60 seconds with Mark Smith
Mon 12 Aug 2013
From stolen asteroids and missing violins to transporting giraffes, complaints from Lloyd’s policyholders around the world can arise from the most unusual circumstances – and responding accordingly is all in a day’s work for Mark Smith, Policyholder & Market Assistance Team Leader at Lloyd’s.
What does the Policyholder and Market Assistance team do?
PAMA, as we are commonly referred to, is responsible for Lloyd’s response to complaints received from Lloyd’s policyholders around the world. We are also key players in Lloyd’s response in the event of a major catastrophe; especially if one occurs where our underwriters provide insurance coverage to personal lines customers and small businesses. For example, in the immediate aftermath of a major hurricane in the US we will be heavily involved in the fielding of enquiries and requests for assistance from individual consumers and the state regulators from the affected states.
What does the average day involve for someone in your team?
The team will receive complaints from policyholders, their representatives or other bodies – notably the Financial Ombudsman Service (FOS) in the UK and the various state insurance departments throughout the USA. The initial task is to identify the interested underwriters and make them aware of the complaint; giving them the opportunity to respond and resolve the matter. If they do not resolve a complaint to the policyholders’ satisfaction the policyholder is entitled to request a formal decision from Lloyd’s. In those circumstances our case officers will review underwriters’ papers and issue a decision on behalf of Lloyd’s. Where appropriate we will engage with underwriters on the policyholders’ behalf if we believe a complaint is “justified” and the underwriters need to alter their position to some degree; this may include asking underwriters to pay claims which have previously been denied.
What’s the most unusual complaint you have received?
There have been several, believe me:
We have been asked to decide the appropriate settlement figure for a sizeable piece of an asteroid a gentleman in Australia had insured at Lloyd’s and which was stolen.
We had a complaint from the owner of a safari park in Malaysia who had insured four giraffes for transportation from South Africa. Regrettably one died in its crate during transport but the other three were released into a wholly inadequate compound, against the advice of the accompanying vet; the fencing broke almost immediately, injured the three remaining giraffes and they had to be destroyed.
We had a Lieutenant from the armed services who thought it a good idea to park his brand new Jaguar on the pavement outside his local pizza restaurant to collect a takeaway pizza and not only leave the car unlocked but he also left the engine running. Not the greatest surprise that it was stolen!
We also had a gentleman who was a virtuoso violinist and who was travelling in India with a violin worth in excess of £40,000. One afternoon he fell asleep on a train and when he awoke he realised he was at his stop so he quickly jumped off the train but regrettably he left his violin behind on the luggage rack above his seat.
And just recently we received a complaint in respect of a claim following the seizure of a vessel and its crew by pirates off the coast of Somalia.
How many complaints do we receive? How quickly do we reply?
At present we receive roughly 3,000 a year although we expect the number to rise as the reporting requirements of the new Code take effect (see below). Over 80% of our cases are handled within eight weeks, fulfilling our regulatory obligations.
Lloyd’s recently launched a new Code for managing agents and their representatives with regard to handling of UK complaints. What does the Code cover?
The Regulator in the UK (the Financial Conduct Authority) requires that Lloyd’s “establish and maintain appropriate and effective procedures for handling complaints by policyholders.” We are also charged with ensuring that the businesses underwriting in our Market comply with those rules. The “UK Personal Lines Claims & Complaints Handling Code,” to give it its full name, is Lloyd’s response to this regulatory obligation; ensuring that the Market is aware of what they need to do in order to comply with the Code. This Code was recently revised and updated by Lloyd’s as part of an on-going review to strengthen and enhance our service to policyholders.
What makes this version of the Code better?
The new Code gives greater clarity of Lloyd’s expectations to all in the Market. It also explains our regulatory obligations and what the Market (and anybody acting on behalf of underwriters, such as a coverholder or a third party administrator (TPA)) needs to do to ensure that we are able to fulfil those obligations.
The previous Code was issued 12 years ago and since in that time there haved naturally been a number of changes to the FCA (previously the FSA) Handbook in which the requirements for the treatment of complaints are detailed. The new Code not only informs the Market as to what is required it also says why we need them to act as requested and gives appropriate reference points to the FCA Handbook where the Regulator outlines the requirements.
The only significant change introduced in the new Code is a requirement that PAMA is now notified of all complaints raised by Lloyd’s UK policyholders, whether they are received directly by managing agents, coverholders or TPAs. Previously, Lloyd’s was only aware of complaints when policyholders had sought PAMA’s input directly or perhaps via the FOS. We will now have a far greater understanding of all complaints, both in terms of numbers as well as the types of complaints being received.
Since the introduction of the new Code Lloyd’s has conducted complaints handling workshops at various locations around the UK, including London, Birmingham, Manchester, Bristol and Edinburgh where over 400 people attended. The attendees received an explanation of the Code, participated in some interesting and interactive case studies and were given the opportunity to meet some of the PAMA and Delegated Authorities teams.
Peter Montanaro, Head, Delegated Authorities said: “It was a great opportunity to meet with some of our UK coverholders and understand at first hand some of the challenges they face when dealing with complaints. The format of the presentations worked extremely well and, given the high level of engagement by the attendees, I think the Delegated Authority Team will steal some of PAMA’s good ideas and do our own ‘UK Roadshow’ next year”.
Paul Jeffrey, Delegated Underwriting Manager at Kiln said: “The sessions I attended in Birmingham opened my mind up to the very real chance that any complacency towards complaints handling processes would expose managing agents..
It is thanks to the excellent session Lloyd's delivered that I am totally committed to ensuring that Kiln's customers’ needs come first in all underwriting decisions and ensuring all my colleagues within Kiln equally understand the importance.
Further information is available at www.lloyds.com/complaintshandling