INSURANCE/TAKAFUL INDUSTRY S CUSTOMER SERVICE CHARTER
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1 INSURANCE/TAKAFUL INDUSTRY S CUSTOMER SERVICE CHARTER Pillar 1 Descriptin Expected Outcme Service Level Target INSURANCE / TAKAFUL MADE ACCESSIBLE Offer an active engagement mdel wherein a custmer is aware f: Multi-channel ptins & accessibility fr purchase and enquiry. Where and hw t prvide feedback, suggestins and t cmplain. BETTER ENGAGEMENT & IMPROVED SERVICES 1. Multi-channels and apprpriate channels are being used fr purchase and enquiry. 2. Online channels are being used fr purchase and enquiry. 3. Feedback, suggestins and cmplaints are received via channels prvided. N. Cmmitment Service Level 1.1 We will make insurance and takaful prducts easily accessible via varius channels, physically and virtually, t btain infrmatin, purchase r make enquiries T this end, the fllwing are t be adpted:- 1. Offer an active engagement mdel wherein a custmer is aware f: Multi-channel ptins and accessibility fr making purchases and enquiries. Where and hw t prvide feedback, suggestins and cmplaints. 2. Reinfrce that insurance / takaful is easily accessible via varius channels, physically and virtually. Custmers are kept infrmed n the physical and engagement channels available fr them t purchase prducts r t make enquiries. Specifically, custmers shuld have access t the fllwing:
2 An insurance / takaful agent lcatr. List f custmer engagement channels, i.e. crprate website, selfservice custmer web prtal and call centre. Scial media (if applicable) - prvide links. 3. Channel availability may vary frm time t time, and custmers will be infrmed accrdingly. 1.2 We will actively seek feedback, suggestins r cmplaints n hw insurers can serve custmers better 1. Custmers are prvided with available channels t prvide feedback and suggestins via: Crprate website (prvide website address). Self-service custmer web prtal (prvide website address). Call centre (prvide htlink number). Branch (prvide link t list f lcatins). (prvide address). Fax (prvide number). Letter (prvide address). Scial Media (if applicable). 2. The Insurer / takaful peratr will cnduct peridic custmer satisfactin feedback/surveys t ensure that custmers needs are fulfilled.
3 INSURANCE/TAKAFUL INDUSTRY S CUSTOMER SERVICE CHARTER Pillar 2 Descriptin KNOW YOUR CUSTOMER T understand a custmer prfile adequately which enables the insurers / takaful peratrs t: Knw and anticipate the custmer s needs and preference. Ask fr requisite infrmatin and dcuments t best advise the custmer. Offer suitable prducts and services. Expected Outcme Service Level Target BUILD TRUST 1. 90% f custmers are served with suitable prducts and services which fit their needs and wants. 2. Minimal cmplaints (rati f 5% f ttal cmplaints) frm custmers are n nt understanding what was ffered and/r nt having the suitable prducts and services. N. Cmmitment Service Level 2.1 We will strive t help custmers find the right prduct t suit their needs 1. Knwledgeable and ethical staff and agents are available t serve custmers. 2. Training Ensure emplyees and intermediaries are prperly trained n prducts and services ffered. Training must be prvided any time a new prduct is launched and regularly as refresher curses n existing prducts. 3. Understanding Custmers Needs In rder t understand the custmers prfile adequately, insurers and takaful peratrs including their agents shall:-
4 Listen attentively t the custmers. Acknwledge and prperly understand the custmers needs and preferences. Ask fr requisite infrmatin and dcuments t advise the custmers accrdingly and in accrdance with the Industry s Cde f Practice n the Persnal Data Prtectin Act Offer ptins f suitable prducts and services t meet the custmers needs and wants. 4. Any ptins prvided t custmers shall be explained and n an pt-inbasis, e.g. riders, sharing/using custmer infrmatin fr marketing and research purpses. Nte: Handling f custmer infrmatin is gverned by Bank Negara Malaysia s Plicy Dcument n Management f Custmer Infrmatin and Permitted Disclsures and insurers / takaful peratrs shall perate accrdingly.
5 INSURANCE/TAKAFUL INDUSTRY S CUSTOMER SERVICE CHARTER Pillar 3 Descriptin TIMELY, TRANSPARENT & EFFICIENT SERVICE Deliver a seamless service wherein custmers are aware f: Insurers / Takaful peratrs respnsibilities twards custmers. Expected service standard and time taken t deliver these services, i.e. time taken t answer enquiries / reslve cmplaints. Where and hw t btain infrmatin required i.e. prduct features and csts. Expected Outcme Service Level Target CUSTOMER SATISFACTION 1. 80% f custmers are being served within the expected service level and timelines % f custmers are issued with plicy dcuments in a timely manner. 3. Declining cmplaints rati. N. Cmmitment Service Level 3.1 We will set clear respnsibilities twards custmers and uphld it. A standard cmmitment n clear respnsibilities t be a mandatry write up n all client charters shuld cver the fllwing guiding principles:- 1) A clear and cncise bjective f the Charter. 2) Missin. 3) Values t be prvided t the custmer, e.g. fairness, transparency, integrity, ethics, prfessinalism, timeliness. 4) Efficient/effective cmmunicatin channels.
