Compliance

Internal Enquiry and Complaints Handling

Introduction
Receiving a Complaint or Enquiry
1. Receiving an Enquiry
2. Receiving a Complaint
Recording Complaints and Enquiries
Responding to Enquires
Responding to Complaints
Complaints in Relation to TOWER Australia's Agents
Resolving Complaints
Monitoring and Reporting
Failure to Comply with Complaint Handling Procedures
Appendix

1. Introduction

The following procedures relate to complaints and enquiries received from policyholders, members of superannuation funds, external trustees or their representatives and investors in managed investment schemes.

At TOWER, we take enquiries and complaints seriously and our objective will always be to resolve the issue in the shortest time possible. An initial enquiry could easily turn into a complaint if a speedy response is not provided.

Some complaints do take longer to resolve, however, there are certain compliance requirements in place to ensure that a solution is reached within a maximum number of days. These procedures are documented in line with the Life Insurance Code of Practice (Code) and the Superannuation Industry (Supervision) Act 1993 (SIS), the Superannuation (Resolution of Complaints) Act (S(RC) Act), the Corporations Law and the Australian Standard on Complaint Handling (AS 4269-1995), and show the maximum number of days in order to comply with the legal requirements.

Please note the procedures for dealing with enquiries is slightly different to the procedures for dealing with complaints.

A complaint is any expression of dissatisfaction accompanied by a request to rectify the problem.

Any interested party (ie policyowner, life insured, other interested or authorised party, unitholders, custodian, researchers or adviser) is able to lodge a complaint. However, adviser complaints will not relate to commission matters, trip credits or similar agency related matters.

Where a complaint is received via an external complaints body the same rules apply, except that a reply must be sent within the stipulated time identified by the external body, but ideally within 10 days.

2. Receiving a Complaint or Enquiry

2.1 Receiving an Enquiry

If you receive a written enquiry it must be immediately (that day) taken (personally if possible) to the area which will be responsible for replying. If an enquiry is received at a state office, the date of receipt must be recorded and the enquiry sent to the relevant area in the overnight bag. That area must be one of the following (in all instances a Redirection Advice form (Appendix B) is to be attached to the correspondence):-

Individual Business
TOWER Policies & FAI
Team Leader Communications, Sydney
TOWER Employee Benefits
Claims Manager
Specialised Products
TMFL

These are the five areas that will be responsible for ensuring that all enquiries are answered.

If you do not know the appropriate area that should handle the enquiry take it to your Manager or the National Manager Customer Relations, or in the case of Melbourne, the Manager, Administration South.

Note: Enquiry handling procedures are currently under review and the above instructions will be brought up to date at the completion of the review.

2.2 Receiving a Complaint

If you receive a complaint it must be immediately (that day) taken (personally if possible) to the responsible area as detailed in Appendix A1 to these instructions. Interstate offices are to record the date of receipt on the correspondence and, if appropriate, forward it to the responsible area by overnight bag.

In all instances a Redirection Advice form (Appendix B) is to be attached to the correspondence.

If you are unsure as to which area to forward a particular complaint to, please refer to your manager who will decide (in conjunction with the Complaints Resolution Officer (CRO) where necessary) the correct responsible area.

Where a complaint is received by TMFL, it must immediately be given to the National Manager, TOWER Managed Funds Ltd for a determination on which officer (i.e. CRO, Special Products complaint officer or TMFL) should deal with the complaint. Where the CRO is not the officer handling the complaint, the National Manager will provide the CRO with a copy of the complaint and the name of the officer handling the complaint. The Complaints Resolution Officer will perform the necessary recording and follow up to ensure that resolution deadlines are met.

Procedural flowchart is detailed in Appendix A2

3. Recording Complaints and Enquiries

All complaints and enquiries must be immediately recorded on the appropriate workflow system (BPM or Scanning) and the Complaints Register. The area responsible for handling the matter is responsible for ensuring this is done.

Complaints being handled by TMFL will however be recorded onto BPM by the Complaints Resolution Officer (CRO).

To enable further on-going monitoring of a complaint (particularly that required time frames are being met) the Complaints Register is to be kept up to date with brief comments on actions taken or being taken.

Appendix 3 is a suggested worksheet for use if the nominated complaint officer believes an outline summary of the case is worthwhile. It is not mandatory to use that form.

The recording of complaints will be monitored by the CRO on a monthly basis. The CRO will prepare a report each month based on the complaints data. The CRO is also required to report to the Risk & Compliance Manager monthly on the level of compliance with the terms of the procedures and legislative requirements for complaints resolution.

If an area is unable to meet the terms of these requirements they will be required to provide details on the nature and extent of the compliance failure.

