The ombud resolves client complaints about claim settlements and in 2017, found in favour of the insurer in some 80% of the cases.
Of the largest companies, those who received more than 100,000 claims, we think OUTsurance maintained the best record last year. Clients only referred 1.4 out of every 1,000 claims to the ombud, and the ombud found against OUTsurance in only 5% of these cases.
By comparison, clients of Old Mutual Insure challenged 4.2 out of 1,000 claims with the ombud – which ruled against Old Mutual in almost 26% of the cases.
Absa Insurance also had one of the highest complainant rates (4.9 out of 1,000) – and the ombud ruled against it in 22% of the cases.
MiWay Insurance had a relatively high number of cases (5.6 out of 1,000) referred to the ombud, who found against it in only 9% of the cases.
Santam had one of the lowest rates of disputes (only 1.5 out of 1,000), but 22% of its disputed settlements were overturned by ombud.
The ombud found against Hollard in 30% of all cases referred to it (but only 1.9 out of 1,000 clients disputed settlements), while a massive 45% – almost half – of all Guardrisk’s claims that were referred to the ombud were overturned.
“If a high overturn rate is registered, this may, but not necessarily, indicate that the insurer is not treating its customers as fairly as it should,” the ombud said in a report.
“However the overturn rate should be treated with considerable caution as a high overturn rate can also be indicative of a high degree of co-operation being received by the ombudsman’s office from a particular insurer in resolving a complaint to the satisfaction of the customer.”
Below are all the latest statistics on claim disputes handled by the ombud: