Terrible Customer Service

Hopeful Society of Lloyd'sWe were encouraged to hear that we would be going thru Stage 2 of the Society of Lloyd’s. Certainly, they have better customer service priorities. Surely the assigned case manager would want to make sure that the Lloyd’s name was not scarred by a lack of response or a bad faith denial.

On Tuesday Dec 5, David Northcott, the FOS adjudicator, told us that he would ask them to let us know who the “case handler” was. We wanted to provide new and updated information. We decided to go ahead and send an email to the general complaints email account at Lloyd’s. In the email, we referenced that the complaint process had started 5 months ago and that we had some new information we wanted to share with the case handler. On their website they state that a response should be received within 3 days.

Three days later

On Friday Dec 8, we hadn’t heard anything so we called the Lloyd’s Complaint’s customer service number. We were passed around to different people. One person said that she could see the email from us and it should have been answered by now. We finally talked with an individual who told us that the person assigned to our case. His desk was just two desks away and he would tell him about our call and have him get in touch with us.

Referred back to the FOS

Lloyd's Bad FaithHere we are 1 week later. No email or call. Not even an email stating that they can not work on the case right now but will be in contact by X date.

So we called Lloyd’s complaints department. The same individual says that it has been decided that the FOS will review our case next. We will not have a Stage 2 review! Lloyd’s complaint department has requested the complaint file from ProSight, which will be forwarded on to the FOS. ProSight’s deadline to provide the information is Tuesday. Unbelievable!

We ask “why?” He said he was looking at an email involving David Northcott of the FOS and this was the decision.

Bad Faith or Just Inept?

We are clearly being tossed around like a hot potato. It’s difficult to tell whether this is intentional or they just do not know what they are doing. One interesting note is that I returned to the “Lloyd’s policy holders outside the UK – How to Make a Complaint” page and the link to the US has been removed. Therefore they offer no direction to any US policyholder who wants to file a complaint.

One of the reasons that we were happy about the Stage 2 review is that there are no financial limitations on findings. The FOS is limited £150,000. Our claim is much higher. We asked how this would be addressed and he said that we had to go through our local system for any additional reparations. But there is no local system!! Not according to the IDOI. So did they send us back because of that limitation and exposure for their syndicate or do they just want to shuffle away the work?

It has been over 19 months since our loss and 6+ months since we started the complaint process. Is this normal for them? It’s clearly unacceptable.

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”

We Are The Society of Lloyd’s and You’re Nobody

The Society of Lloyd's brashly ignores FOSThe deadline of Nov 22 came and went without any word from David Northcott from the FOS. He’d requested a response from The Society of Lloyd’s by that date on whether they believed the FOS has authority to investigate the non-UK complaint. 

We sent an email to David at the end of his work day on the 23rd and he immediately responded stating:

“Lloyd’s were chased up on the 21 November 2017 asking for a response to my letter of 8 November 2017. They were originally asked to respond by 22 November 2017.

I will continue to chase them. Once I have news I will update you again.”

Frustrated by a lack of response of The Society of Lloyd’s and now to even the FOS, we contacted our UK solicitor Daniel Crockford to see if he could assist in moving this forward. It appears to us that this could go on indefinitely since they do not feel any obligation to meet the deadline set by the FOS. We do face some legal time limits and we don’t want our back against the wall.

”More”

Daniel called Al soon after he talked with David. He said that David felt hopeful that the FOS would be investigating the complaint since it is a Lloyd’s policy AND the policy was written by LJJ a UK-based company. However, he felt they needed to wait for the response from Lloyds. He wanted to make sure that this did not become an issue after a decision was made by the FOS.

David also stated that he clearly understood our frustration as it is now more than 19 months since the claim was submitted. He stated that he felt positive that it would move forward based on his conversation with the judicial expert within the FOS. However he felt it was important to receive a response from them either agreeing or providing solid reasons why the FOS should not proceed.

So we continue to wait….

