What to expect once you’ve brought your complaint to us.
When you bring your complaint to us – and we’ve checked it’s something we can help with – you’ll be given a case handler to look into your complaint. Your case handler will:
- ask the claims management company (CMC) for their side of the story
- weigh up the facts of what’s happened, fairly and impartially
- tell you and the CMC what we think
If we think there’s just been a misunderstanding – or you haven’t lost out – we’ll explain why. But if we decide you’ve been treated unfairly, we’ll tell the CMC to put things right.
When you get in touch with us your complaint may be taken on by a case handler there and then. Other times we’ll need to find the right person for your complaint, and they’ll get in touch when they’re ready to start looking into it. Either way, your case handler will introduce themselves and ask you for anything important that you haven’t already given us – such as a copy of the final response the CMC sent to you.
They’ll also get in touch with the CMC – either to get their side of the story, or to give them a chance to look at your complaint if they haven’t already.
After we’ve heard from the CMC, we’ll look at all the information we have. We might request more details from you or the CMC, or you may want to give us more information to look at.
How we’ll communicate with you
We usually sort things out over the phone and in writing – so we won’t usually ask you to discuss your complaint face to face. We will be clear and straightforward in the way we communicate and we won’t use jargon.
We can also communicate with you using things like large text, Braille, British Sign Language or Next Generation Text. Find out more about how we make our service accessible to customers with additional needs.
We’ll keep you updated about your case while we’re looking into things, and you can get in touch with us at any point if you have any questions.
Telling you what we think
When we’ve reviewed everything you and the CMC have told us, we’ll let you know whether we think the CMC treated you fairly or not. We’ll always explain the reasons behind our view. If we think the CMC treated you unfairly, we’ll say what they need to do to put things right.
Both you and the CMC have a chance to agree or disagree with what we’ve recommended. At this point, if both you and the CMC agree with what we’ve said, the matter is settled.
If you disagree with what we said – and have more information that you think will change our view – let us know. We may change our view, or it might stay the same – we’ll tell you why either way.
Taking your complaint further
If you or the CMC don’t want to accept what we’ve said, you can ask for your case to be referred to an ombudsman.
The ombudsman will then look at all the details of your complaint, and make a final decision.
If you accept the ombudsman’s decision, the CMC has to do what the ombudsman has told them to. This might, for example, include requiring the business to pay you compensation.
If you don’t want to accept the ombudsman’s decision you don’t have to. But it does mean our involvement has come to an end and the CMC doesn’t need to do anything. You can still take your complaint to court, but we won’t be involved in this.
How long it takes
It is currently taking around one month for us to allocate most CMC complaints to a case handler for review.
How long it takes to sort out your complaint after that depends on how complex it is – and how long it takes to get all the information we need. If there’s just been a misunderstanding we can often sort things out very quickly. If things are more complex, it will probably take longer. It will also take longer if you or the CMC don’t agree with what we say, and want an ombudsman to make a formal, final decision.
When you get in touch with us about your complaint, let us know if your situation is urgent – for example, if you’re seriously ill or in financial difficulty.
Putting things right
If we decide a CMC has treated you unfairly, we’ll tell them what they should do to put things right.
Sometimes we’ll ask the CMC to pay you compensation. This may be because we think you lost out financially as a result of something they did wrong. Or it might be because the actions of the CMC meant that you experienced trouble and upset.
Read more about our approach to calculating compensation.
If you’re unhappy about our service
We want to give you the best possible level of customer service, whatever the outcome of your complaint. But if you’re not happy with the way we’ve handled your case, you can complain.
Find out how to complain about the service we’ve given you.