Complaints Policy & Procedure

Transcription

1 Page 1 of 1 Complaints Policy & Procedure Revision No: 0, Issue Date: Maria Lesiva Senior Customer Relationship Officer Jehad B. Rahima Chief Medical & Life Ahmed Al Emadi Chief Executive Officer PREPARED BY REVIEWED BY APPROVED BY

2 Page 2 of 1 Document Change History Issue No. Issue Date Revision Description Page No Approved by New policy created All CEO

3 Page 3 of 1 Table of Contents Description Page Contents 1. Purpose 4 2. Scope 4 3. Abbreviations 4 4. Procedure 4

4 Page 4 of 1 1. Purpose The purpose of the document is to define the complaints policy & procedure for any client or member who would like to raise an official complaint to Al Koot Insurance & Reinsurance or its regulator. 2. Scope The document covers step-by-step procedure for placing and escalating a complaint to Al Koot Insurance or Reinsurance. 3. Abbreviations 4. Procedure Records Procedure Responsibility Complaint from Client 4.1 If the Insured is not happy with the service offered by their Insurance Company, or the way they have been treated, the Insured has the right to complain to the Insurance Company. The Insurance Company will look into the complaint and see if it s appropriate to redress the Insured. However, if the Insured thinks that their claim has been unfairly rejected, they can still raise a complaint against the Insurance Company. 4.2 Definitions 'Grievance/Complaint' - A "Grievance/Complaint" is defined as any communication that expresses dissatisfaction about an action or lack of action, about the standard of service/deficiency of service of an insurance company and/or any intermediary or asks for remedial action. 'Inquiry" - An "Inquiry" is defined as any communication from a customer for the primary purpose of requesting information about a company and/or its services. 'Request' - A "Request" is defined as any communication from a customer soliciting a service such as a change or modification in the policy. 'Company' shall mean Al Koot Insurance and Reinsurance Company 'Complainant' shall mean any policyholder (including legal heirs, assigns or legal representatives) who reports a Grievance to the Company 4.3 Grievance Procedure Heads of departments Call from Client Step 1 It is sometimes possible to resolve a complaint through a telephone call to Al Koot helpline The insured should note down the name of the agent the date of call and the phone number from which they called for easy tracking in case of future escalations Call center agent

5 Page 5 of 1 from Client Complaint application from Client Step 2 In case the Complainant is not happy with Al Koot response they can raise the grievance or complaint through sending a written communication to Al Koot Complaints section the following address: complaints@alkoot-medical.com The Complainant can also submit Grievance at Al Koot Office located in Al Maha Building, Bin Omran Area, Doha. The Grievance should be expressed in writing duly signed by the Complainant or legal heirs, assigns, legal representatives with full details of the complaint and contact details of the Complainant. Step 3 In case the Complainant is still not satisfied with the decision or resolution of the Grievance, the Complainant may approach the Insurance Section at QCB. The details of the Insurance Section of QCB is given below: Fill in the complaint/inquiry form published on the Qatar Central Bank s website under Consumer Protection tab. (or) Send a complaint / inquiry to fax number (or) in person to Banking Services Consumer Protection Department located at the building of the Qatar Central Bank, C-ring Road Near Al Muntaza signal, Doha. As per QCB Regulations, No complaint to the Insurance Section of QCB shall lie unless: The Complainant had before making a complaint to the QCB made a written representation to the Insurer named in the complaint and either the Insurer had rejected the complaint or the Complainant had not received any reply within a period of one month after the Insurer concerned received his representation or the Complainant is not satisfied with the reply given to him by the Insurer. The complaint is made within one year after the Insurer had rejected the representation or sent final reply on the representation of the Complainant; and the complaint is not on the subject matter, for which any proceedings before any court, or arbitrator is pending. Head of Customer Care QCB