Login






I've forgotten my password
Conduct Matters

Register for Updates

Enter your email address for the latest information from Conduct Matters.

About Me

40 years in insurance and 20 years specialising in conduct and customer service. Find out more about me. 

Contact Me

Thank you for visiting my website. If you want to find out more, please fill out the form on my contact page. 

The Portal

Learn more about the portal, how it can be accessed, used and how you can track the progress of your learners.

The Courses

See the courses I have designed and try a free taster. Courses cover a variety of insurance conduct topics.

When is a complaint a complaint?

22nd December 2020

When is a complaint a complaint?

Do you struggle to identify a complaint?

The FCA rules are fairly clear and essentially takes the same approach as many other industries with the essential element being an “expression of dissatisfaction”.

I remember training a motor claims team in complaint recognition where (at the start of the training) they told me this definition would mean most of their interactions would be a complaint. They said most of their claims work required negotiations where they would ask questions or suggest settlements and the response back (usually a challenge/negotiation) could be interpreted as an “expression of dissatisfaction”.

It’s a question I am often asked by firms - and so I thought I would share a few thoughts and suggestions with you.

Negotiations

It’s reasonable to engage in negotiations without the need to treat such discussions as a complaint. However, you must still watch out for those signs that the matter should be treated as a complaint. These are often there if the claim is progressing slowly or if the customer feels they are struggling to get a fair claims settlement.

The tone of voice and the evident frustration. If someone is clearly unhappy then this is a complaint.

Deadlock

I have seen some claims teams insist that claims negotiations can only be treated as a complaint if they have reached deadlock. This is not true. A customer may be unhappy about the handling of their claim before the matter reaches deadlock.

However, if the claim has reached deadlock then it is very likely the matter needs to be escalated to the complaints process.

Just ask

The key rule is that if you have any doubt, then the matter should be treated as a complaint. However, I always think the easiest option is to ask the customer.

I’ll know what it is when I see it

Sometimes it’s hard to describe something but you just know what it is when you see it. That can often be the way with complaints. People who work in customer services and speak to people everyday know the signs. It may be the tone of the voice or the words used - but they just know.

Oversight

An important part of any complaints process is to look at whether the complaint should have been identified at an earlier stage. If it should have been then this can be fed back to the front line team. There are three ways to identify this:

  • ·Complaint file sample checking.
  • ·Reviewing complaints notified by the ombudsman (or direct to Lloyd’s for Lloyd’s market) which is an indicator a complaint notification could have been missed.

These are both part of the complaint oversight checking process Conduct Matters Ltd can undertake for you.

There’s no point ignoring or hoping a complaint will go away. 

It will come back and at a later stage is more complicated to resolve. And anyway, don’t you want to know what is bugging your customers and learn what you need to do to fully meet their needs?

If your policy wording isn’t clear, if your staff need training - or you need more people - or if you need to review your processes or look into using different tools, it is better to know sooner rather than later. 

Author: Sally Pearce (Conduct Matters Ltd)


Sally Pearce started Conduct Matters in 2014 after 35 years working in the insurance industry. She was originally an underwriter, but since 2000 has worked in dispute resolution and helping Insurance firms understand how to treat their customers fairly. Her experience includes working for the Financial Ombudsman, in the Lloyd’s market and dealing with regulators. Sally is ACII, a qualified mediator and yoga teacher. She is also available for public speaking.


Powered by Conceptulise CMS