Emergence is committed to meeting and exceeding our clients’ expectations whenever possible and would like to know if your expectations haven’t been met. You are entitled to make a complaint about any aspect of your relationship with Emergence including the conduct of anyone acting on our behalf. The complaints process also applies to complaints regarding a declined claim, the value of a claim or financial hardship.
This policy complies with the requirements of the LMA 5302a and the Fair Insurance Code, and we process and manage complaints in accordance with our Internal Complaints and Disputes Policy.
This document sets out the Complaints and Dispute Resolution Process for the business written by emergence under each binding authority with Lloyd’s.
What is a complaint: A complaint is an expression of dissatisfaction made to or about us, related to our products, services, staff, or the handling of a complaint, where a response or resolution is explicitly or implicitly expected, or legally required. A complaint also includes such expressions of dissatisfaction made about us on a social media channel or account owned or controlled by us, where the person making the complaint is both identifiable and contactable.
Emergence recognises that when a complaint is made that the person making the complaint expects emergence to do something about the complaint. Emergence commits to keep an open mind about any complaint and to attempt to resolve it.
What we do when we receive a complaint.
emergence will investigate complaints competently, diligently and impartially obtaining additional information as necessary and must assess fairly, consistently and promptly the subject matter of the complaint, whether the complaint should be upheld and what remedial action or redress (or both) may be appropriate.
Making a complaint
A complaint can be made by email telephone or by mail. A complaint can be directed to either of:
M: Level 11, Shortland Centre, 55 Shortland Street, Auckland 1140 New Zealand.
T: 0800 129 237
E: privacyandcomplaints@emergenceins.co.nz
How we handle a complaint
Stage 1
Emergence must acknowledge any complaint in writing. Emergence must do so within 2 business days of receiving the complaint.
Emergence will immediately, or at least within 24 hours, advise the lead underwriter (complaints@markel.com) of any complaint.
Emergence must investigate the complaint and issue a Stage 1 Response within 10 business days of receiving the complaint.
Emergence will keep the complainant informed of the progress of the complaint.
Within 7 calendar days of issuing a Stage 1 Response Emergence must notify the Lloyd’s General representative in New Zealand.
The address for the Lloyd’s general representative in New Zealand is:
M: Lloyd’s General Representative in New Zealand, c/o Hazelton Law, Level 29 Plimmer Towers, 2–6 Gilmer Terrace, PO Box 5639 Wellington
T: 04 472 7582
E: scott.galloway@hazelton.co.nz
If Emergence is unsure how to resolve the complaint or if the complaint involves any financial redress, then Emergence must immediately pass the complaint and all relevant documentation to Lloyd’s General representative in New Zealand (details above). Alternatively, if the complainant remains dissatisfied, they can escalate the complaint to idrnz@lloyds.com.
Emergence will provide all assistance to underwriter or Lloyd’s to understand the issues involved in the complaint and to resolve the complaint.
Stage 2
Following receipt of a complaint by Lloyd’s, the complainant will be advised whether the dispute will be handled by Lloyd’s Australia (on behalf of the Lloyd’s General representative in NZ) or the Lloyd’s Complaints team in the UK, or what other avenues are available to the complainant.
Where a complaint is eligible for referral to the Insurance & Financial Services Ombudsman (IFSO), the complaint will generally be reviewed by a person at Lloyd’s Australia with appropriate authority to deal with the dispute.
Where a complaint is not eligible for referral to the IFSO, Lloyd’s Australia will refer your complaint to the Lloyd’s Complaints team in the UK if it falls within the jurisdiction of the UK Financial Ombudsman Service, who will review the complaint and will liaise directly with the complainant.
For all other matters the complainant will be advised of what other avenues may be available.
A complaint will be acknowledged in writing within 5 business days of receipt, and the complainant will be kept informed of the progress of the 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 10 business days of receipt, provided we have received all necessary information and have completed any investigation required.
If the matter cannot be resolved at stage 2 and/or it has been more than two months since the complaint was made, you will be advised of the reasons for this via a ‘deadllock’ letter and advised of your right to elevate the matter to IFSO.
