1 reviews | Active since Aug 2018
Ombudsman looks after the insurer!
Be careful of Ombudsman rulings. Apparently if the Ombudsman sides with the insurance company , it will be used against you to back up the insurance company’s decision to not pay you out. It makes it harder to go legal with your complaints thereafter. If insurance doesn’t pay out, see your attorney first. The Ombudsman is paid ‘ membership fees’ by insurance companies. Are they unbiased? Think about it.
Dear Monique Harrisberg
This office is concerned with the statement you have made in the above post, which is without merit.
The Ombudsman is appointed to serve the interest of the insuring public and all short-term insurers. Although the insurer pays a fee for each complaint that is submitted to OSTI, we understand that insurers get their funding from consumers who pay their premiums. We therefore appreciate at all times that our services are funded both by the consumer and the insurer. In any event, OSTI takes its role as an impartial and independent forum very seriously and deals with each complaint that is lodged with it in this way.
Any Ruling made by the Ombudsman is not binding on the insured. Therefore, if you are not happy with OSTI’s decision, your rights are not at all affected. You are still free to look for other ways to continue to challenge the insurer’s decision. You can see a lawyer, go to court or pursue other forms of dispute resolution such as arbitration. Our Terms of Reference state that both parties shall not be entitled to make use of any information which comes to their knowledge as a result of the intervention of the Ombudsman during the course of any investigation. Documents brought into being as a result of any approach to the Ombudsman shall not be liable to disclosure or be the subject of a discovery order or subpoena in the event of any legal proceedings between the Complainant and insurer.
We trust that this will address the concerns you may have with regard to our process.
Yours faithfully,
AYANDA MAZWI
Senior Assistant Ombudsman
Dear Monique Harrisberg
This office is concerned with the statement you have made in the above post, which is without merit.
The Ombudsman is appointed to serve the interest of the insuring public and all short-term insurers. Although the insurer pays a fee for each complaint that is submitted to OSTI, we understand that insurers get their funding from consumers who pay their premiums. We therefore appreciate at all times that our services are funded both by the consumer and the insurer. In any event, OSTI takes its role as an impartial and independent forum very seriously and deals with each complaint that is lodged with it in this way.
Any Ruling made by the Ombudsman is not binding on the insured. Therefore, if you are not happy with OSTI’s decision, your rights are not at all affected. You are still free to look for other ways to continue to challenge the insurer’s decision. You can see a lawyer, go to court or pursue other forms of dispute resolution such as arbitration. Our Terms of Reference state that both parties shall not be entitled to make use of any information which comes to their knowledge as a result of the intervention of the Ombudsman during the course of any investigation. Documents brought into being as a result of any approach to the Ombudsman shall not be liable to disclosure or be the subject of a discovery order or subpoena in the event of any legal proceedings between the Complainant and insurer.
We trust that this will address the concerns you may have with regard to our process.
Yours faithfully,
AYANDA MAZWI
Senior Assistant Ombudsman