How to make a complaint to the Insurance and Savings Ombudsman

How do I lodge a complaint?

If you wish to complain to the Insurance and Savings Ombudsman (ISO) about an insurance company or savings organisation that is a participant in the ISO scheme, you should write to:

* Insurance and Savings Ombudsman
PO Box 10-845
Wellington

Alternatively, you can call the ISO’s freephone number 0800 888 202, or email them at iombudsman@clear.net.nz.
Who can complain to the Insurance and Savings Ombudsman?

This service is available to any person (or group of people):

* who has a complaint relating to personal or domestic insurance against an insurance company that is a participant in the Insurance and Savings Ombudsman scheme, or a complaint against a savings organisation that is a participant in the scheme, and
* who has already exhausted the internal complaints procedure of the company or organisation in question

The Ombudsman can only consider complaints made by a policyholder or customer of the company or organisation to which the complaint relates.

The Insurance and Savings Ombudsman does not have power to deal with complaints if they relate to commercial insurance or savings, or to an insurer’s assessment of risk or the setting of premiums.

The amount you are claiming cannot be more than $100,000. However, this may be extended with the agreement of both parties.

The events giving rise to the complaint must have first occurred after 1 March 1993.
First you must use the internal complaints procedure of the company or organisation

You should ask the insurance company or savings organisation to supply you with the details of its internal complaints procedure. Follow the steps of this procedure through to the end.

If your complaint is not resolved through this procedure then the matter is in "deadlock", which means that you may now take your complaint to the Insurance and Savings Ombudsman. The company or organisation concerned should provide you with a letter stating that they have reviewed your complaint and that the matter is now in "deadlock".
What information should I include in my complaint to the ISO?

In notifying the Ombudsman of your complaint you should include information on:

* what you feel the company or organisation has done wrong
* what, if any, loss you have suffered, and
* what remedy you seek from the company or organisation

You should also include the letter from the insurer or savings organisation stating that deadlock has been reached.
How will the Ombudsman deal with my complaint?

An Investigating Officer from the Ombudsman’s office will assess your complaint, present his or her views to both parties, and try to get agreement between them. If one party doesn’t accept these views, then either of you can request that the Ombudsman review your complaint and make a recommendation.

If the company or organisation doesn’t accept the Ombudsman’s recommendation within one month, then the Ombudsman makes an "award", which means that the company or organisation must pay a specified amount of money. An award cannot be for more than $100,000.

If you do not accept the Ombudsman’s recommendation then the Ombudsman’s involvement in the matter is ended, and you may seek to have your complaint dealt with in the courts or elsewhere.

In dealing with your complaint the Ombudsman must act impartially, in a manner that is fair to both sides, and in accordance with the law and good insurance practice.
How do I find out who the participants in the ISO scheme are?

A list of the insurance companies and savings organisations that participate in the ISO scheme can be found on the ISO’s website at www.iombudsman.org.nz. Alternatively, you can phone or write to the ISO at the number and address given above.
Will it cost me anything to make a complaint?

No, the ISO’s service is free.
Cautionary notes

* If you accept the Ombudsman’s decision, then it will become a full and final settlement of the matter. This means that all parties become bound by this decision and cannot re-open the complaint. However, if you choose not to accept the Ombudsman’s findings then you are entitled to take civil or criminal action through the courts or to enlist the services of any other organisation that may be able to help resolve the matter.