By Eunice Nyoni

As an insurance policy holder, have you ever felt unfairly treated? Or felt like your insurance company did not take your query with the seriousness you expected? Was there a time you felt you needed to report your insurance company to its regulatory body?

Many policyholders can relate to the unsatisfactory treatment they have received from their insurance companies. Satisfied customers are the best brand ambassadors, unfortunately, policyholders in many cases have been left displeased by their insurers. Today’s column focuses on the unfair treatment of clients, what can be done to ensure a complete customer experience and what one can do if they are unsatisfied with the services rendered to them by their insurance company.

Treating Customers Fairly (TCF) isan outcome based regulatory and supervisory approach designed to ensure that regulated financial institutions deliver specific, clearly set out fairness outcomes for financial customers. The principle aims to raise standards in the way firms carry on their business by introducing changes that will benefit consumers.

The six outcomes of TCF are;

  • Culture and Governance

Clients are confident that they are dealing with firms where the fair treatment of customers is central to the firm culture.

  • Product Design

The products and services marketed and sold are designed to meet the needs of identified customer groups and are targeted accordingly.

  • Clear Communication

To give clear information to clients and keep them informed before, during and after the time of contracting.

  • Suitable Advice

Where clients receive advice, the advice is suitable and takes account of their circumstances. 

  • Performance and Standards

The performance of products and service levels are according to clients’ expectations.

  • Claims, Complaints and Changes

Clients do not face unreasonable post-sale barriers to change product, switch provider, submit a claim or make a complaint.

The fair treatment of customers should be at the heart of insurance business. They should be able to demonstrate this by creating an amicable business environment with their clients.

Policyholders are happy when their “Must Be” needs have been satisfied. “Must-be” needs include the “unspoken” yet expected, basic features or characteristics of an insurance product or service. These are not the only elements of service that can necessarily increase satisfaction but without them, the policyholderis left feeling displeased.

As such, the Pensions and Insurance Authority (PIA), expects that all industry players treat their consumers fairly throughout the product life cycle, from product design and promotion, through advice and servicing, to complaints and claims handling.

Having policyholders at the heart of the insurance business and ensuring a good culture at a firm is imperative to ensuring that customers are treated fairly.

It is important for insurance companies to understand the needs of policyholders– both overall and at an individual customer level so that their business model and strategy take in account customer interests and put policyholders at the heart of what they do.

The key to good customer service is building good relationships with policyholders that includes appreciating the consumers and promoting a positive, helpful and friendly environment that will ensure they leave with a great impression. A happy policyholder will return often and is likely to spend more with that particular company.

Further, insurers are expected to explicit in communication and should avoid vague terms that could be misinterpreted or lead to confusion. All communication should be balanced and carefully calibrated.

How do you make your customers feel valued?

  1. Express your appreciation and thank your policyholders for doing business with you.
  2. Pay attention to your policyholders‘ inquiries, make it an aim that all employees should be able to respond to an enquiry or query from either a walk in client or over the telephone
  3. Try to find out what your policyholders like and dislike by listening to their inquiries and feedback.
  4. Educate your customers of the complaints procedure and who they can escalate their case if they are not satisfied
  5. Be presentable.

How to complain if one feels they have been unfairly treated

If you are unhappy with an insurance product or service, you have the right to complain to the insurance company. All insurance companies are expected to have an internal procedure of resolving policyholder disputes.

If you are unhappy with an insurance product or service, you can take the following steps to make a complaint:

Step 1: Contacting the insurance company directly

If you have a complaint about an insurance company, it is best to first ask the company to put things right.

Insist you speak to someone more superior within the company if you feel your complaint is not receiving the attention it deserves.

Contact them as soon as possible in writing, so you have a record of your correspondence with the company.

They must tell you whether the complaint has been successful or why they need more time to investigate the complaint. 

Unless they resolve your complaint, all insurance companies are required to respond in writing to let you know they have received your complaint.

Ensure that you exhaust the complaint procedure in pursuing your case.  This helps you to have a more solid case if you decide to go to the second step which is discussed below.

Step 2: Contact the Regulator

If you are not happy with the response you receive from the insurance company, and you have exhausted the complaint and dispute resolution mechanism with the entity with which you have a compliant with, you can escalate your complaint to the Pensions and Insurance authority (PIA), by putting your complaint in writing and addressing it to the Registrar.

In the past, people chose which insurance company to deal with based on price, or the product or service offered, but today things have changed, people will judge a place from the beginning they walk through the door. Customer complaints cannot be avoided. What is important is how the institution deals with them once they happen. A happy customer will certainly speak good about the company. This will ultimately raise the company’s revenue through referrals. Treating customers fairly is thus paramount for any business to thrive.

For comments or questions, send us an email at pia@ or follow us on our Facebook page, Pensions and Insurance Authority.

You can call us on 211-251 401/5 0r 0977-335809 or 0965 – 255136.

For complaints, kindly use the following details:

Pensions’ related complaints: Mobile: 0950 – 136663, Email: pensions@

Insurance – related complaints: Mobile: 0950 – 136662, Email: complaints, insurance@

The author is an Inspector – Market Conduct in the insurance department at Pensions and Insurance Authority