Customer Service

What is customer service?

Understand customers → meet needs → build loyalty

What is the difference between external and internal customers?

External = outside buyers | Internal = employees served internally

What are customer service activities in the insurance industry?

Policy administration, sales and renewals, claims handling, complaints procedures, and access via agents, phone services, websites, and mobile apps, all aimed at delivering fast, efficient, and transparent service to customers

What are the benefits of providing quality customer service?

Loyalty • growth • differentiation • profit • productivity • happy staff

What are the benefits of quality customer service to customers?

fast and efficient service, quick claims settlement, accurate advice, and added value services such as 24‑hour helplines and mobile apps

What are customer service standards?

Targets used to measure service quality and performance

Why is training important in regulated insurance roles?

Builds competence and supports regulatory compliance

What does fair treatment of customers mean under FCA rules?

Culture • Right products • Clear info • Suitable advice • Expected performance • No barriers

What is the FCA Consumer Duty?

Deliver good outcomes for retail customers, acting in good faith, avoiding foreseeable harm, and supporting customers’ financial objectives, across products, price and value, consumer understanding, and consumer support.

Who is considered a vulnerable customer under FCA rules?

A vulnerable customer is someone who, due to personal circumstances, is more likely to experience harm if a firm does not act with appropriate care. Vulnerability drivers include health issues, life events (e.g. bereavement), low financial resilience, and limited capability (e.g. poor literacy or numeracy).

What are the FCA requirements for claims handling?

Under ICOBS, insurers must handle claims promptly and fairly, provide reasonable guidance, and not reject claims unreasonably; CIDRA and the Insurance Act 2015 also apply, ensuring fair treatment for both consumer and non‑consumer customers.

What are the duties of intermediaries during claims handling?

Act with care, skill, and diligence in claims handling

What are the rules on avoiding conflicts of interest for intermediaries?

Avoid where possible → disclose fully → get informed consent → otherwise do not act

How must insurers respond to a consumer’s claim notification?

No set timeframe — must be prompt and fair

What are the rules for settling an insurance claim?

Must be paid promptly — delays can lead to damages under the Enterprise Act

What is the Financial Ombudsman Service (FOS)?

free, independent, and impartial service that resolves unresolved disputes between eligible complainants and authorised financial firms. Membership is compulsory for authorised firms.

Who can complain to the FOS?

Consumers, micro‑enterprises, small businesses, charities, trustees, and guarantors, subject to size and turnover limits.

When can a complaint be referred to the FOS?

A complaint can be referred once the firm has issued a final response or after 8 weeks with no response, and must meet FOS time limits unless exceptional circumstances apply.

How does the FOS handle complaints?

Investigates based on what is fair and reasonable, using law, FCA rules, and industry practice.

What outcomes can the FOS award?

• Money awards (up to statutory limits, with interest); or

• Directions awards, requiring firms to take actions such as paying claims, recalculating redress, or apologising.

How is the FOS funded?

By a general levy paid by all firms and a case fee paid by the firm complained about.