An ombud’s guide to dealing with high-maintenance complainants

There has been a steady increase in unreasonable conduct on the part of people complaining to the Ombudsman for Long Term Insurance‚ fuelled by what Ron McLaren describes as “anger‚ frustration and an exaggerated sense of entitlement”.

By all accounts‚ this is a global phenomenon‚ McLaren says in his 2015 annual report‚ released on Tuesday. But while such complainants are in the minority‚ they clearly present enough of a challenge to the office to warrant a detailed mention in the report.

The office provides consumers with an independent‚ free dispute resolution service when they feel they are not treated fairly by long term insurance companies.

Also read: Ombudsman helps consumers recover R184.4m from long-term insurers‚ even as unreasonable complaints climb

More than 9800 written requests for intervention were received last year‚ among them several from those unreasonable‚ entitled folk.

“There seems to be a correlation between unusually persistent‚ or ‘high maintenance’ complainants‚ and complex complaints‚” McLaren said. “They just seem to go together – which can make life difficult.”

Here’s how the office staff can tell they have a difficult one on their hands:

- They exhibit unreasonable behaviour‚ arguments or demands and a lack of co-operation.

 - They claim to be seeking “justice” or “a moral outcome”‚ and they often appear to focus rigidly on a “principle”. “One kept a tally of the number of hours he spent working on the complaint‚” McLaren said. “It had reached over 400 hours before a final determination‚ dismissing his complaint‚ put an end to what appears to have been a pleasurable pastime.”

- They make inappropriate use of medical or legal terms in correspondence. “For instance‚ a letter which starts with a greeting in Latin is a dead giveaway.”

- They use highlighters for emphasis‚ repeatedly underline words and make copious marginal notes.

- They use “increasingly frenetic and energised communication styles”. One complainant wrote 10 letters to the office in two days.

- They lodge a complaint against the ombudsman’s office itself. “It can be an unnerving form of intimidation‚ which could be aimed at manipulating the office towards a favourable complaint outcome‚” McLaren said.

And here’s how the office deals with these “difficult” complainants‚ in McLaren’s words. Much of it is very useful advice for anyone whose job involves fielding complaints from the public:

- Prevention is better than cure. An effective and efficient complaints handling process presents less opportunity and less scope for unreasonable complainant conduct.

- Manage complainant expectations — unrealistic or even simply incorrect complainant expectations are fertile breeding ground for unreasonable conduct.

- Give reasons for rulings. Some complainants only resort to unreasonable conduct after receiving an unfavourable complaint outcome. If adequate reasons are given for a decision‚ this may avert unreasonable behaviour.

- Stay in control. If a complainant makes any attempt to take over the ombudsman’s office’s function‚ he or she is politely‚ but firmly‚ told to desist.

- Make personal contact. “It has been our experience that complainants who write the rudest and most insulting letters are often meek and mild in a personal meeting or a telephone conversation‚” McLaren said.

- Finally‚ and no doubt the most challenging advice — “Never lose your cool!”

* Last year‚ the Ombudsman for Long-Term Insurance recovered R184‚4-million in the form of lump sums for consumers from long-term insurance companies during 2015 and complainants received more than R577 000 in compensation for poor service.

Denied claims made up the lion’s share of total complaints at 55%‚ with funeral policies (35%) and life cover (31%) dominating the complaints. Less than 30% of cases were resolved in favour of consumers.

For the full report‚ go to


- TMG Digital/The Times

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