The Gazette 1994

GAZETTE

N E W S

MARCH 1994

Early Days for t he First Insurance

Ombudsman

After one year in her new role as

Ireland's first Insurance

Ombudsman, Barrister,

Paulyn

Marrinan Quinn,

reviews the

Progress of her Office and notes the

relatively high proportion of

solicitors who have used this

5^thod^ofaIternative dispute

resolution on their clients' behalf.

I feel quite at home in my job and,

Perhaps, in a way that is because I am

not in foreign territory in that the

relationship between a policyholder

and his insurer is not unlike the

relationship between a lawyer and his

or her client. Often there is more

loathing than loving in the

relationship particularly when,

Perhaps, it could be argued that the

client's expectations far exceed what

is practicable or possible.

At the inauguration of the Insurance

Ombudsman Scheme in October 1992,

there was considerable interest

expressed by the media, who enquired

particularly about the independence of

the role, to which I replied then, and

still firmly reply, that I have been

given a job with independence

guaranteed. To the minority who

suggest that this might be just a public

relations exercise, I bring their

attention to the fact that the member

companies participating in the Scheme

have agreed, in advance, to be bound

by the Ombudsman's decision and

also to make available all files and

documentation and any other informa-

tion which the Ombudsman needs

sight of in pursuit of the investigation

and review of the dispute.

If, as is often the case, complainants

write to me in the first instance, I

reply enclosing a copy of the

explanatory leaflet, setting out the

procedures, in broad terms, and direct

them back to their insurance company. |

I explain that they must first go

through the internal complaints

procedures and exhaust all existing

Pauline Marrinan-Quinn, BL, Insurance

Ombudsman of Ireland.

remedies within those procedures in

order to have gone through due

process. In referring complainants

back to the internal complaints

procedures in the companies, it is

crucial that they find those procedures

accessible and functional.

Every company participating in the

Scheme has nominated a member of

senior management, whose

responsibility it is to review and "sign

off' unresolved disputes before they

can be referred to me. I have indicated

to those members of senior

management so nominated that it is

helpful if the "signing o f f' letter

contains a brief summary of the

reasons for repudiation or otherwise

sets out the company's position and/or

details of any settlement proposals

which have been put to the

complainants.

In a report prepared recently in the

UK, in which Lord Ackner reviewed

the viability of complaints handling

systems, the Law Lord concluded that

an ombudsman system is better than

any arbitration arrangements for

handling consumer's investment or

other complaints. Alternatives, such as

committees or panels, with industry

nominees as well as consumer

representatives balanced by an

independent chairman, as adopted, for

example, in Hong Kong and Australia

(not to mention LAUTRO'S own

complaints sub-committee) do not

appear to have been serious

contenders. Having investigated the

Insurance Ombudsman Bureau model

in the UK, Lord Ackner referred to the

ombudsman system providing "a

unified complaints procedure".

The UK Ombudsman Association was

established recently in order to

preserve the integrity and credibility

of ombudsman schemes. There is a

threat that the establishment of

sham or bogus ombudsman outfits

could denigrate the office and do

irreparable damage. The Association

has drawn up four fundamental

criteria which must be in place before

the term "ombudsman" can properly

be used:

1. independence from those whom

ombudsman has the power to

investigate;

2. effectiveness;

3. fairness;

4. public accountability.

Having studied the model in the UK

and also in Copenhagen, as part of my

initial researches, my objective is to

take the best from tried and tested

systems, but to do it our way.

Ombudsman systems have been

working well for many years in

Scandinavian countries, where

complaint handling systems are open,

accessible, transparent and generally

accepted to be fair.

It is now well established that in order

for an ombudsman scheme to work,

the right to complain to the

ombudsman should be adequately

publicised by those subject to

complaint. I would hope, by now, that

details of the Ombudsman Scheme

have percolated down through the