I am often asked, “What is an Ombudsman?”, when people learn about my role as a Consumer Service Officer (CSO) with the General Insurance OmbudService (GIO). I will take this opportunity to provide a summary of the role while touching on the subjects of being an effective complaint handler and complainant.

As a CSO, I work with policy holders who have complaints against their own insurers regarding automobile, property and business insurance in Canada. I act in an independent and impartial manner while seeking to help complainants. The GIO’s services are free to policy holders. Normally, there is no charge to approach an Ombudsman. I endeavor to find ways to help complainants in a multitude of ways.

Complainant Assistance

Assistance can come in many forms. Sometimes, it is a matter of listening and allowing the complainant to vent. Listening is a powerful tool which can show respect for the person while validating the person.

Another form of assistance can come in my role as a subject matter expert. The use of knowledge is illustrated by delving into the particular legislation, Insurance Act, insurance policy wordings, other contractual wordings and/or exhibiting an understanding of the processes utilized by stake holders involved in the particular situation. I believe that knowledge should be used as a key to illuminate understanding and allow an individual to focus and realize the key underpinnings of their situation. Knowledge can provide the necessary information that helps the complainant find resolution. Normally, complainants want to find ways to obtain assistance, find ways to help themselves and/or understand what is happening and what can or cannot be done. I think knowledge is poorly used when it becomes a sledge hammer to force compliance because it does not normally cultivate a spirit of understanding and co-operation. In other words, a person can be shown to have a lack of understanding of the rules/contract wordings/legislation in a manner which demonstrates patience, humility and respect.

I believe that an effective Ombudsman recognizes the importance of intellect and emotional intelligence. By emotional intelligence, I am referring to an individual’s ability to navigate the social environment to achieve positive relationships. While it is helpful to know the subject matter at hand, it is vitally important to communicate the subject matter in a manner that encourages the parties to reach an understanding without labeling anyone (i.e. the individual is ignorant and so on).

The real strategy is to avoid an adversarial mentality. In a battle or warfare, it is difficult to create a solution which allows both parties to win (“win-win” solution). An attitude which disarms individuals and focuses on ways to resolve the situation will help avoid the pitfalls of condemnation, name calling and behavioral attacks. It is a cliché but there is truth to the old adage which says, “It is not what you say but how you say it”. Thus, it is especially important in conflict management, to build rapport by overcoming a confrontational stance in order to seek resolution.

Rapport Building

Rapport building does not necessarily mean that the parties involved in the situation have to like one another. I believe the Ombudsman should treat complainants with politeness and demonstrate a sense of urgency in attending to complainants’ situations. The Ombudsman can set the tone in dealing with complainants. Complainants are smart and will detect disdain, apathy or lack of commitment. It takes a special desire and willingness to put the interests of complainants before one’s own interest. It is this selfless attitude which will reap many rewards.

Complainants will normally “care back” when they realize that their interests are being put first. This is the main reason I am passionate about my career at GIO – I put people first. Part of putting people first is being genuine, sincere and grateful for the opportunity to use one’s skills to provide assistance. After all is said and done, a person feels important when they are treated as being important.

There are other key aspects in addition to rapport building that allows an Ombudsman to be effective. Some other aspects include:

1. Ensuring privacy and confidentiality
2. Keeping one’s word and calling the complainant within the agreed upon times
3. Providing useful information in a timely manner
4. Having some efficacy in dealing with the institution/organization that is the source of the complaint
5. Having some formal authority to resolve disputes (i.e. mediation and/or adjudication)
6. Strong organizational skills
7. Infrastructure that allows quick and easy access to needed resources
8. Strong work ethic
9. Supportive culture from management and colleagues
10. Buy in from all stake holders regarding the complaint handling process

I believe it is a privilege to help complainants. I also believe that complaints are a natural component of life because certain expectations or desired results are not always met.

Coming to a Resolution

Many of the elements previously described about being an effective Ombudsman could also apply to being an effective complainant (i.e. respectful, good listener, and so on). Here are a few more tips on useful complaining:

1. Try to be succinct - focus on the particular area of the disagreement;
2. Have dates/times/names/titles of people to provide a chronological order of the circumstances;
3. Find out about the complaint handling process within the institution;
4. Learn about the particular rules/ contract wordings/legislation that is applicable to the situation; and
5. Try not to blame but seek ways to resolve the situation.

In both cases, an Ombudsman and complainant will garner more effectiveness when each seeks resolution. After all, a complaint exists for the purpose of finding a resolution.

Peter Boos is an Advisor on CIM’s Toronto Board of Directors. He also works at the General Insurance OmbudService (GIO) as a Consumer Complaints Officer (CSO). Mr. Boos can be reached toll free at 1-877-225-0446 ext. 105. Insurance complaints about automobile, property and business insurance can be sent by going onto the following website: www.giocanada.org.