CR162

Poor service – Insurer providing confidential policy information to a third party

Facts

This was a complaint with a difference; a reminder that a woman scorned can cause a hell of a fury.

Ms A, the woman in question, had recently been divorced. Lots of love was lost between her and her ex-husband. She had an existing policy which he had effected several years before. As she was nearing 60, she decided to effect another policy with the insurer concerned to provide for her retirement. For some or other reason she was particularly anxious, so she informed the broker, that her ex-husband should not have access to the details of her new policy.

But her ex-husband’s own broker (who had in the meantime also become his new girlfriend) was up to the challenge. She telephoned the insurer’s call centre pretending to be Ms A. She quoted her and “her husband’s” existing policy numbers to the consultant who informed her that she could not be provided with details of “her husband’s” policy but nevertheless volunteered the information that she had another policy herself, the number of which she disclosed. The insurer faxed the policy values of both policies to her ex-husband’s “broker”.

Ms A, when she discovered what had happened, was livid. She could not understand how the insurer could have provided information of this nature to a third party without verifying the contact details that were given and did not correspond with the information on the new policy. The insurer took the view that it acted in good faith and suggested that Ms A take the matter up with the broker concerned.

Ms A was particularly upset as her ex-husband was using the information to withhold money from her. She complained to the office who again approached the insurer, who immediately issued a letter of apology to Ms A and indicated that it would take further action against the fraudster. At our suggestion it also offered compensation of R1 000. Ms A rejected the offer stating that “The ‘inconvenience’ I suffered is possibly my share of a R1.5m pension”!

At this point Ms A insisted that the new policy be cancelled and that all premiums paid be refunded to her, her reason being “I feel I need to invest in a company that will respect my confidentiality at all times”.

Discussion

The office did its best to smooth the ruffled feathers, put the request to insurer and attempted to persuade the insurer to increase the compensatory award to R2 000. We also suggested that the conduct of the broker be referred to the FAIS Ombud. The insurer refused the request for cancellation and a refund of all premiums paid, saying “As we have no voice recordings in place to identify, whether the caller is in fact our policyholder, it is impossible to determine whether the caller is indeed our client. Our Call Centre Staff has no training in Forensic Examinations and can therefore not determine a fraudulent action during a telephone conversation”.

At an adjudicators’ meeting it was decided that, as the office made every effort to assist Ms A, we could take the matter no further. Cancellation of the policy and a refund of premiums from inception was not in our view justified. It was then that Ms A directed and vented her fury on the poor adjudicator who had to inform her of the decision.

And that, as far as the office was concerned, was the end of an unhappy story.

Result

We did not hear from Ms A again.

AR
April 2006