Introduction
Resilience Insurance Pty Ltd (referred to in this Complaints Policy as “Resilience”, “We”, Our, or “Us”) is licensed to carry on financial services in Australia subject to the terms and conditions of its Australian Financial Services License (“AFSL”).
As a condition of Our AFSL, Resilience has an internal dispute resolution (“IDR”) process for handling complaints and is also required be a member of an external dispute resolution (“EDR”) scheme for specific types of policy, such as retail insurance products. For those retail insurance products, Resilience is a member of the Australian Financial Complaints Authority (AFCA), that is the independent body charged with dealing with external complaints. For other insurance product (those other than retail insurance products), such as Latent Defects Insurance (“LDI”), We participate in EDR in forums other than AFCA. More detail about alternate EDR options for LDI and policies other than retail insurance products is provided further in ‘Stage 3’ of this document.
You may complain about any aspect of your relationship with Us and We have a Complaints and Disputes Resolution Process in place to address those complaints. The Resilience complaints and disputes resolution service is free of charge
Scope
This Resilience Complaints Policy applies to complaints made by customers, direct customers or not.
What is a complaint?
A complaint as an expression of dissatisfaction made to or about Resilience, related to its products, services, staff or the handling of a complaint, where a response or resolution is explicitly or implicitly expected or legally required. A complaint can be made in writing or orally. You may complain about any aspect of your relationship with Resilience.
An expression or complaint made on social media channels or accounts administered by Resilience is also considered a complaint, where the author is identifiable and contactable.
A response or resolution is ‘explicitly expected’ if you clearly request it. It is ‘implicitly expected’ if you raise the expression of dissatisfaction in a way that implies you reasonably expect Resilience to respond and/or take specific action.
A complaint does not have to expressly state the words ‘complaint’ or ‘dispute’.
Three Stages of Complaints Handling
Stage 1 - Making a complaint or raising a dispute
If you are dissatisfied with any aspect of your relationship with Resilience and wish to make a complaint, please contact Us at:
Complaints Manager
Resilience Insurance Pty Ltd
Level 2, 2 Glen Street
Milsons Point NSW 2061
Email: complaints@resilienceinsurance.com.au
Phone: 1300 073 745
We are flexible about how you lodge your complaint.
A complaint does not need to be lodged in writing. If you require assistance to lodge a complaint, We would be pleased to discuss the matter with you.
We will also accept a complaint lodged on your behalf by a representative that you nominate.
To assist Us in dealing with your complaint, please provide Us with your claim or policy number (if applicable) and as much information as you can about the reason for your complaint.
Once We receive your complaint, We will:
- within one (1) business day of receipt, acknowledge receipt of your complaint. We will inform you of the name and relevant contact details of any people assigned to manage your complaint;
- within five (5) business days, if We can resolve the complaint to your satisfaction, or We have given you an explanation and/or apology when We can take no further action to reasonably address the complaint, we will not be required to respond to your complaint in writing, unless you make this request, or the complaint relates to hardship, a declined insurance claim or the value of an insurance claim;
- investigate your complaint and keep you informed of the progress of Our investigation every ten (10) business days, unless the complaint is resolved earlier or We have agreed with you to a different timeframe;
- only ask you for, and rely on, information that is relevant to Our decision;
- aim to respond to your complaint in writing within fifteen (15) business days, although in all cases We will make Our decision and respond to you in writing within thirty (30) calendar days. If We require further time, We will work with you to agree a different timeframe. In our written response, We will explain your right, if you are not satisfied with the decision, to request the complaint be referred to Stage 2; and
- within ten (10) business days of you making such a request, We will provide you with the information We relied upon in making Our decision.
Stage 2 - Internal Disputes Resolution - IDR
If you advise us that you wish to take your complaint to Stage 2, your complaint will be reviewed by Our IDR Team, who are independent from the staff members that were involved with the decision or conduct which is subject of the complaint, or the staff member that handled the complaint at Stage 1.
The IDR Team will aim to respond to your complaint in writing within fifteen (15) business days of receipt of the escalation of the complaint to the IDR process, although in all cases we will make Our decision and respond to you in writing within thirty (30) calendar days of receipt of the escalated complaint. If We require further time, We will work with you to agree a different timeframe. In our written response, We will explain your right, if you are not satisfied with the decision, you can escalated the complaint to an external service or forum as set out in Stage 3 below
Stage 3
If you are dissatisfied with the decision in Stage 2, or We are unable to resolve your complaint to your satisfaction within thirty (30) calendar days, you may refer your complaint for EDR.
Importantly, determining the correct forum for your complaint or dispute to be considered, you need to understand if your complaint relates to an insurance product that is a retail insurance product or not. EDR matters for retail insurance products are generally considered by AFCA. However, AFCA do not generally consider EDR matters outside of these products.
To assist in understanding which forum your complaint or dispute should be referred to, you can use the table below that sets out if it is a product to which AFCA would generally consider a complaint or dispute, or you can visit the AFCA website at www.afca.org.au for further information. Determining the appropriate forum for referral of an EDR matter, please use the table below, setting out the insurance products Resilience currently offers and the appropriate mechanisms available to have EDR matters considered.
Insurance product or category
AFCA complaints considered
Other EDR forums
Latent Defects Insurance – LDI
Contract Works Insurance
General Liability Insurance
Currently there are not any products that Resilience offer, to which AFCA would generally consider a complaint, however that will likely change in the future. While AFCA may not generally consider your complaint, there may be useful information on the AFCA website that could assist you with any complaint that you may wish to escalate to EDR.
While AFCA do not consider complaints for LDI or products currently distributed by Resilience, there are various mechanisms available to you to consider your EDR options, some of these are free or low-cost services. Some options open to you, for an alternate EDR service to that offered by AFCA may include:
- An ombudsman in the State or Territory where you reside
- A dispute resolution service, which may even be able to facilitate mediation or other mechanisms of support
- Legal Aid services in your State or Territory
- The relevant State or Territory Consumer Affairs or Fair Trading body
- The Insurance Law Service at www.financialrights.org.au
- Community Legal Centers near you which you can locate at www.clcs.org.au
You can determine the most appropriate forum in which to escalate your complaint or dispute, which may include more formal dispute resolution, such as litigation. You should seek your own advice on which option is best for you, which may include any or more of the above forums.
Privacy
We collect, use, store, disclose and destroy your personal information in accordance with the Australian Privacy Principles and in accordance with our Privacy Policy available online at resilienceinsurance.com.au
More Information
If you would like to discuss this Complaints Policy further or if you have questions about our Complaints Policy, please contact us at:
Complaints Manager
Resilience Insurance Pty Ltd
Level 2, 2 Glen Street
Milsons Point NSW 2061
Email: complaints@resilienceinsurance.com.au
Phone: 1300 073 745