4. Responding to Enquires

Where a written enquiry is received seeking information about an existing policy, including the variation or termination of a life policy, the following procedures are to be followed:

Ensure that your area is the appropriate area to answer the enquiry. If not, immediately take it to the area that should be responsible for answering it. When redirecting an enquiry an Inter-departmental Redirection Advice form must be used (Appendix B) and forwarded within 1 day. Where 5 working days have passed before the enquiry is passed on to the appropriate area, the Inter-departmental Redirection Advice must be sent by the Manager of the forwarding department to the Manager of the receiving department (copy to the person who initially received it). Both managers must sign the form;
Record the enquiry on the appropriate workflow system (BPM or scanning);
If the enquiry cannot be answered immediately (e.g. investigation required) send an acknowledgment letter in the form of Appendix G to the enquirer within a maximum of 5 working days (ideally, within 2 days) of receipt of the enquiry;
The enquiry is to be answered in writing within a maximum of 20 working days (ideally, within 10 days) of receipt of the enquiry (note, this is a requirement of the Code);
Where you are unable to answer the enquiry within 10 days a second acknowledgment letter (Appendix H) is to be sent to the enquirer within a maximum of 20 working days (ideally, within 15 days) of receipt of the enquiry. A copy of this letter is to be sent to the National Manager, Customer Relations. Remember you must have exceptional grounds for not being able to answer an enquiry within the time period.

5. Responding to Complaints

The following procedures are to be followed:

Ensure that your area is the appropriate area to handle the complaint. If not, immediately refer to Appendix A1 and then take the complaint to the appropriate area. When redirecting a complaint an Inter-departmental Redirection Advice form must be used (Appendix B) and forwarded within 1 day. Where 5 working days have passed before the complaint is passed on to the appropriate area the Inter-Departmental Redirection Advice must be sent by the Manager of the forwarding department to the Manager/Team Leader of the receiving department. The individual who mis-sent the complaint in the first instance is to be informed, and both Managers must sign the form;
Record the complaint on the appropriate workflow system (BPM or scanning) and Complaints Register;
The nominated Complaints Officer from the responsible area must manage the complaint process to completion;
If the complaint cannot be handled immediately (investigation required), an acknowledgment letter (Appendix C) is to be sent to the complainant within a maximum of 10 days (ideally, within 5 days) of receipt of the complaint;
The complaint must be resolved within a maximum of 45 days from the date it was received. Within the 45 day period, a complainant is to be informed no later than 15 days after a complaint has been dealt with, the reasons for the decision reached, the details of any proposed resolution as well as details of further avenues available for the person i.e. external dispute resolution bodies available.

If the complaint has not been resolved, or is unlikely to be resolved, at the time the 45 days period expires, the client is to be contacted by telephone with an explanation of the reason(s) for the delay and an extension requested. Letter (Appendix D) is to be sent in confirmation.

Note the above is specifically required by the Code.
Where additional information or investigation is required on a complaint or enquiry from a specific area, a request for report (Appendix E or Appendix F) must be completed and sent. This will either be sent to another department in TOWER (Appendix E) or to a Sales Manager (copies to the Sales Director and State Manager) (Appendix F) where an Agent’s conduct is questioned. The report must contain a recommendation and must be completed within 7 working days. If the area cannot respond within this period they must provide the person requesting the information with documented reasons. A reminder via E-mail is to be sent by the responsible area to the specific area one day prior to the expiry of the specified time limit (7 working days). If neither a reply or documented reasons for the delay is received it will be recorded and the relevant Director and CRO notified;
The responsible area will respond to the complainant, record the date of resolution and the outcome on the Complaints Register (and BPM where in use).

6. Complaints in Relation to TOWER Australia's Agents

Where a complaint is received about a current or ex agent of TOWER, a detailed report from the agent must be obtained. To obtain a report, a Request for Agent Report form is to be sent to the appropriate Sales Manager (copy to the General Manager TOWER Adviser Services and State Manager) by the Complaints Resolution Officer. A copy of the request form is contained in Appendix F.

The Sales Manager has 7 working days in which to obtain a report from the agent. If the Sales Manager is unable to meet this deadline, they must notify the Complaints Resolution Officer in writing providing the reasons for the delay. The Complaints Resolution Officer must notify the appropriate State Manager if the Sales Manager fails to meet this deadline.

A copy of the request form must accompany the agent’s report when it is returned to the Complaints Resolution Officer.

7. Resolving Complaints

Complaints must be resolved in accordance with Authorities and Delegations.

The authorities and delegations manual sets out those staff who have the authority to authorise specific courses of action in respect of complaints.

8. Monitoring and Reporting

Complaint handling statistics are to be collated on a monthly basis by each department and included in end of month departmental reports.

Failure to meet stipulated time-frames and procedural requirements will be included in the monthly SILC return by the CRO.

In addition to routine management reporting, the CRO will also provide a monthly report, in a form to be agreed from time to time, on the complaints position to the Risk & Compliance Manager.

9. Failure to Comply with Complaint Handling Procedures

An officer's or an area's non-compliance with TOWER’s complaint handling procedures will be recorded as a failure to meet departmental and company objectives. If an area is having difficulty complying with the procedures the relevant manager is to be immediately informed.

The procedures are meant to be of assistance to TOWER in providing the best possible service to its customers as well as enabling TOWER to comply legally. Because of TOWER’s legal obligations any non-compliance will be recorded and the officer or departmental representative requested to explain. Any serious non-compliance by an officer may also result in their dismissal.

Appendix

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