Current FOS Ombudsman experience: is their first acceptance reply taking more than 7 working days?

Annemos

Thanks Phoenix72. My whole Insurance thing has been going wrong since 2018. So I live on my nerves. 

From my experience, anything that can go wrong will go wrong, when it comes to my Insurance Claim. Only needs something like this to set me off again! 

DullGreyGuy

Annemos said:

Oh noooooo.  I hope you were more chilled out than I am!  Thank you for the SLA mention. 

I will try and give them call. I have sent an e-mail, but it takes 7 days for a reply and again it says "if they can help!"

I've worked in insurance for 20 years and so very used to the pace of speed with the FOS... dont always agree with their decisions, unfortunately I more often do when I am representing my client rather than myself but the biggest point I disagreed with them on was the case that too 2 years for which their compensation for mismanaging the case was more than I was originally claiming so 

Obviously this all becomes a self perpetuating problem... they are behind target so people are chasing which means they have more work to do which means they get further behind. 

Annemos

DullGreyGuy

I still feel that there are quite a few issues, that if the Ombudsman and the Insurance Industry just put some clear "rules" in place, instead of leaving it ad-hoc, there would potentially be less escalation. 


Things I have in mind are, for example, the one I am going to the FOS on, which involves that ABI Subsidence Agreement and how such "claims" are set up by the "Previous Insurer". And once the "rule" is in place, it should be made clear to Homeowners, as well as to the Insurance Industry, how this should be done. 

Another thing is when the Claims Cost has been greatly over-inflated by bad workmanship by Insurance Contractors. It should absolutely be the done thing that The Homeowner will be given a rectified Claim Cost to use for their renewals. There are many FOS cases on this, but the homeowner has to fight and fight to get it acted upon. 

The other thing of people being dropped from Insurance mid-Subsidence claim, when elements of the extended Policy-chain-providers stop working with each other. There should immediately be alerts in place to intercept homeowners and provide the required help. And all the Companies in the chain should be aware of the issue and work together. 


Homeowners are often left in the dark about what is going on within the Insurance Industry, things end up getting escalated for even the most basic clarification of whether they are being treated fairly. 

(But I come from a different world. Well-defined Rules and Regulations in very thick books!) 

Annemos

Problem solved. Got through on the phone. 

The e-mail had been sent to the Insurer I am complaining about. But it had not been sent to me. 


I am very happy now, because I have the Case Number and so I can send off my case evidence and forget it for a little while. 

Many thanks everyone for your inputs. 

DullGreyGuy

Insurance, like all financial services, have a vast amount of rules and regulations to follow coming from both the regulators (FCA and PRA) and legislation (eg CIDRA,  FSMA, Insurance Act etc). Like the whole common law system its intentionally not codifying every single possible scenario and much more based on broader rules. FS in the UK is 8.3% of GDP and employs 3% of workers, there will always be a trade off between having broad rules that allow innovation to happen and hopefully growth -v- having to codify absolutely every possible scenario and as a consequence stifle innovation because you cannot do something new until new regulations are set. 

The cost of claims is not an area of great significance when it comes to pricing and it can be artificially adjusted... when my mother lost her Rolex she hadn't declared it as a high value item and so she only got paid out £1,000 as the unspecified single article limit. When a customer of a former client lost theirs their insurer spent well over £1,000 on divers trying to find the watch at the bottom of the lake and then paid out the full cost when it couldn't be found. Both people sustained the same loss but claims values were vastly different because firstly the terms of the policy and secondly the later being more customer focused and acknowledging its sentimental value so spent money trying to locate it. In principle both should have the same future premium adjustment. 

Most customers aren't interested in the insurance supply chain... just look at the number of people here who state their insurer is the RAC when RAC Car Insurance is just a white label of Budget who are a broker and will be placing the business with an insurer, cover holder or wholesale broker with the later two then having an insurer or a consortium of insurers under them.  The average punter is going to wonder who the hell Tokio Marine Kiln are were RAC required to let you know mid term that they are being dropped from their panel which generates queries which add costs that increase premiums. 

harrychown

I think people are misunderstanding the OP's point. They are saying things like "bit of an OTT reaction?" 
The OP is not concerned about how long the investigations take. He is very specifically concerned with the wording of the acknowledgement email. It reads //"If we can help, you can expect to hear back from us within 7 days. Due to the volume of enquiries we receive, we are only able to reply to those customers we can help."\\

OP isn't expecting a resolution to his case within 7 days. He's taking what the FOS say in their acknowledgement email, literally. As have I. I received such an email 9 days ago (I am complaining about an unfair CIFAS fraud marker against my name for defaulting on a loan which they've classed as fraud). I received the acknowledgement email saying "we have received your complaint. If we can help, we will confirm this within 7 days. If you do not hear from us within 7 days, it means we can't help you". 
Seems crystal clear to me. The OP is now concerned that they cannot help him (or her). Because he took what they said as being truth and fact. I am in the same position. Based on their wording of the acknowledgement email, I had been expecting to receive something within 7 days saying something like "we can confirm your complaint falls within our remit. We will start investigating the complaint. It may take months by the way!". And that's fine. But we haven't received that. We are in the territory of no reply within 7 days = we can't help you. 

dunstonh

Care.  June 2024 thread revival.