FOS’s Authority to Investigate Complaint

Waiting on Lloyd's againToday is 7 days after the deadline the FOS gave the Society of Lloyd’s to respond and 21 days since the letter was sent by David Northcott of the FOS. David asked if the Society of Lloyd’s agreed that the FOS had the authority to review our complaint. The FOS wants to proceed but they want the SOL to agree so there are no problems after the investigation and decision.

ProSight originally told us to go to the Indiana Department of Insurance  if we disagreed with the denial. However, the IDOI said that they have no authority to investigate this complaint.

LJJ Associates, and ProSight are regulated by the FCA. Therefore, we believe that the FOS should be able to investigate our complaint. Otherwise, no organization is overseeing them.

”More”

One nice thing about putting this blog together has been revisiting documents and websites that you haven’t looked at in a while. We never imagined this specific road block and hadn’t looked at the documents from this perspective. Therefore we were looking at them with a different perspective. Below is what we found.

Lloyd’s Complaint Process

Lloyd's of London Complaint Options (UK or non-UK)The Lloyd’s Complaints page identifies the complaint processing procedures based upon your location and role. Our logical choice is “Lloyd’s policyholders outside the UK. How to make a complaint“.

 

 

 

 

The “outside the UK” page it states “Lloyd’s is currently introducing complaint handling processes for International policyholders and where possible complaints will be handled in line with local regulations.  Where no local regulations exist, complaints will be handled in line with UK principles and standards.”  That’s us! But we need to make sure what that process is!

 

Lloyds US Complaints Handling:

Lloyds US Complains Handling - FCA Authority

On the Lloyd’s US complaints handling page. it states “Lloyd’s arrangements for international complaints are intended to allow for the oversight of complaints handling, consistent with the regulatory expectations of the UK Financial Conduct Authority (FCA), whilst allowing flexibility for managing agents in the way they handle complaints in accordance with local rules.”  So essentially they are giving the agents (ProSight) the latitude to choose. 

However, at the bottom of that page it links to a page Market Bulletin Y5019 (International Complaints Handling: USA). Within the document it states “The new arrangements are being implemented commencing from 1 January 2017 on the renewal of each binding authority or placement.”  Our policy begin April 1 2016. Therefore it appears that we should be processed as a UK policyholder would.

Lloyd’s UK Complaint Process:

The Complaints by Lloyd’s UK Policyholders is described below:

Lloyds Complaints Process for UK policy holders - FOS Authority

If we should be processed in that manner then it appears that the next step is Stage 2. The Society of Lloyd’s should review our complaint.

FOS Authority?

Lloyd’s acknowledges the authority of the FOS to review all complaints in the “Code for Underwriting Agents: UK Personal Lines Claims & Complaints Handling” dated June 2016.

International Complaints

The procedures set out in this Code apply to complaints that arise from UK policies of insurance. Lloyd’s operates separate arrangements for non-UK policyholder complaints. While managing agents must comply with the local rules of any territory where a policy is written, the jurisdiction of the Financial Ombudsman Service is wide and covers firms for all activities carried on from an establishment maintained by it in the United Kingdom (see DISP 1.1.3 & DISP 2.6.1R).

The Financial Ombudsman Service may therefore have jurisdiction over complaints made by eligible complainants in all territories where Lloyd’s underwriters write business. However, the Financial Ombudsman Service has the discretion to dismiss complaints without a consideration of the merits where the complaint is or would be more suitable to be dealt with by a comparable independent complaints scheme or dispute resolution process (DISP 3.3.4(7) & (10)). This would include any equivalent overseas scheme in the jurisdiction where the complainant is based.”

Therefore, since the FOS has the authority and there is not overseas scheme, it would make sense that we proceed.

Conclusion:

  • The new US policy holder procedure didn’t go into effect until policies written starting January 1, 2017. Our policy was written April 1, 2016
  • Lloyd’s acknowledges that when there are no local regulations (which should include the IDOI stating that they have no jurisdiction), it should be reviewed by the FOS.
  • The Lloyd’s underwriting handbook specifically recognizes the FOS’s jurisdiction over all complaints regardless of the territory.

It appears that the only question is whether we should go thru Stage 2 of the UK process or just go right into the FOS process.

Fingers Crossed - AuthorityWe shared our learnings with David Northcott and Daniel Crockford. We don’t want to assume that they are aware of these. We hope that this will move along soon.

”Less”

Tell us what you think.