These are complaints escalated to a senior authority for independent review and adjudication. These referrals may come from either the complaints divisions of the business themselves or the complainants directly. In some cases, these complex complaints are referred internally to managers or forums within the business. However, there is a growing trend in the industry to outsource the function to ensure customers receive a fair and independent review of their complaint.

This is a unique service offering which certain major insurers have implemented in recent years. Some major Insurers have incorporated the use of adjudication or arbitrator services for the purposes of improving on customer complaint outcomes. This has translated into improved Ombudsman statistics, cost savings and outcomes for their customers.

The focus is on an independent, senior functionary who has the sufficient experience and expertise to manage this important area of work. This has proved effective for the following main reasons

• Independent decision making
• Cost effectiveness
• A more considered outcome for customers.

This model can be adapted to suit the structure of any financial services provider in the insurance industry including insurance companies, brokers, administrators and underwriting managers.