Is the Ombudsman going to bat for insurance clients?

by Will Ashworth25 Sep 2015
The OLHI released its annual report earlier this week and there was plenty of good news but one statistic underscores how the life and health insurance complaint resolution service may need to do more to protect consumers.

"Improvements over the past two years have made case reviews more thorough and rigorous, hence easier to identify complaints that merit negotiation," said Holly Nicholson, Executive Director. "For example, we consult more with both consumers and insurers to make sure we have all the facts. Changes like this have led to a settlement ratio of 50 per cent in favour of consumers at the investigation stage – a big jump from 30 per cent."

It’s encouraging from a client’s perspective that the national complaint resolution service was able to increase the number of investigations settled in their favour by almost 70% year-over-year. That’s progress for sure but OLHI definitely has work to do when it comes to launching actual investigations.

In 2014/2015 the complaint resolution service undertook 42 official investigations originating from 2,464 complaints across the country. That’s an investigation to complaints ratio of 1.7%. In 2013/2014 the OLHI investigated 51 complaints out of a total of 2,480 complaints, an investigation to complaint ratio of 2.1%, slightly higher but still too low, say critics.

Still the organization has its work cut out for it.

“It seems like a small number but having read the press release it looks like they [OLHI] have a very arduous process that they’re cleaning up,” veteran insurance sales training consultant Helena Smeenk-Pritchard told LHP Thursday. “Clearly they’ve got some kind of process that says this one’s worth paying attention to and that one isn’t. What the criteria are I have no idea.”

Note: Insurance advisors interested in reading the entire OLHI annual report click here.