Dispute Resolution

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Proclaim’s goal in dealing with any customer complaint is to provide a prompt, transparent and fair process for the resolution of complaints and disputes.

Why does proclaim have an Internal dispute Resolution Policy?

Proclaim’s Internal Dispute Resolution Policy (IDR Policy) incorporates the standards and requirements prescribed by the Corporations Act 2001 and The Insurance Council of Australia Code of Practice.This includes the following general requirements:

  • We will conduct complaints handling in a fair, transparent and timely manner
  • We will make available information about our complaints handling procedures.
  • We will only ask for and take into account relevant information when deciding on your complaint.
  • You will have access to information about you that we have relied on in assessing your complaint and an opportunity to correct any mistakes or inaccuracies.
  • Where an error or mistake in handling your complaint is identified, we will immediately initiate action to correct it.
  • We will keep you informed of the progress of our response to your complaint.

In the event your complaint is not resolved, it will be treated as a dispute and will enter our “Internal Dispute Resolution” (IDR) process. The issue will then be considered by an independent and impartial Officer of Proclaim with the appropriate experience, knowledge and authority to deal with it. In some cases this function will be performed by our insurer client.By documenting our IDR policy in this way, we aim to ensure our staff:

  • Understand and comply with the IDR procedures; and
  • Promote accountability and transparency of the IDR policy.

How do you make a complaint?

A complaint can be made by telephone, in person or in writing. If a complaint is made in writing all responses will also be in writing.If you tell us you want our response reviewed, we will:a. Treat it as a dispute;b. Notify you of the name and contact details of the employee assigned to liaise with you in relation to your dispute; andc. Respond to your dispute within 15 business days provided we receive all necessary information and have completed any investigation required.In cases where further information, assessment or investigation is required we will agree reasonable alternative timeframes. If we cannot reach agreement you can report your concerns to Lloyds Australia.

How do you contact us?

A complaint can be made by contacting us in any of the following ways:Internet:

Website: www.proclaim.com.au
Telephone:    03 9660 5200
Mail:  Proclaim, Level 9, 271 Collins Street, Melbourne, Vic, 3000

What are the time limits for responding to complaints?

If all the relevant information has been received by us, then we will, within 15 business days of receipt of a complaint, either:Complete the investigation and advise you of the outcome; or

  • Refer the matter to our client (where it falls outside our authority): or
  • Advise you of the need for more time to complete our investigation.

What happens next

When we have completed our investigation of your complaint, we will advise you, in writing, of the outcome of the investigation. If the outcome is not in your favour, we will:

  • Advise you of the reasons for our determination; and
  • Advise you that the dispute may be referred to an External Dispute Resolution scheme.

In special circumstances or where a claim is being or has been investigated, we may decline to release information but we will not do so unreasonably. In these circumstances, we will give you reasons. We will provide our reasons in writing upon request.

Lloyd’s policies

Where your policy is issued under a binding authority with an Australian coverholder and should Proclaim be unable to resolve your complaint, you may refer the matter to Lloyd’s Australia.  It is necessary to refer these matters to Lloyd’s Australia before you are able to approach FOS with a dispute relating to a Lloyd’s policy.  In these instances we will provide you with a brochure from Lloyd’s Australia explaining the complaint process. Again, this service is free to claimants.

Lloyd’s Australia Limited
Suite 2, Level 21 Angel Place, 123 Pitt Street, Sydney NSW 2000
Tel:    (02) 9223 1433

Further assistance

We will do everything to reach a resolution within the terms of the policy. If, however, you are still dissatisfied with our decision you may choose to refer to the Insurance Industry’s independent external dispute resolution body, Financial Ombudsman Service Limited (“FOS”). The FOS Scheme offers claimants the facility of an impartial alternative to litigation. Insurers are bound by any determinations made by the FOS. Like our IDR process, the FOS Scheme is free to claimants. Claims to the FOS should be lodged within 90 days of as failure to resolve the dispute at FDR.To find out more about the role of the FOS and the FOS’s Terms of Reference, visit the FOS website at www.fos.org.au.

Financial Ombudsman Service Limited, GPO Box 3, Melbourne 3001,National Toll Free:  1300 78 08 08Tel:    (03) 9613 7366Fax:    (03) 9613 6399

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