Public Appeals
Public appeals
Contents
1. Introduction – Data for 2003 ...................................................................................... 3
2. Multi-year trends in the scope of appeals .................................................................... 5
A. Multi-year trends in the distribution of appeals relating to insurance, provident
funds and pensions ................................................................................................ 5
B. Multi-year trends in the scope of appeals relating to insurance ............................. 6
C. Multi-year trends in the scope of appeals relating to provident funds and pensions ........... 7
3. Decision categories of the complaints ......................................................................... 8
A. Distribution of complaints relating to insurance ................................................... 8
B. Distribution of complaints relating to provident and pension funds ...................... 15
4. Rating insurance companies according to the criterion of public complaints
that were resolved in 2003 ........................................................................................... 17
Appendices........................................................................................................................ 23
Table J-1
Table J-2
Table J-3
Table J-4
Table J-5A
Table J-5B1
Table J-5B2
Table J-5C
Table J-6
Table J-7
Comparison of Data About Appeals in All Fields, 2003 Versus
Previous Years ........................................................................................... 5
Distribution of Handling Periods for Complaints Closed in 2003 ............ 6
Appeals Processed and Closed – Multi-Annual Comparison in the
Insurance Field, 1999-2003 ....................................................................... 6
Number of Appeals Processed and Closed – Multi-Annual Comparison
in the Provident and Pension Fund Fields, 1999-2003.............................. 7
Distribution of Complaints Closed in the Insurance Field, 2001-2003..... 8
Distribution of Resolved Complaints in the Insurance Field,
2001-2003.................................................................................................. 8
Distribution of Substantial Complaints in the Insurance Field,
2001-2003.................................................................................................. 9
Distribution of Unresolved Complaints in the Insurance Field,
2001-2003.................................................................................................. 9
Distribution of Resolved Complaints in Selected Lines of the I
nsurance Field, 2002-2003 ........................................................................ 12
Distribution of Complaints in the Provident and Pension Fund Fields,
2002-2003.................................................................................................. 15
±
Annual Report 2003
List of Tables
Chart J-7a
Chart J-7b
Table J-8
Table J-9
Table J-10
Table J-11
Distribution of Decisions Relating to Provident Funds and Pension
Funds Where a Position Was Taken, 2001-2003 ....................................... 16
Distribution of Decisions Relating to Provident Funds and Pension
Funds Where No Position Was Taken, 2001-2003 .................................... 16
Rating of Insurance Companies by Substantial Complaints in All
Insurance Lines, 2003 ............................................................................... 19
Rating of Insurance Companies by Substantial Complaints in Life
Insurance, 2003 ......................................................................................... 20
Rating of Insurance Companies by Substantial Complaints in
Non-Life Insurance, 2003 ......................................................................... 21
Rating of Insurance Companies by Substantial Complaints in
Vehicle (Property) Insurance - Comprehensive and Third Party, 2003 ..... 22
List of Charts
Chart J-5a
Chart J-5b
Chart J-5c
Chart J-6a
Chart J-6b
Chart J-6c
Distribution of Complaints in the Insurance Sphere Where a Position
Was Taken in 2001-2003 ........................................................................... 10
Distribution of Complaints in the Insurance Sphere Where No Position
Was Taken in 2001-2003 ........................................................................... 10
Distribution of Complaints in the Insurance Sphere Found to be Justified
in 2001-2003 ............................................................................................. 11
Distribution of Appeals Opened in Selected Lines in the Insurance
Sphere in 2003 ........................................................................................... 13
Distribution of Justified Decisions in Selected Lines in the Insurance
Sphere in 2003 ........................................................................................... 13
Distribution of Partially Justified Decisions in Selected Lines in the
Insurance Sphere in 2003 .......................................................................... 14
Public appeals
1. Introduction – Data for 2003
This report presents a statistical analysis of the data for 2003, compared with the data for
2001-2002 (the period from January 1 to December 31 in each year).
