This link will open a table of the complaints data of the 56 life insurers that subscribed to the Ombudsman for Long-term Insurance (OLTI) in 2023.
The table lists the insurers by each insurer’s complaints expressed as a percentage of the total complaints received. Of the 56 insurers, only 20 received more than 100 complaints – although one, Old Mutual Life Assurance Company, received more than 1 000.
As the OLTI states in its annual report, one must be careful when drawing conclusions from this data.
A large insurer with many clients will invariably attract more complaints than one with fewer clients.
“The office does not interpret what any of the figures may mean. That is left to insurers, intermediaries and industry bodies, reporters, and consumer organisations, as we are of the view that such interpretation and comment by us would not be consistent with our role in impartial dispute resolution,” the ombud said.
The OLTI does not provide the market share of each life insurer. It says although a number of reports reflect market share in the long-term insurance industry, there is no single generally accepted measure for it.
Another reason the OLTI does not include market share is that the office does not hold the underlying data that could be used to determine market share, which “makes it impossible for the office to verify its correctness”.
Clarifying notes to the table
Complaints received
The number of new complaints received in respect of an individual insurer. Some of these complaints are sent to the insurer to deal with directly. If a complainant is not satisfied with the insurer’s response, the OLTI will take up the case.
Percentage of total
This indicates the complaints received in respect of an individual insurer expressed as a percentage (to two decimal places) of the total number of complaints received by the OLTI.
Cases considered
The complaints where case files are opened, and the complaints are investigated by the OLTI.
Cases finalised
The cases finalised during 2023, some of which were received in earlier years.
Percentage resolved in favour of complainants
The percentage of cases that were resolved wholly or partially (W/P) in favour of the complainants. These cases are resolved by way of settlement, mediation, conciliation, recommendation or determination. The overall W/P percentage in favour of complainants in 2023 was 26%, down from 29% in 2022 from 34.09% in 2021.
The W/P classification is not limited to cases where the office issued a determination. The classification is also not limited to cases where a sum of money is paid to a complainant – it can apply to service complaints, reinstatement of policies, or the adjustment of benefits.
The W/P percentage should not be viewed in isolation. A low W/P percentage in favour of complainants is, by itself, not necessarily good or an indication that the insurer has exemplary complaints-handling processes. A higher percentage is not necessarily negative or an indication that the insurer’s complaints-handling is poor.
Some insurers are more inclined than others to settle matters. Such insurers choose to settle matters, either wholly or partially, when there may, strictly speaking, be doubt about legal liability.
There may also have been a large number of cases on the same issue. This can “skew” the W/P percentage either up or down for one or more years. This effect is noticeable when an insurer’s W/P percentage changes markedly from previous years.
If an insurer has a disproportionately high percentage of complaints and has had a high W/P percentage for a number of years, this will raise a question about its complaints management and other practices.
