Complaints against insurance industry rise by almost 50%

COMPLAINTS against the insurance industry rose by almost 50 per cent last year, the Insurance Ombudsman has announced.

COMPLAINTS against the insurance industry rose by almost 50 per cent last year, the Insurance Ombudsman has announced.

Presenting her third annual report, the Ombudsman, Ms Paulyn Marrinan Quinn, said the increase in written complaints related mainly to life and investment policies. She received 825 written complaints in 1995, an increase of 48 per cent on the previous year.

There was an increase of 50 per cent in the average number of written complaints she received every month last year, compared to 1994.

The office dealt with 3,172 telephone complaints and inquiries.

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By far the largest reason for complaint was repudiation of a claim by a company, accounting for 28 per cent of written complaints. In cases where the company repudiated liability, the largest number were on the grounds of alleged non disclosure on the part of the policy holder of what were deemed by the company to be material facts.

Alleged maladministration by a company was the reason for 13.5 per cent of complaints, while 11 per cent represented alleged misrepresentation by the company.

Complaints arising out of dissatisfaction over the surrender value of policies accounted for a quarter of complaints received. This has risen significantly since 1994. Premium rates lay behind 10 per cent of cases.

Ms Marrinan Quinn said that member insurance companies were committed by the Codes of Practice to continue to develop clearer and more explicit proposal forms and policy documents.

"I have taken the view that, where the company purports to rely upon wording which is ambiguous, unclear or misleading, the complainant must be given the benefit of any doubt that such ambiguity causes," she said.

The Ombudsman said it was clear that many complaints have their origin in poor communication or lack of understanding or information at the time the policy is purchased".

Companies, she said, should continue to develop clearer and more explicit proposal forms and policy documents with properly trained representatives.

Of the cases concluded by the ombudsman, a fifth were adjudicated in favour of the complainant, over a quarter in favour of the company and over half were settled to the satisfaction of both parties. The balance (1 per cent) were not ruled on.

She condemned the practice whereby a company changes, without written warning, the way in which it reports on investment returns.

Among the other main causes of complaint to the Ombudsman were direct debits, partial encashments, guaranteed sum policies, no claims bonuses, motor leasing, travel insurance, under and over insurance of property, HIV related illness and refusal to cover.