”Less”

Whoa…Not so Fast

STOP - US Complaints are not so simple

We started the process with the FOS on July 15 and were now waiting for an investigator who specializes in marine cases. But it wasn’t going to be that simple.

On Oct 10, we received an email from David Northcott an FOS adjudicator. It stated “I regret to confirm we are unable to consider your complaint as the policy complained about is not a UK-based policy. The full explanation as to why we don’t have jurisdiction is explained in my letter.” 

”More”

David followed up on Oct 16 with an email stating that he was aware that we had filed a complaint with the Indiana Department of Insurance (IDOI)In my previously assessment I said your complaint was one that we could not consider because on the basis of “Not a service from within UK” but now we cannot considered it because “Other ADR Entity dealing/dealt with”. That is to say another complaint arbitration scheme is dealing with your complaint.”

He gave us one day to respond before it would be put aside. We responded and requested additional time to receive a determination from the IDOI if they could even address the complaint. He said he would return to the office on Nov 1.

Nov 1, 2017 we sent David Northcott an email communicating that the  IDOI did not have statutory authority. We explained that it only made sense that their organization review the case since they ensured the FCA regulations that ProSight and LJJ Associates were to abide by.

David responded that he would “be able” to respond to us on Nov 8. We didn’t understand the reason for the delay. So we called him. He said that the case was very unique and “complicated” and he needed to talk with an “expert” to determine if they could proceed.

We explained that we believed that even though the policy was paid for in the US, the policy was written by a UK broker and underwritten by a Lloyd’s syndicate. Therefore, it should be heard by the FOS who enforced the FCA’s regulations.

On Nov 8, we received an email from David “As a result of the discussion, I have written today to the Society of Lloyd’s (the underwriters of the policy cover) to seek clarification on various points to include jurisdiction confirmation from it that we can deal with your complaint. They may raise reasons why they don’t think we can consider the complaint. Because the issues are complex in nature I have allowed until 22 November 2017 for a reply.”

We were shocked! It sounded like they were asking the financial institution that forced people into bankruptcy if they should be regulated or not. However, when we talked with David Northcott, he stated that he felt that the FOS should be able to investigate the case and the Society of Lloyds needed to put forth reasons the FOS shouldn’t proceed.

So we wait….again.

”Less”

The FOS and Lloyd’s of London Complaint Process

Financial Ombudsman Service

During one of our initial conversations with Daniel Crockford, he explained to us that in the UK there was an independent organization which would investigate unfair practices and denials called Financial Ombudsman Service (FOS). The FOS has a complaint process which is available to everyone with a Lloyd’s of London policy.

Background

The Financial Conduct Authority (FCA) regulates the financial and insurance industry of UK based companies including Lloyd’s of London. If an individual feels they are not treated fairly they can submit a complaint to the FOS and it will be investigated. If the FOS determines that the complainant is correct, the FOS has the authority to force the respondent to pay. Companies do not want cases heard by the FOS because the results are made public. An unfavorable decision reflects poorly on the company and most do not want that exposure.

”More”

This service is also free to the complainant, making it very attractive over seeking expensive legal council. Also in the UK court system the looser pays, significantly increasing the risk of the complainant. This service is intended to equal out the playing field of the large powerful corporation against the individual.

There is also the Lloyd’s of London complaint process. If you have a Lloyd’s of London policy, you can complain to them. In fact, you are supposed to complain to them prior to the FOS. They provide the opportunity for the syndicates internal complaint department to address it. If the result is not satisfactory to the complainants than there is a complaint process within the overseeing Society of Lloyds.

The SOL complaints department will hear the complaint and make a determination. According to the internet, the majority of the cases are overturned. However, if the individual is not satisfied, they still has the ability to go to the FOS.

Recent changes to Lloyd’s complaint process

FOS Complicated Complaint ProcessHere is where it starts to get convoluted.  Effective January 1, 2017, Lloyd’s of London changed their process. If the policyholder is non-UK, and the response from the syndicate’s complaint department is not acceptable, the individual is referred back to the department of insurance in the state where the policy was purchased.