The category of "appeals" includes all appeals sent to the Public Appeals Unit: complaints,
questions for clarification and copies forwarded to the Commissioner of Insurance of
complaints that were sent directly to the supervised bodies.
The category "complaints" includes only appeals complaining of a specific action by a
supervised body. The category "questions for clarification" includes only queries to which
the Public Appeals Unit responded. The category "copies of complaints" includes only
copies forwarded to the Insurance Commissioner of complaints that had been sent directly
to the supervised bodies. The complaints are resolved and classified under different decision
categories.1
1. For explanations of the decision categories, see Appendix B.
≥
Annual Report 2003
The statistics presented in the report are based on the number of complaints received, unless
stated otherwise.
In 2003, the Public Appeals Unit received 3,849 appeals, including 2,347 complaints, 662
questions for clarification and 813 copies of complaints.
In 2002, the Unit received 2,762 appeals, including 1,441 complaints, 503 questions for
clarification and 818 copies of complaints. The total number of appeals received in 2003
represents a 39% increase in comparison with 2002. The number of complaints increased by
65%, the number of questions for clarification increased by 32% and copies of complaints
dropped by 1%.
Appeals concerning the insurance and provident fund spheres were distributed as follows:
3,423 appeals refer to the insurance sphere and 426 appeals refer to pension and provident
funds. This distribution among insurance and provident funds is similar to that noted last
year.
In the insurance sphere, the distribution according to lines and secondary lines indicates a
significant increase in complaints regarding home/property insurance (fire and associated
risks), where there was an increase of 63% compared with 2002 (163 complaints in 2003
versus 100 complaints in 2002). An increase was also noted in the area of business insurance.
Taken together, these two spheres had an average increase of 62% in the number of complaints
(with 189 complaints in 2003 compared to 117 in 2002). There was also an increase in
Annual Report 2003
The Capital Market, Insurance and Saving Division
the number of complaints relating to life insurance (individual and executive insurance),
continuing the upward trend that began in 2001. The number of complaints pertaining to
life insurance (individual) rose by 30% (296 complaints in 2003 versus 228 in 2002), and
the number of complaints pertaining to executive insurance rose by 56% (153 complaints
in 2003 versus 98 in 2002). The average escalation in these two spheres came to 38%. The
number of complaints relating to health insurance did not decrease. There was a rising trend
in the number of complaints in this sphere in 2002, compared with 2001; but this year there
was a negligible increase of only 1% (341 complaints in 2003 compared with 336 in 2002).
In the sphere of motor vehicle insurance (property), there was a slight increase of 5% (697
complaints in 2003 compared with 664 in 2002). It should be noted that the increase in
number of complaints, which characterized the period between 1996 and 2000, has been
checked in the last few years.
In cases of complaints against more than one body, it is now possible to open a separate file
against each complainee (i.e., against several insurance companies, insurance agencies or
agents). Each complaint file can be handled separately and a different decision can be given
regarding each party. We therefore divided the data into "complaints" (the overall number
of complaints filed) and "complaints against supervised bodies" (the number of files opened
against specific parties). In light of this change the number of "complaints" files opened in
2003 was 2,374, and the number of "complaints against supervised bodies" was 2,695. This
indicates that some complaints were lodged against more than one supervised body.
The statistics presented in this report are based on the overall number of complaints and not
on the number of files opened against specific parties, since the latter type of data cannot be
compared to data from 2002, since it was not yet possible to file separate complaints against
different supervised bodies.
The data on the distribution of "complaints where no position was taken" includes a new subcategory: "inactivity on the part of the complainant." This category includes cases in which
the complainant failed to supply all the documents needed to process the complaint, and
which were closed after the allotted time-period expired. Some of the files in the category
"unresolved cases" included several sub-categories where no position was taken, because
sometimes they were difficult to classify more accurately.
¥
Annual Report 2003
Public appeals
2. Multi-year trends in the scope of appeals
A. Multi-year trends in the distribution of appeals relating to
insurance, provident funds and pensions
Table J-1
Comparison of Data About Appeals in All Fields, 2003 Versus Previous Years
Yearly distribution of appeals
2001
No.
