What to do if you have a complaint?
Lloyd’s is the world’s specialist insurance and reinsurance market, bringing together an outstanding concentration of underwriting expertise and talent.
In Australia, Lloyd’s is proud to be a member of the Insurance Council of Australia. Lloyd’s has adopted the General Insurance Code of Practice subject to certain specific qualifications. You can obtain a copy of the code at www.codeofpractice.com.au
Our aim is to provide the highest service to our Australian policyholders and, to this end, we have developed the following procedures for the fair handling of complaints from Lloyd’s policyholders.
How can we help you?
There are established procedures for dealing with complaints and disputes regarding your policy or claim. Policyholders may be able to take advantage of the complaints service, as may third-party motor vehicle claimants who are uninsured and where the amount in dispute is less than $5,000.
Any enquiry or complaint relating to a Lloyd’s policy or claim should be addressed to either your Lloyd’s insurance intermediary (“the coverholder”) or to the administrator handling your claim in the first instance – in most cases this will resolve your grievance.
They will respond to your complaint within 15 business days provided they have all the necessary information and have completed any investigation required. Where further information, assessment or investigation is required, they will agree to reasonable alternative timeframes with you. You will also be kept informed of the progress of your complaint.
In the unlikely event that this does not resolve the matter or you are not satisfied with the way your complaint has been dealt with, you should contact:
Lloyd’s Australia Limited
Level 9, 1 O’Connell St
Sydney NSW 2000
Telephone: (02) 8298 0783
We will usually require the following information:
Name, address and telephone number of the policyholder;
Details of the policy concerned (policy and/or claim reference numbers, etc);
Details of the insurance intermediary through whom the policy was obtained;
Reasons why you are dissatisfied;
Copies of any supporting documentation you believe may assist us in addressing your dispute appropriately.
Following receipt of your complaint, you will be advised whether your matter will be handled by Lloyd’s Australia or the Lloyd’s Complaints team in the UK, or what other avenues are available to you:
Where your complaint is eligible for referral to the Financial Ombudsman Service Australia (FOSA) or Australian Financial Complaints Authority (AFCA), your complaint will generally be reviewed by a person at Lloyd’s Australia with appropriate authority to deal with your dispute.
Where your complaint is not eligible for referral to FOSA or AFCA, Lloyd’s Australia will refer your complaint to Lloyd’s Complaints team in the UK if it falls within the jurisdiction of the UK Financial Ombudsman Service. They will review your complaint and liaise directly with you.
For all other matters, you will be advised of what other avenues may be available to you.
How long will the Stage 2 process take?
Your complaint will be acknowledged in writing within 5 business days of receipt, and you will be kept informed of the progress of our review of your complaint at least every 10 business days.
The length of time required to resolve a particular dispute will depend on the individual issues raised, however in most cases you will receive a full written response to your complaint within 15 business days of receipt, provided we have received all necessary information and have completed any investigation required.
External Dispute Resolution
If your complaint is not resolved in a manner satisfactory to you or we do not resolve your complaint within 45 calendar days of receiving it at Stage 1, you may refer the matter to FOSA or AFCA as follows:
For complaints lodged on or before 31 October 2018
You may refer the matter to FOSA. FOSA can be contacted by post GPO Box 3, Melbourne VIC 3001, phone 1800 367 287 or email email@example.com. More information can be found on their website www.fos.org.au
For complaints lodged on or after 1 November 2018
You may refer the matter to AFCA. AFCA can be contacted by post at GPO Box 3, Melbourne VIC 3001, phone 1800 931 678 or email firstname.lastname@example.org. More information can be found on their website www.afca.org.au
FOSA and AFCA are independent bodies that operate nationally in Australia and aim to resolve disputes between you and your insurer. FOSA and AFCA provide fair and independent financial services complaint resolution that is free to consumers. Your dispute must be referred to FOSA or AFCA within 2 years of the date of our final decision. Determinations made by FOSA and AFCA are binding upon us.
Customers not eligible for referral to FOSA or AFCA, may be eligible for referral to the UK Financial Ombudsman Service. Such referral must occur within 6 months of the final decision by the Complaints team at Lloyd’s. Further details will be provided with their final decision to you.
How much will this procedure cost you?
This service is free of charge to policyholders.