SAIA

South African Insurance Association

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From the Desk of the Chief Executive- SAIA Bulletin May 2019

The Ombudsman for Short-Term Insurance (OSTI) recently released its Annual Report on Operations for 2018. We value the role that the OSTI plays in providing consumers with a fair and transparent dispute resolution mechanism when it comes to non-life insurance disputes and welcome the report as it provides important information which offers relevant insight into the conduct of our industry with regards to complaints.

What is notable in the 2018 Annual Report is the new method in which insurer figures have been reflected. The statistics reveal the number of matters where the insured received some benefit as a result of the OSTI’s intervention (formally described as the overturn rate) in two separate ways. The first part reflects those matters which were resolved consensually and through discussion or conciliation with the insurer and the second part reflects those matters resolved through enforcement by the OSTI.

As an industry body, we encourage conciliation and were pleased to note that only a small percentage of the share of complaints were resolved through enforcement by the OSTI.
Another key highlight from the Annual Report is that in more than half of the finalized complaints, consumers complained about the insurer’s decision on a claim as a result of an exclusion or warranty in the policy wording. This demonstrates, in part, that consumers do not comprehend their insurance policies and more work needs to be done to address this concern.

The revision of the SAIA Code of Conduct (the Code) is in progress. The Code plays a significant role in the non-life insurance industry as it goes beyond legislation and regulation, by creating a common ethos for member adoption, by shaping ethical conduct and guiding decision-making by its members. The Code is supported by our regulatory authorities and is acknowledged as an instrument that promotes industry best practice and increases consumer confidence and protection.

As part of the revision of the Code, SAIA has demonstrated its commitment to the government policy objective to transform the non-life insurance industry by incorporating its adoption of the Financial Sector Code, and reflecting its resolutions to participate in industry transformation initiatives and to build an inclusive society by contributing towards the SAIA Consumer Education Fund and developing access products, where appropriate.

SAIA also recognises the shift in the legislative and regulatory landscape and has aligned the revised Code accordingly. Further, the approach adopted in the Code is one that incorporates principles, underpinned by relevant rules.

We look forward to relaunching our revised Code with the support of all our members, regulators, policy makers and the broader non-life insurance community.

Regards,

Viviene Pearson
SAIA Chief Executive