%
Open appeals from previous years at the beginning of each year 2387
41
2002
No.
%
1
2818
51
2003
No.
%
2662
41
Open appeals against supervised bodies from previous years2
Appeals received in the course of each year
3498
59
2762
49
Appeals received against supervised bodies in the course of each year
Total active appeals each year
5885
100
5580
100
Total active appeals each year against supervised bodies
2662
39
3849
59
4170
61
6511
100
6832
100
Distribution of appeals opened and closed in the course of each year
2001
Opened
No.
2002
Closed
Opened
2003
Closed
Opened
Closed
%
No.
%
No.
%
No.
%
No.
%
2653 76
2295
74 1441
52
1545 55
2374
62 3764 70
Clarifica-tion inquiries
461
13
417
14
503
18
512
18
662
17
676
13
Copies of complaints
384
11
374
12
818
30
772
27
813
21
922
17
Complaints
No.
%
3498 100
3086
100 2762
100
2829 100
3849
100 5362 100
Distribution of appeals closed in the course of each year
2001
2002
2003
No.
%
No.
%
No.
%
Total complaints closed each year
2295
100
1545
100
3764
100
Resolved complaints
1485
65
927
60
2161
57
Unresolved complaints
810
35
618
40
1603
43
Total appeals open at the end of each year
2001
2002
2003
No.
No.
No.
2799
2751
1149
Source: Public Appeals Unit, Capital Market, Insurance and Savings Division
Footnotes:
2. Included in the number of pending complaints at the beginning of 2002 were 739 appeals received in 2001 and recorded
in the beginning of 2002
3. Until 2003 the number of appeals received was identical to the number of complaints against supervised bodies.
µ
Annual Report 2003
Total appeals
Annual Report 2003
The Capital Market, Insurance and Saving Division
Table J-2
Distribution of Handling Periods for Complaints Closed in 2003
Complaint’s
handling period
One month
2 months
3 months
4 months
5 months
6 months
7 months
8 months
9 months
10 months
11 months
12 month
One year or more
Total
Number
Percent
473
202
184
199
184
197
195
297
261
207
233
145
987
3764
13%
5%
5%
5%
5%
5%
5%
8%
7%
6%
6%
4%
26%
100%
Cumulative
percent
13%
18%
23%
28%
33%
38%
43%
51%
58%
64%
70%
74%
100.00%
Source: Public Appeals Unit, Capital Market, Insurance and Savings Division
B. Multi-year trends in the scope of appeals relating to insurance
Table J-3
Appeals Processed and Closed – Multi-Annual Comparison in the Insurance
Field, 1999-2003
Year
Appeals
processed3
1999
2000
2001
2002
2003
2,485
3,014
2,555
3,201
3,423
Rate of change in
number of appeals
processed versus
previous year
(%)
13
21
-15
25
7
Appeals
closed4
2,027
2,624
2,777
2,628
4,778
Rate of change in
number of appeals
closed versus
previous year
(%)
11
29
6
-5
82
Source: Public Appeals Unit, Capital Market, Insurance and Savings Division
Footnotes:
4. This data refers to complaints that were closed by December 31 of each year and also include complaints recorded in
previous years.
5. This data refers to complaints there were received by December 31 of each year and does not include complaints that
were received until that date but were not yet recorded, except in 2002 and 2003, when all complaints received were
recorded.
∂
Annual Report 2003
Public appeals
C. Multi-year trends in the scope of appeals relating to provident
funds and pensions
Table J-4
Number of Appeals Processed and Closed – Multi-Annual Comparison in the
Provident and Pension Fund Fields, 1999-2003
Year
1999
2000
2001
2002
2003
Appeals processed5
206
201
204
300
426
Appeals closed6
250
204
309
201
584
Source: Public Appeals Unit, Capital Market, Insurance and Savings Division
∑
Annual Report 2003
Footnotes:
6. See Footnote 5, above.
7. See Footnote 4, above.
Annual Report 2003
The Capital Market, Insurance and Saving Division
3.
