Call me maybe?

In 2018, Caitlyn approached her insurance adviser about updating her cover. She already had suitable life insurance but wanted mortgage repayment cover as well.  The insurance adviser made some inquiries and identified a suitable policy.

Caitlyn’s insurance adviser sent her medical information and application to the insurer and in July 2018, the insurer sent back an offer of terms.

The insurance adviser called Caitlyn several times over the next few months, to arrange a time to discuss the terms of the policy with Caitlyn. If she was happy with the terms, they would then make a time to sign the contract and finalise the application. However, Caitlyn never called the insurance adviser back to arrange this meeting.

In October 2018, Caitlyn had a heart attack, and was left unable to work. Because she had never accepted the insurer’s offer of terms, she did not have any cover for the heart attack.

 

Dispute

Caitlyn said that her insurer should have done more to encourage her to finalise the insurance application. In particular, Caitlyn pointed out that the offer of terms from the insurer was only available for one month. She said that if she knew the offer had an expiry date, she would have made the effort to come in and finalise the application.

Caitlyn said the insurance adviser should have sent her the offer of terms in writing – instead, he only contacted her by phone. 

The insurance adviser said he had tried his best to contact Caitlyn and finalise the insurance application. He said he had called Caitlyn nine times between July and October to arrange a meeting. Although Caitlyn did not pick up most of these calls, the adviser said he did have one conversation with Caitlyn in July, where he went through the key terms of the insurer’s offer.

The adviser said, in his opinion, Caitlyn was never going to accept the insurance policy. The premiums were much too high, and when he described the offer to Caitlyn, she was very unhappy with the high cost of the policy.

Caitlyn complained to FSCL.

 

Review

When we looked through the adviser’s file, we found he had not kept file notes of any of his calls to Caitlyn. This was concerning, as he could not show what he had discussed with Caitlyn. The adviser was, however, able to produce phone records showing nine calls from his number to Caitlyn’s mobile phone.

We noted the premiums offered by the insurer were particularly high – over $200 per month.

As Caitlyn had not made any effort to contact the insurer to finalise the insurance application, it seemed probable that Caitlyn had decided not to proceed with the insurance policy after hearing about the high premiums. We found that even if Caitlyn had received a copy of the offer of terms, she most likely would not have accepted the offer.

 

Outcome

We found that the insurance adviser’s actions had not caused Caitlyn any loss, so we recommended Caitlyn discontinue her complaint.

As part of our recommendation, we did note our concerns about the insurance adviser’s lack of file notes, and he agreed to review his processes and keep better records in future.

 

Key insights for the participant

If the insurance adviser had kept file notes of his calls to Caitlyn, this would have been a simple case to assess. He would have been able to clearly show he had been in contact with Caitlyn and had discussed the relevant terms of the insurer’s offer.

It is always best to keep detailed records of your contact with clients, so you can show you have complied with best practice if a complaint ever arises.

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