6 3.2 We will set clear expectatin n time taken fr varius services. T include a clear expectatin n time taken fr varius services:- 1. Delivery f Services:- Infrmatin n turnarund time n delivery f services must be made available in the Clients Charter thrugh varius channels (head ffices / branches / brchures / call center / website / scial media). 2. Standards t be adpted:- Serve Walk-in Custmer Prmptly: Custmer Waiting Time: Within 10 minutes. 3.3 We will ensure efficient plicy servicing and prviding relevant dcumentatin in a timely manner. 1. Custmers shall be infrmed f each step and dcumentatin required t alter, renew, surrender r cancel a plicy, e.g. what happens when there are changes t the plicy, ntice n renewal, etc. as well as cnsequence arising frm any f these actins. 2. Custmers are t be reminded in the renewal ntice t infrm the insurance / takaful cmpany f any changes in the risk befre renewal. 3. The standard perating prcedure n dealings with custmers must be clearly cmplied with. 3.3(a) We will ensure efficient plicy servicing and prvide relevant dcumentatin in a timely manner (Life & Health including Takaful) Life & Health (including Takaful) 1. Plicy Accunt Turnarund Time (frm receipt f full dcumentatin, infrmatin and payment f premium):-
7 a) Plicy Issuance (upn acceptance in the plicy system) New and Existing Custmer:- i) Standard cases within 5 wrking days ii) Additinal infrmatin required / pre-existing medical cnditin / cmplex cases within 10 wrking days b) Change f plicy accunt details (endrsement): i) Plicy/Certificate Changes (Nn-financial) : within 3 wrking days ii) Plicy Changes (Financial) : Standard cases - within 5 wrking days Nn-Standard cases within 10 wrking days c) Reinstatement: within 10 wrking days (with payment & cmplete dcumentatin.) 2. Renewal ntice issuance: i) Fr plicy with guaranteed renewal, premium due ntice will be issued nt less than 30 calendar days befre the next premium due date. ii) Ntificatin f Revised Premium t renewable basic term plicy / term rider will be issued nt less than 30 calendar days befre the expiry f existing plicy / rider. 3 Cancellatin/surrendering f plicy: 10 wrking days upn receipt f full dcuments t als include prcessing f refund premium.
8 4. Issuance f medical / hspitalizatin card fr individuals - Within same business day f plicy issuance. Nte: The timelines abve d nt take int accunt nbarding prcess insurers/takaful peratrs have their wn nbarding prcess/intrductin t its prducts and services. 3.3(b) We will ensure efficient plicy servicing and prvide relevant dcumentatin in a timely manner (General) 1. Plicy Issuance (upn acceptance in the plicy system) New and Existing Custmer: i) Mtr E-plicy Immediately Manual: 5 wrking days (with the exceptin f new vehicles t be registered with JPJ) ii) Nn-Mtr - within 10 wrking days (applicable fr individuals nly, nt applicable t grup) 2. Change f plicy details / reissuance upn lapse / endrsement (upn acceptance in the plicy system): i) Mtr - within 3 wrking days ii) Nn-Mtr - within 5 wrking days 3. Renewal ntice issuance: 30 calendar days befre expiry f existing plicy. 4. Cancellatin/ surrendering f plicy (including refund f premium). i) Mtr - within 5 wrking days ii) Nn-Mtr - within 7 wrking days
9 Nte: The timelines abve d nt take int accunt nbarding prcess insurers / takaful peratrs have their wn nbarding prcess/intrductin t its prducts and services. 3.4 We will be pen and transparent in ur dealings The fllwing infrmatin shall be easily accessible and made available thrugh the varius channels f cmmunicatin such as branches / brchures / call centers / scial media / website: 1. Prduct related details, i.e. prduct features, prduct disclsure sheets, terms and cnditins, key facts and exclusins will be shared at the pint f sale. 2. Fees, charges (ther than premiums), and interest (if any) as well as bligatins in the use f a prduct r service (e.g. when premium needs t be paid and explaining payment befre cver warranty). 3. Anti-fraud statement and key pints t remember, i.e. cnfidentiality f custmer infrmatin, free lk perid f nt less than 15 calendar days (life & family takaful) & insurers / takaful peratrs right t reject r accept applicatins. 4. All the abve infrmatin shall be explained and stated using simple wrds and in an easy t understand manner.
10 3.5 We will fllw thrugh and prvide the requisite answers / updates t custmers queries & cmplaints prmptly 1. Phne Where n fllw up is required Immediate such as first call reslutin. Where fllw up is required Within 3 wrking days frm the date f the first call. 2. Written ( , fax, written letter & scial media) Fr /Scial media:- Prvide acknwledgement respnse within 1 calendar day. Acknwledgement t include expected timeline and any ther relevant infrmatin. Nn-cmplex enquiry - respnd within 3 wrking days frm date f receipt. Fr letter r fax Enquiries will be replied within 3 wrking days frm the date f receipt n nn-cmplex enquiries. 3. Cunter/Branches Where n fllw up is required, insurers / takaful peratrs will endeavr t prvide first tuch pint reslutin immediately. Where fllw-up is required within 5 wrking days frm the date f the first visit. Nte: Where enquiry is cmplex, insurers / takaful peratrs will prvide a reasnable timeframe and keep the custmer updated accrdingly.