External Dispute Resolution
Complainants can make a complaint to IFSO through their website.
Complainants must make a complaint to IFSO within 3 months of the date of our deadlock letter. Determinations made by IFSO are binding upon us.
Clients not eligible for referral to IFSO, may be eligible for referral to the Financial Ombudsman Service (UK). 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.
You can contact Lloyd’s in the UK at:
Complaints
M: Fidentia House, Walter Burke Way, Chatham Maritime, Chatham Kent ME4 4RN
T: +44 (0)20 7327 5693
E: complaints@lloyds.com
INTERNAL DISPUTE RESOLUTION PROCESS (IDR – Stage 1)
1.1 What to do if you have a complaint
To allow Emergence to consider your complaint the following information needs to be provided (where available):
- Name, address, email and telephone number of the policyholder;
- Policy Number, claim number and product type;
- Name and address of the insurance intermediary through whom the policy was obtained;
- Reasons why you are dissatisfied and an explanation of the situation that led to the complaint, and
- Copies of any supporting documentation you believe may assist Steadfast UW Agencies in addressing your complaint appropriately.
1.2 How Emergence will initially handle your complaint
Emergence will acknowledge receipt of your complaint by either phone, email, social media channels or letter within 1 business day and advise the name and contact details of the employee assigned to liaise with you.
Emergence or Lloyd’s will respond to your complaint in writing within 30 calendar days of first being notified of the complaint, provided Emergence or Lloyd’s have all the necessary information and have completed any necessary investigations.
Emergence or Lloyd’s will keep you informed of the progress no less than every 10 business days unless it is resolved earlier.
If Emergence is unable to resolve your complaint to your satisfaction within 10 days, it will escalate the complaint to Lloyd’s. Emergence can seek an extension of time for m Lloyd’s to resolve your complaint, with your agreement.
If Emergence or Lloyd’s is unable respond within 30 calendar days, emergence or Lloyd’s will provide you with an Internal Dispute Resolution Delay Notification outlining the reasons for the delay and your right to complain to the Insurance & Financial Services Ombudsman (IFSO) if you are dissatisfied.
EXTERNAL DISPUTE RESOLUTION PROCESS (EDR)
Insurance and Financial Services Ombudsman
If Emergence or Lloyd’s response following the IDR process does not resolve your complaint to your satisfaction, or if Emergence or Lloyd’s have not resolved your complaint within 10 calendar days of the date Emergence or Lloyd’s first received your complaint, you can seek an external review via Lloyd’s external dispute resolution scheme.
IFSO is an independent national scheme for consumers, free of charge and aimed at resolving disputes between the insured and their insurance intermediary/insurer/Lloyd’s. IFSO can advise you if your dispute falls within their Rules.
Determinations made by IFSO are binding on Emergence, its underwriting security and Lloyd’s, where relevant. If you would like to refer your dispute to IFSO, you must do so within 2 months of receiving a ‘deadlock’ letter from Emergence. IFSO may still consider a dispute lodged after this time if they consider that exceptional circumstances apply.
Insurance and Financial Services Ombudsman contact details are:
T: 0800 888 202 or 04 499 7612
E: info@ifso.nz
M: Insurance & Financial Services Ombudsman Scheme, PO Box 10-845, Wellington 6143, New Zealand
W: Complaints | Make A Complaint
If you choose to lodge your dispute with IFSO, they will contact emergence and/or Lloyd’s and ask for a response from both parties. Response times requested by IFSO vary depending on the situation.
If IFSO advises you that their Rules do not extend to you or your dispute, you can seek independent legal advice or access any other external dispute resolution options that may be available to you. If your complaint is not eligible for IFSO, it may be eligible for referral to the Financial Ombudsman Service Ltd (UK). Any referral must occur within 6 months of the final decision from IDR.
The Financial Ombudsman Service Ltd (UK) contact details are:
T: 0300 123 9 123 or 0800 023 4 567
E: complaint.info@financial-ombudsman.org.uk
M: Financial Ombudsman Service, Exchange Tower, London E14 9SR
W: www.financial-ombudsman.org.uk