your declarations i.e. what was stolen and what it's worth. If you were attempting to defraud, it's unlikely you'd be so brave to write to a media columnist. So you've passed my fraud filter, but that's not the one that counts. Here are three easy steps for you to follow:
1. Start communicating in writing: Email is easiest and set a timeframe for replies. Say you are very concerned about delays and you now feel these are unreasonable. You would like a response within two days to explain the status of your claim and expect settlement within two weeks. Point out they have all the information required. Ask for a reply via email and for the contact details of a senior manager. I would give things a good prod in writing before starting a formal complaint.
2. Print off a letter of complaint to your insurer: this is on the Insurance and Savings Ombudsman's website (www.iombudsman.org.nz). Don't go to the 'Complaints' tab (this is slightly confusing) go to 'Information' where you will find a letter called 'Make a Complaint to Your Provider'. The complaints section of the website is for people who have already been through a formal process with their insurer. You can't skip this step.
3. Ask for a letter of deadlock: this is the step I predict you wont need. The insurer has to put in writing why they have declined your claim in full or part. You take this letter to the ombudsman and begin the journey of their external complaints process.The insurers own internal complaints system is a powerful beast. I found this out on my own claim and it's nice to be able to report that big decisions were made very quickly when it was escalated. While I've still not had any form of settlement, there is a clear plan in place and communication now feels transparent and regular.
While insurers treat all formal complaints equally, I would encourage you to present yours on the form provided by the Ombudsman. It has their logo on it. This is a great little feature, because it signals that you will progress to this step. The form asks for the facts and what you want the insurer to do to resolve the matter. Send the form directly to your insurer to start the complaint process.Rest assured, insurers are loath to let cases escalate to the Ombudsman. If they allow this, without trying to settle or negotiate, then they seriously think they'll win. They settle everything else before it gets anywhere near her desk.The last annual report shows 300 cases were heard by the Ombudsman. Only 10% went fully in favour of the consumer and 65% went in favour of the insurer. The balance were partly upheld, settled via negotiation or withdrawn. More importantly though, they took over 7600 phone calls and 3200 complaint enquiries. Only 300 ever made it to a formal investigation, due to their skill in helping people navigate the jungle.
Janine Starks is a financial commentator with expertise in banking, personal finance and funds management. Opinions in this column represent her personal views. They are general in nature and are not a recommendation, opinion or guidance to any individuals in relation to acquiring or disposing of a financial product. Readers should not rely on these opinions and should always seek specific independent financial advice appropriate to their own individual circumstances.