11 3.6 We will ensure cnsistent and thrugh cmplaints handling T adpt the fllwing:- 1. Custmers shall be infrmed f the varius ptins fr submitting a cmplaint thrugh available channels, depending n the insurers / takaful peratrs channel presence and whichever applicable, i.e. prvide cmplaints unit cntact details (telephne number and address), website, scial media, etc. 2. A verificatin prcess has t be perfrmed n the plicyhlders / participants. 3. Cmmunicate clearly n the issue and gather adequate infrmatin fr an infrmed reslutin. 4. Address the issue in an equitable, bjective and timely manner by infrming the cmplainants n insurers / takaful peratrs decisin n later than 14 calendar days frm the date f the receipt f the cmplaints. 5. If the case is cmplicated r requires further investigatin, insurers / takaful peratrs shall infrm the cmplainant accrdingly and update prgress every 14 calendar days. If nt reslved, t update within anther 14 calendar days. Thereafter, after every 30 calendar days. 6. Keep the cmplainants updated if unable t address issues within the stipulated timeframe. 7. Refer the cmplainants t the next level f escalatin if the reslutins are nt t the satisfactin f the cmplainants. Cntact details f Bank Negara Malaysia LINK, BNMTELELINK and Financial Ombudsman Scheme must be clearly prvided. Nte: Cmplaints handling and timelines is gverned by Bank Negara Malaysia (BNM) s Guidelines n Cmplaints Handling and insurers / takaful peratrs shall perate accrdingly.
12 INSURANCE/TAKAFUL INDUSTRY S CUSTOMER SERVICE CHARTER Pillar 4 Descriptin Expected Outcme Service Level Target N. Cmmitment 4.1 We will set clear timeline fr claims settlement prcess and strive t settle claims within these prescribed timeline and in a transparent manner. FAIR, TIMELY & TRANSPARENT CLAIMS SETTLEMENT PROCESS Deliver a seamless claims prcessing and settlement experience wherein custmers are aware f: Prcedures, dcumentatin and steps including varius ptins (if any) fr first ntificatin f lss in an event f a claim. Expected service standard fr claims prcessing and specific time taken fr each step within the claims prcessing stages. Varius redress mechanisms fr unsatisfactry claims payment. PROVIDE PEACE OF MIND TO CUSTOMERS 1. 75% f the custmers are satisfied with the claims decisins and prcesses. 2. Declining cmplaints rati ver the years frm custmers n claims settlement and prcesses % f legitimate claims are paid accrdingly. Service Level T set clear timeline fr claims settlement prcess and strive t settle claims within these prescribed timelines and in a transparent manner by adpting the fllwing prcedures:- 1. Custmers will be infrmed f the estimated time taken fr claims settlement prcess and expected service standard. This infrmatin shall be made available thrugh varius channels (i.e. branches/brchures/call centers/scial media/website). 2. Custmers shall be infrmed n the acknwledgment f their claim within 7 wrking days frm receipt f claims ntificatin. 3. All claims ntificatins thrugh agents must reach the insurers / takaful peratrs within 3 wrking days, except fr crime related claims which shuld be ntified within 24 hurs frm time f lss. 4. If dcumentatin/infrmatin is incmplete, custmers shall be infrmed within 14 wrking days frm acknwledgement f the claim by the Claims
13 Department. 5 T state key claims prcedures and assign timelines t it, i.e. appintment f adjuster, claims assessment, etc. 6. Custmers will be updated n the prgress / decisin every 14 wrking days. 7. In the event f a catastrphe / disaster, e.g. large number f claims may be received, as such meeting timelines stipulated may nt be pssible, the insurers / takaful peratrs will strive t update every 20 wrking days n the prgress. Nte: Claims settlement and timeline fr general insurance business is gverned by Bank Negara Malaysia s Guideline n Claims Settlement Practices and general insurers / takaful peratrs shall perate accrdingly. 4.2 We will infrm custmer f the next level f escalatin if the claims settlement / rejectin is nt t his/her satisfactin T keep the custmer infrmed f the next level f escalatin if the claims settlement /repudiatin is nt t his/her satisfactin. 1. Custmers shall be prvided with available channels t appeal n a decisin / raise disputes (i.e. branch / brchures / call center / website). 2. Any letter f rejectin/repudiatin f any element f a claim and dispute n quantum which is within the purview f the Financial Ombudsman Scheme must cntain the fllwing statement prminently:- Any persn wh is nt satisfied with the decisin f the Insurer / Takaful Operatr, shuld refer t the prcedure fr appeal as stated in the leaflet issued by the Financial Ombudsman Scheme, entitled: (Nte: fr the plicy wners wh made a claim/reprt).
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