Ombudsman of Financial Services
Bank Negara Malaysia
Jabatan LINK & Pejabat Wilayah
Bank Negara Malaysia
P.O. Box 10922
50929 Kuala Lumpur
Tel: 1-300-88-5465 (Overseas: +603-2174 1717)
Fax: +603-2174 1515 E-mail: email@example.com
Pillar 4: FAIR, TIMELY AND TRANSPARENT CLAIMS SETTLEMENT PROCESS
A. We set clear timeline for claims settlement process and strive to settle claims within these prescribed timeline and in a transparent manner.
1. We will inform you of the estimated time taken for claims settlement process and the expected service standard through various channels (i.e. branches / call center / website / email).
2. We will inform you of the acknowledgment of your claim within 7 working days from the receipt of claims submission.
3. We will ensure that our agents forward all claims submitted through them to us within 3 working days, except for crime related claims which should be notified within 24 hours from the time of loss.
4. If documentation/information is incomplete, we will inform you within 14 working days from the acknowledgement of the claims.
5. We will advise you on the key claims procedures including the appointment of adjuster, claims assessment etc, and also the assigned timelines.
6. We will update you on the progress of the claim every 14 working days. We will inform you of the decision once it is finalised.
7. In the event of a catastrophe / disaster we may receive a large number of claims, as such, meeting the timelines stipulated may not be possible. We will aim to provide updates every 20 working days.
B. We provide information to you on the next level of escalation if the claims settlement or rejection is not to your satisfaction
1. We will provide you with available channels for you to appeal on a decision or for you to raise disputes (i.e. branches / call center / website / email).
2. The statement below will be stated clearly on the decision letter to you if the claim is not approved, or the amount is not the same as what you have claimed. This is for claims that are within the purview of the Financial Ombudsman Scheme.
“Any person who is not satisfied with the decision of the Insurer / Takaful Operator, should refer to the procedure for appeal as stated in the leaflet issued by the Financial Ombudsman Scheme, entitled: ………”