1. Introduction and Purpose
Capital Legacy Solutions (Pty) Ltd (hereafter referred to as Capital Legacy) strives to achieve policyholder satisfaction and customer confidence in its insurance products. Accordingly, Capital Legacy has drafted and adopted this Policy to address all forms of policyholder dissatisfaction.
Capital Legacy recognises a complaint as an expression of dissatisfaction by any customer, or potential customer, of Capital Legacy who has a direct interest in an insurance policy with Capital Legacy. Such dissatisfaction could relate to alleged unfair treatment of the customer; failure by Capital Legacy to adhere to the agreement or any legal or contractual obligation; or maladministration, wilful or negligent action by Capital Legacy.
2. Implementation Date
This Policy shall take effect on the day it is adopted by the Board of Directors.
Compensation payment: a payment by a firm to a complainant to compensate the complainant for a proven or estimated financial loss incurred as a result of the matter complained about. In this case, the firm accepts responsibility for having caused the loss concerned.
It is Capital Legacy’s policy to achieve policyholder satisfaction, and accordingly to properly consider and respond to any complaint received from a policyholder, prospective policyholder, customer or from the Ombudsman. Capital Legacy envisages a fair and accessible complaints process, and endeavours to respond to all complaints promptly and within a reasonable time of having received them.
4.1 Complaints Management Process
Capital Legacy will adopt a Complaints Management Process which shall ensure that:
4.1.1 Appropriately trained staff receive and respond to complaints;
4.1.2 A transparent and clear complaints process is adhered to, through which complainants are regularly updated on the status of their complaint, should the complaint not be finalised within fourteen (14) working days;
4.1.3 Communications to complainants shall be in clear and understandable language;
4.1.4 Proper investigation of complaints shall be conducted before a complaint is responded to;
4.1.5 Complaints shall be dealt with promptly, and within the shortest possible time;
4.1.6 Receipt of complaints shall be acknowledged in writing to the complainant and internally recorded;
4.1.7 Complaints shall be given proper consideration;
4.1.8 Complainants are informed of the resolution of the complaint with full, written reasons and within a reasonable time frame;
4.1.9 Complaints shall be recorded and arranged by category of complaint;
4.1.10 All records of complaints are kept for five years;
4.1.11 Complaints shall be reported on a regular basis in accordance with regulatory requirements; and
4.1.12 A fair resolution to both the complainant and Capital Legacy is sought.
The Complaints Management Process shall be monitored and audited regularly, to ensure effective compliance. The Complaints Management Process shall also be subject to risk and control processes.
The Complaints Management Process shall be displayed in all Capital Legacy offices and on the Capital Legacy website. This process document has been written in plain language so that it is easy to understand.
Capital Legacy will review and monitor complaints records to ensure the fair treatment of policyholders, to reduce the occurrence of similar complaints in future, and to ensure customer satisfaction.
4.2.1 Characteristics that define record-keeping, at Capital Legacy, include that records:
- Are kept for a period of five (5) years;
- Are accurate, and efficiently and securely recorded in line with Capital Legacy’s IT Governance Policy and Record Retention Policy;
- Contain all relevant details of the complainant and the subject matter of the complaint with copies of all relevant evidence, correspondence and decisions;
- Include all personal information of the complainant according to the Protection of Personal Information Act, 2014; and
- Include categories of complaints, and all relevant complaints statistics.
4.2.2 Capital Legacy shall keep and analyse the following statistical records:
- Number of complaints received;
- Number of rejected complaints;
- Number of complaints resolved in favour of the complainant;
- Number of escalated complaints;
- Number of compensation payments made;
- Number of goodwill payments made; and
- Number of complaints received from the Ombudsman.
4.3 Categories of Complaints
Capital Legacy shall categorise complaints according to specific characteristics. These categories include:
- Design of the Policy;
- Information provided about the Policy;
- Advice given;
- Customer service;
- Product accessibility by the policyholder, and changes to policies;
- Complaints handling process; and
- Claims process.
4.4 Complaints Analysis
Capital Legacy will use information garnered from complaints to manage risks and improve customer satisfaction. Information garnered from complaints will be analysed on a regular basis in order to achieve this.
Capital Legacy’s complaints analysis shall be used to:
- Identify root causes of common categories of complaints;
- Identify weaknesses in control systems;
- Detect poor performance, lack of skills or misconduct;
- Track Capital Legacy’s Treating Customers Fairly progress or delivery; and
- Determine meaningful improvements for policyholders and Capital Legacy business.
4.5 Internal Review
Due to the insignificant number of complaints received, Capital Legacy does not have an internal escalation process. Each complaint is reviewed at the highest level, by a Company Director, and receives personalised attention. This process is proportionate to the Business and to the average number of complaints received per quarter.
4.6 Engagement with the Ombudsman
Capital Legacy shall disclose and display the details of the relevant Ombudsman services to policyholders. However, complaints shall only be escalated to the Ombudsman once internal remedies have been exhausted. Capital Legacy will ensure open and honest communications and cooperation with the Ombudsman at all times.
Complaints received by staff at Capital Legacy, are recorded in writing and forwarded to email@example.com where they are reviewed by a Director of Capital Legacy, who has extensive experience in dealing with customer complaints. Complaints are recorded categorically.
6. Adoption of the Policy
This Policy had been adopted by the Board of Directors on 12 April 2019.
Contact Details to Lodge a Complaint
The following contact details of Capital Legacy and external parties to whom Capital Legacy is accountable is provided hereafter.
Should any insured person or any person claiming under this Policy have a complaint of any nature, the first port of call is a Capital Legacy Administrator, at the following contact details:
Or, alternatively, a complainant may contact our Compliance Officer as the first port of call, at the following contact details:
Mrs CM van Wyk
Post: PO Box 2577, Honeydew, 2040
Telephone: 011 794 1189
Online submission: http://ctb.co.za/contact-us/
For complaints that the Administrator, or Compliance Officer, is unable to resolve, please contact the Insurer at:
Guardrisk Life Limited
Post: PO Box 786015, Sandton, 2146
Telephone: 011 669 1000
For complaints that neither the Insurer nor the Administrator/Compliance Officer are able to resolve, please contact the Ombudsman at:
The Ombudsman for Long-term Insurance
Post: Private Bag X45, Claremont, 7735
Telephone: 021 657 5000 / 086 010 3236
Fax: 021 674 0951
If the complaint remains unresolved, after having been acknowledged and attempted by the previous three levels, please contact FSCA at:
The Financial Sector Conduct Authority (FSCA)
Post: PO Box 35655, Menlo Park, 0102
Telephone: 012 428 8000
Fax: 012 346 6941
Online submission: https://www.fsca.co.za/Customers/Pages/Complaints-Compliments-Feedback.aspx
For complaints relating to the product, the way it was sold, or in relation to any advice given, please contact the FAIS Ombudsman, as the first port of call:
The FAIS Ombudsman
Post: PO Box 74571, Lynwood Ridge, 0040
Telephone: 012 762 5000
Fax: 012 348 3447