The Gazette 1994

GAZETTE

MARCH 1994

N E W S

Early Days for t he First Insurance Ombudsman

After one year in her new role as Ireland's first Insurance Ombudsman, Barrister, Paulyn Marrinan Quinn, reviews the Progress of her Office and notes the relatively high proportion of solicitors who have used this 5^thod^ofaIternative dispute resolution on their clients' behalf. not in foreign territory in that the relationship between a policyholder and his insurer is not unlike the relationship between a lawyer and his or her client. Often there is more loathing than loving in the relationship particularly when, Perhaps, it could be argued that the client's expectations far exceed what is practicable or possible. At the inauguration of the Insurance Ombudsman Scheme in October 1992, there was considerable interest expressed by the media, who enquired particularly about the independence of the role, to which I replied then, and still firmly reply, that I have been given a job with independence guaranteed. To the minority who suggest that this might be just a public relations exercise, I bring their attention to the fact that the member companies participating in the Scheme have agreed, in advance, to be bound by the Ombudsman's decision and also to make available all files and documentation and any other informa- tion which the Ombudsman needs i sight of in pursuit of the investigation and review of the dispute. I feel quite at home in my job and, Perhaps, in a way that is because I am If, as is often the case, complainants write to me in the first instance, I reply enclosing a copy of the explanatory leaflet, setting out the procedures, in broad terms, and direct them back to their insurance company. | I explain that they must first go through the internal complaints procedures and exhaust all existing

nominees as well as consumer representatives balanced by an

independent chairman, as adopted, for example, in Hong Kong and Australia (not to mention LAUTRO'S own complaints sub-committee) do not appear to have been serious contenders. Having investigated the Insurance Ombudsman Bureau model in the UK, Lord Ackner referred to the ombudsman system providing "a unified complaints procedure". The UK Ombudsman Association was established recently in order to preserve the integrity and credibility of ombudsman schemes. There is a threat that the establishment of sham or bogus ombudsman outfits could denigrate the office and do irreparable damage. The Association has drawn up four fundamental criteria which must be in place before the term "ombudsman" can properly be used: 1. independence from those whom ombudsman has the power to investigate; 2. effectiveness; systems, but to do it our way. Ombudsman systems have been working well for many years in Scandinavian countries, where complaint handling systems are open, accessible, transparent and generally accepted to be fair. It is now well established that in order for an ombudsman scheme to work, the right to complain to the ombudsman should be adequately publicised by those subject to complaint. I would hope, by now, that details of the Ombudsman Scheme have percolated down through the 3. fairness; 4. public accountability. Having studied the model in the UK and also in Copenhagen, as part of my initial researches, my objective is to take the best from tried and tested

Pauline Marrinan-Quinn, BL, Insurance Ombudsman of Ireland.

remedies within those procedures in order to have gone through due process. In referring complainants back to the internal complaints procedures in the companies, it is crucial that they find those procedures accessible and functional. Every company participating in the Scheme has nominated a member of senior management, whose responsibility it is to review and "sign off' unresolved disputes before they can be referred to me. I have indicated to those members of senior management so nominated that it is helpful if the "signing o f f' letter contains a brief summary of the reasons for repudiation or otherwise sets out the company's position and/or details of any settlement proposals which have been put to the complainants. In a report prepared recently in the UK, in which Lord Ackner reviewed the viability of complaints handling systems, the Law Lord concluded that an ombudsman system is better than any arbitration arrangements for handling consumer's investment or other complaints. Alternatives, such as committees or panels, with industry

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