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Complaints ombudsman outlines systemic issues 

The Australian Financial Complaints Authority identified and investigated 111 possible systemic issues in the second half of last year, leading to more than $40 million in remediation to more than 139,000 consumers.

A breakdown of remediation by industry is not provided in the authority’s systemic issues report for the July-December period. But it lists a selection of case studies from across the financial services sector, including general insurance.

“Some systemic issues impacted large numbers of consumers while others impacted a small group. No matter the number of impacted consumers, in most cases financial firms worked to ensure consumers were remediated fairly and appropriately,” the authority says. “The case studies have been selected to illustrate common types of issues observed across the relevant sector.”

In general insurance, the authority says common issues relate to dealing with third-party representatives, engagement during open complaints and policy interpretation.

In a case study involving third-party representatives, an insurer’s process for accepting the appointment of and dealings with external parties who were helping a complainant was unfair because it created unreasonable barriers, the authority says. The insurer asked for the personal details of the representatives, such as date of birth.

The authority urges insurers to review customer complaints and feedback, to identify and remove barriers.

“Prompt action in response to customer complaints and feedback can reduce the risk of further complaints and regulatory action. This leads to better outcomes for customers and the firm.”

In another case study, the authority says an insurer failed to ensure dispute determinations were actioned within reasonable time frames.

It says companies are obliged to comply with complaint outcomes within the stipulated time frame upon resolution. “Complainants are entitled to expect that, after having had their complaint resolved ... the firm will prioritise compliance and will finalise the outcome in a timely and efficient way.”

Click here to access the report.