Guidelines for resolving disputes

Insurance is a contract between the insurer and the customer based on the principle of "good faith".

The customer (by paying a premium) depends on the insurer to provide a service and to settle claims fairly and efficiently. In turn, the insurer relies on the customer to act honestly, and to accurately disclose all information relevant to the insurer being able to provide insurance cover that meets the customer's needs.

The Fair Insurance Code was developed by the Insurance Council as a set of principles which aims to continually improve the standard of practice and service member companies provide to their customers. This set of principles is in additional to those obligations created by the law.

See a PDF of the Fair Insurance Code here

There are a number of steps that you should take if you have a complaint about your personal insurance

1. Contact the branch manager of your insurance company.

2. If the branch manager is unable to resolve your complaint, you can make a formal complaint to your insurance company's controlling officer or person responsible for handling complaints.

3. When your formal complaint is received, your insurance company must do the following:

• Acknowledge your complaint within three working days
• Investigate your complaint and advise you of its progress or outcome within ten working days
• If the company is unable to resolve your complaint, they must inform you within two months. The company must also advise you of your right to take the complaint to the Insurance and Savings Ombudsman.

4. If your insurance company is unable to resolve your complaint, you may approach the Insurance and Savings Ombudsman to consider your complaint.

The Insurance and Savings Ombudsman is an independent authority. It considers complaints regarding all types of personal and domestic insurances, and savings services, provided that the amount claimed does not exceed $100,000.

The scheme is free of charge for insured people, and the Ombudsman's decision is binding upon the insurance company involved in the dispute.

A number of insurance and savings companies participate in the Insurance and Savings Ombudsman scheme, including members of:

• Insurance Council of New Zealand
• Health Funds Association of New Zealand
• Investment Savings and Insurance Association of New Zealand

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Finding out more

Please contact your insurance company for more information on its internal disputes process.