Compliments Complaints & Dispute Resolution

Retaining your confidence and loyalty is key to us.

We are dedicated to providing high quality service to our clients and the way in which we handle complaints is an integral part of our customer service to clients. If you have a complaint in respect of any aspect of the service we provide, we would appreciate you letting us know and giving us the opportunity to resolve your concerns. We will attempt in good faith to resolve any complaint/dispute in a fair, transparent and timely manner.

Where we identify, or you tell us about, an error or mistake in handling your Complaint, we will immediately initiate action to correct it.

This Policy applies to all new complaints from 1 June 2017.

General Insurance Code of Practice

We support and QBE is a signatory to the General Insurance Code of Practice issued by the Insurance Council of Australia (the Code). Further information about the Code and your rights under it is available at www.codeofpractice.com.au and on request.

Compliments

We welcome compliments and feedback from our customers. If you would like to provide us with positive feedback on our products or services, please email us at info_nsw@chu.com.au.

Complaints and Dispute Resolution

What to do when you have a complaint
We have tailored our complaints handling and internal resolution procedure to ensure that we deal with your complaint immediately. We will also ensure that it is handled by an appropriate person within our organisation.

We have broadly identified the following 3 types of complaints:

  1. Claims Decision Complaint – arising out of a declined claim, the value of a claim or financial hardship;
  2. Claims Service Complaint – arising out of services provided by our Service Providers or employees;
  3. Non-Claims Complaint – any complaint which is neither a Claims Decision Complaint nor a Claims Service Provider Complaint
Claims Decision Complaints

Step 1 – tell us about your Complaint
If your complaint relates to a claims decision, please initially contact the Claims Handler who is handling the Claim. The Claims Handler will immediately escalate the Complaint to the Claims Team Leader. The Claims Team Leader will try to resolve your Complaint within 2 business days in accordance with our Stage 1 IDR process.

Step 2 – IDR Committee
If the Claims Team Leader cannot resolve your Complaint within 2 business days, your Complaint will immediately be referred to our IDR Committee (as part of Stage 1 IDR), which will consider your Complaint. Our IDR Committee will provide its response in writing within 15 business days of us first being notified of the Complaint, provided the Committee has all necessary information and has completed any investigation required.

If the Committee requires further information or investigation, we will work with you to agree reasonable alternative time frames and if we cannot agree, you may request that your complaint is taken to Stage 2 and referred to the QBE IDR team. We will otherwise keep you informed about the progress of your response at least every 10 business days, unless you agree otherwise.

Step 3 – referral to QBE
If we cannot resolve your Complaint within 15 business days, we will refer your Complaint to the QBE dispute resolution department as part of our Stage 2 IDR process. QBE will provide its Final Response within 45 business days of your initial complaint to us.

Claims Service Complaints

Step 1 – tell us about your Complaint
If your complaint relates to our service provider(s), please initially contact the Claims Handler who is handling the Claim.

Please advise us at this point if you require a written response from us in relation to your Complaint. If you do not request a written response, we will endeavour to resolve your Complaint to your satisfaction within 5 business days of first being notified of the Complaint.

If you inform us that you do require a written response and your Complaint is in respect of the service provided by a service provider, then we will immediately refer your Complaint to Stage 1 IDR. In this instance, the Claims Handler and the Claims Team Leader will try to resolve your Complaint within 15 business days in accordance with our Stage 1 IDR process.

Step 2 – referral to QBE
If we cannot resolve your Complaint within 15 business days, we will refer your Complaint to the QBE dispute resolution department as part of our Stage 2 IDR process. QBE will provide its Final Response within 45 business days of your initial complaint to us.

Non-Claims Complaints

Step 1 – tell us about your Complaint
In the first instance, please contact the CHU representative who originally assisted you.

Please advise us at this point if you require a written response from us in relation to your Complaint. If you do not request a written response, we will endeavour to resolve your Complaint to your satisfaction within 5 business days of first being notified of the Complaint.

If you do require a written response and your Complaint is in respect of the service provided by a service provider, then in the first instance, the relevant State Underwriting Manager and/or State Service Manager will try to resolve your Complaint within 5 business days.

Step 2 – referral to National Underwriting Manager
If the State Underwriting Manager (or State Service Manager) cannot resolve your Complaint within 5 business days, your Complaint will be escalated to Stage 1 of our IDR process and referred to the National Underwriting Manager who will consider your Complaint and provide his/her response within 15 business days from the date of the initial Complaint. If further time is required due to for example insufficient information, he/she will provide a response as soon as possible and notify you of the further time required to provide a response.

Step 3 – referral to State Manager
If the National Underwriting Manager cannot resolve your Complaint within 15 business days, he/she will refer your Complaint to the State Manager as part of our Stage 2 IDR process. The State Manager will provide his/her Final Response within 45 business days of the initial complaint to us.

Financial Ombudsman Service

If you are dissatisfied with our internal dispute determination or if we are unable to resolve your complaint or dispute to your satisfaction within 45 days of first being notified of the Complaint, (or we cannot reach an agreement on a timeframe acceptable to you), you have the right to refer the matter to the Financial Ombudsman Service Australia (FOS).

FOS is an independent and free external dispute resolution scheme approved by the Australian Securities and Investments Commission. We (and QBE) are a member of this scheme and have agreed to be bound by its determinations about a dispute. You may contact FOS at any time at:

Contact number: 1800 367 287 (or 1800 FOS AUS)
Address: GPO Box 3, Melbourne Victoria 3001
Email:  info@fos.org.au
Website: www.fos.org.au

If you would like to refer your dispute to FOS, you must do so within 2 years of the date of our internal dispute determination. FOS may still consider a dispute lodged after this time if FOS considers that exceptional circumstances apply. Your application to FOS will be subject to its Terms of Reference (TOR) (See www.fos.org.au/about-us/terms-of-reference).
FOS can also advise you if your dispute falls within its TOR. If your Complaint falls outside the TOR, you can seek independent legal advice or access any other external dispute resolutions options available to you.

Request for Information

You may request copies of information we have relied upon to arrive at our decision(s) in the Complaint Handling process. In some instances, we may not release the information as requested and you may request a review of our decision not to release such information. We will comply with Code requirements regarding providing information you request.

Contact Us

Find your local CHU office here www.chu.com.au/contact-us

This Policy was prepared on 12 May 2017.


* CHU Underwriting Agencies Pty Ltd (ABN 18 001 580 070, AFS Licence No. 243261) policies are underwritten by QBE Insurance (Australia) Limited (ABN 78 003 191 035, AFS Licence No. 239545).