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Jon-Paul Hale

Complaints processes and the rules can be two different things

Thursday 12th of December 2024

Let's deal with the complaint situation:

  • The insurance company cancelled the cover.
  1. This appears to have been through a complaint process and suggests the insurance company came to a settlement of some sort to pay the client what is probably at least the face value of the cover.
  2. I can't see how the insurer can do that without paying at least the face value of the cover.
  3. The client was largely satisfied with this outcome, suggesting it was more than the face value and more likely included the overpayment.
  • Vulnerability. I appreciate the fall, and the hospital stay would have been challenging, but this is an issue at complaint time, not advice time. This isn't a factor in the professional advice review.
  1. It is an issue for FSCL in the way they operate with a vulnerable client and likely increased their need to "find" a solution for the client being that the client was vulnerable when FSCL was engaged.
  • It was more stressful knowing the client didn't have funeral cover in place during their hospital stay.
  1. Ah, so where's the money that was paid to them by the insurer? This is instead of the coverage being in place and is already in their bank account.
  2. Additionally, the client clearly saw value in the cover for the premium being paid; they still wanted the cover during the complaint process against the adviser!
While the adviser has apologised and copped to the payment, this is more about making it go away than addressing a professional complaint.

Let's recap:

  • The policy was taken before any advice regulation was enacted.
  • The client sounds like they have not had a review, but it is questionable if the client engaged in requests for review.
  1. There is also no clarity on the adviser offering a review either.
  • The insurer had been providing annual updates and engaged with the complaint they received.
  1. Again, the letters have an offer to have a review.
  • Under the new rules, the FAP is responsible for the advice they provide.
  1. It sounds like the FAP has not provided advice to the client on the suitability of this contract, so how is this captured by the current rules as a professional complaint against the adviser?
If the link is being drawn because the adviser was receiving renewals. Let's revisit this for the umpteenth time.

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