Woman smiling at camera in call centre

Your policyholder rights and responsibilities

Posted  March 13, 2018

As a long-term insurance policyholder, you have the right to fair treatment by your insurer. How do these rights protect you and what are your responsibilities? 

Long-term insurers, and indeed all financial services companies in South Africa, follow Treating Customers Fairly (known as TCF) principles. These principles protect your rights and make sure that you are treated fairly.

You have the right to good service and to products that do what they say they do.

World Consumer Rights Day, celebrated on 15 March, is an ideal time to take a closer look at how these principles protect your rights - and the responsibilities that come with them.

Your rights as a policyholder
TCF was introduced in South Africa in 2011 by the Financial Services Board. Our TCF principles are similar to the ones introduced in the United Kingdom. Although there is no legislation that deals specifically with TCF, financial services companies like insurers are bound by them.

It is a broad set of principles that covers all aspects of your insurance products and relationship with your insurer. TCF promotes the fair treatment of customers and the principles influence financial rules and regulation.

There are six TCF principles, or outcomes as they are more formally known.

1. TCF is central to the corporate culture
That sounds like a bit of a mouthful, but it is really important. When we deal with a company we not only want to know that they are doing the right thing, but that they are doing it because they believe it is the right thing to do, not only because there’s a rule saying they must.

If TCF is central to your insurer, they will listen to you, put your interests first, and keep their product and service promises such as paying valid claims in good time.

2. You are sold suitable products that will meet your needs
When insurers develop products such as disability insurance, they must meet specific needs and they must identify who those products will be suitable for.

If you have dependants who rely on your income, life insurance, disability insurance and expense protector policies will cover your income should something happen to you. If you are single with no dependants but need to protect your income, disability insurance or expense protector policies are suitable.

Whenever you buy a financial product, ask who it is suitable for and what need it fulfils. If your insurer can answer this, they are sticking to TCF principles.

3. You have access to clear information before, during and after the sale
Ever had an experience where you buy something, and then you never see or hear from the company again? This shouldn’t happen, and this TCF principle identifies it as a right that your insurance company must follow.

Very importantly, the information the company gives you – in letters, emails, adverts, brochures and websites - must be clear and in plain language. Important terms and conditions mustn’t be hidden in small print in obscure places.

4. You get suitable advice that takes your circumstances into account
Any advice you receive must be personal and relevant to you. This includes not only what products you may need, but also things like affordability.

5. Products perform as expected, service is as expected and of a good standard
This principle gives you the right to good service and to products that do what they say they do. Your insurance company they must deliver on what they promise in the time they promise - so, for instance, your policy pays when it says it will pay.

6. There are no unreasonable barriers to change products, switch providers, submit a claim or make a complaint
It must be easy to submit a claim or make a complaint and, if you buy a product and change your mind, cancel in 30 days from the date of commencement.

What are the responsibilities of policyholders?So, you now know what you can expect from your insurer and what you must hold us accountable for. What are your responsibilities?

1. Disclose all your information
Be honest when you complete our forms. Tell us your medical and claims history in full. Non-disclosure will be a problem when it comes to claims – we can only pay a claim if the policy was taken out in good faith and you disclosed all your information.

2. Pay your premiums on time
Premiums must be paid. If you can see that paying your premium is going to be a problem, tell us so we can see if changing your policy is an option. Inform your family members about your policies so that they can ensure payments are made, to ensure that cover continues, even if you are incapacitated.

3. Read your policy document
Long-term insurance is a product that covers many possibilities, so it means there are quite a few pages you need to read. We’ve applied TCF principle 3 and made these clear and easy to understand, but you need to read them and understand them. If anything is unclear ask us or your financial advisor.

4. Tell your family about your policy and how to claim
They need to know what insurance you have, and how to claim should something happen to you.

5. Tell us if something changes in your life
If you move to a new house, change an email or contact address, change jobs or move countries, tell us. And keep your beneficiary details up to date – we want to pay the person you want to benefit from your policy.

For more tips on your responsibilities as a policyholder follow this link.

Popular reads

Family taking selfie on couch

Smaller properties are increasing in value much faster than bigger, more expensive homes. If you’re in the market for a property, buying cheap will help your investment grow.

man with healthy food and eating plan

For some people, no matter what they eat or how much they exercise, those extra kilograms aren’t going anywhere. It could be that something other than diet and lifestyle is at play. Find out more.

Calculator with aeroplane on top of world map

If overseas travel is on your bucket list, don’t wait. Start saving today. This is how much it will cost you and how long it will take.