 

Actual Authority

We went to the Indiana Department of Insurance where we live and Florida Department of Insurance where Blue Water Insurance is based. Neither have the authority to address the issues within their complaint process. Therefore, it appears that the Society of Lloyd’s sends us into a black hole and effectively the syndicates have no regulatory oversight. Our only option would be costly arbitration.

Daniel Crockford, our UK solicitor, believes that our case should be heard by the FOS.

Our policy was written in the UK by a FCA regulated company, LJJ. We paid for the policy via Blue Water Insurance, US broker. However, our policy is with LJJ Associates. The policy is underwritten by ProSight Syndicate 1110 which is also regulated by the FCA. The IDOI doesn’t have authority over these organizaitons, therefore it makes sense that our case is investigated by the FOS.

The procedural change is the Lloyd’s of London procedure and not the FOS complaints procedure. So we submitted our complaint to the FOS on July 15, a few days after we had received the final claim denial from ProSight’s complaint department.

”Less”

Submitted Complaint to Financial Ombudsman Service

Waiting for the Financial Ombudsman Service to respond to the submitted complaintOn July 16, 2017 we received an automatic response from the FOS acknowledging the submitted complaint. It said “If you haven’t heard from us, it’s worth checking our junk mail or spam folder to see if our response is there”

After the recommended three weeks of waiting and checking our junk mail on a regular basis, we call the FOS customer line. Moray Pringle answered the call. He pulled our submitted complaint from the queue and said he will look at it.

”More”

August 15, 2017 I followed up with Moray and he responded that ProSight submitted their data, but due to the format it is taking an extended period of time to load it into their system. We ask him if we can get a copy of the files they submit. He said that he can do that, but he may have to redact information that represents their internal process. Moray suggests that we request a copy of the documents from them. We respond, telling him that they have not been transparent. We believe it would be more efficient to get it from him.

August 31. Moray responds to our inquiry that it is still taking time to input the information from ProSight.

Sept 15. Moray says that they are still technically delayed in uploading the data.

Sept 27. Moray says that the data has now been uploaded. “After having a brief look over what’s involved, I feel I personally may not be best placed to look into your complaint due to the complexity and depth of the situation. There is somebody within the organisation that specialises in marine insurance, however she isn’t due to return to the office until 10 October at the earliest. Can you let me know if you would be happy to wait for her to return for your complaint to be investigated?”

Watching the calendar after submitting complaintWe agree to wait until Oct 10, 2017 for the more marine knowledgeable investigator.

”Less”

Prepare Complaints Against ProSight & LJJ Associates

Have to Complain Against ProSightOur UK solicitor, Daniel Crockford advised us to prepare complaints and file them with ProSight. We needed to objectively lay out the facts and evidence. Perhaps a new set of eyes within their organization would see the problems and recommend a settlement.  If that was unsuccessful, we should then go to the Financial Ombudsman Service and file the complaints with them.

”More”

Prepare Complaints

Prepare Complaints - LOTS of work

Over the next two months we prepared and accumulated  documents. Another report was written by Bill Trenkle, addressing the seaworthiness question. Jay Butler of Butler rigging inspected the remaining rigging verifying that they were in good condition. We accumulated the maintenance information information which demonstrated the money and effort expended. Each issue in the Hill Dickinson letter denying the claim without prejudice was addressed.  We kept going over and over the documents critiquing and improving them, doing our best to organize it logically. We knew that the technical issues needed to be made as clear as possible to a lay person.

Daniel reviewed the documents and was highly complementary stating that if we have to go to court, most of the work has already been done.

Theft & Damage Complaints

We also filed a complaint about the theft and damage claims which have not been processed. ProSight’s position is that we have to go thru our attorney to submit them. This was stated clearly by Wayne Scott of LJJ in a letter.

File the Complaints and Wait

Crossing off the days, waiting for a complaint response

We submit the two complaints on May 21, 2016. Our understanding is that it could take up to 8 weeks for them to respond. While we don’t like it, it seems reasonable as the case has some complex information in it.

”Less”