Decision categories of the complaints
A. Distribution of complaints relating to insurance
Table J-5A
Distribution of Complaints Closed in the Insurance Field, 2001-2003
2001
2002
2003
No.
%
No.
%
No.
%
Total complaints closed each year
2012
100
1391
100
3316
100
Total resolved complaints
1119
56
754
54
1823
55
Total unresolved complaints
893
44
637
46
1493
45
Source: Public Appeals Unit, Capital Market, Insurance and Savings Division
Table J-5B1
Distribution of Resolved Complaints in the Insurance Field, 2001-2003
2001
2002
2003
No.
%
No.
%
No.
%
Total resolved complaints
1119
100
754
100
1823
100
Total substantial complaints
(total number of justified and partially
justified complaints)
677
61
439
58
1119
61
Complaints resolved as unjustified
442
39
315
42
705
39
Source: Public Appeals Unit, Capital Market, Insurance and Savings Division
∏
Annual Report 2003
Public appeals
Table J-5B2
Distribution of Substantial Complaints in the Insurance Field, 2001-2003
2001
2002
2003
No.
%
No.
%
No.
%
Total substantial complaints
677
100
439
100
1119
100
Justified complaints
103
15
99
23
137
12
Partially justified complaints
574
85
340
77
982
88
Source: Public Appeals Unit, Capital Market, Insurance and Savings Division
Table J-5C
Distribution of Unresolved Complaints in the Insurance Field, 2001-2003
2001
2002
2003
No.
%
No.
%
No.
%
Total unresolved complaints
893
100
637
100
1493
100
Ended without resolution
753
84
387
61
732
49
Ended due to factual dispute
47
5
142
22
376
25
Ended due to legal proceedings
25
3
53
8
120
8
Complaints not in the purview of
the Commissioner of Insurance
68
8
55
9
68
5
Inactivity on the part of the
complainant
-
-
-
-
127
8
Other
-
-
-
-
70
5
π
Annual Report 2003
Source: Public Appeals Unit, Capital Market, Insurance and Savings Division
Annual Report 2003
The Capital Market, Insurance and Saving Division
Chart J-5a
Distribution of Complaints in the Insurance Sphere Where a Position Was
Taken in 2001-2003
(percent)
±∞∞•
π∞•
∏∞•
Complaints resolved
as unjustified
∑∞•
∂∞•
Partially justified
complaints
µ∞•
¥∞•
Justified
Complaints
≥∞•
≤∞•
±∞•
∞•
≤∞∞±
≤∞∞≤
≤∞∞≥
Source: Public Appeals Unit, Capital Market, Insurance and Savings Division
Chart J-5b
Distribution of Complaints in the Insurance Sphere Where No Position
Was Taken in 2001-2003
(percent)
±∞∞•
Other
∏∞•
Inactivity on the part of the
complainant
∂∞•
Complaints not in the purview of
the Commissioner of Insurance
¥∞•
Ended due to legal proceedings
Ended due to factual disputs
≤∞•
Ended without resolution
∞•
≤∞∞±
≤∞∞≤
≤∞∞≥
Source: Public Appeals Unit, Capital Market, Insurance and Savings Division
±∞
Annual Report 2003
Public appeals
Chart J-5c
Distribution of Complaints in the Insurance Sphere Found to be Justified
in 2001-2003
(percent)
Partially justified complaints
Justified complaints
±∞∞•
π∞•
∏∞•
∑∞•
∂∞•
µ∞•
¥∞•
≥∞•
≤∞•
±∞•
∞•
≤∞∞±
≤∞∞≤
≤∞∞≥
±±
Annual Report 2003
Source: Public Appeals Unit, Capital Market, Insurance and Savings Division
±≤
Annual Report 2003
26
120
114
35
Unresolved
Factual dispute
2002
No. %
2003
No. %
0
-
2
-
54
15
70
95
261
290
420
4
1
6
8
21
24
34
2002
No. %
2003
No. %
Managers’ insurance
Health (health, nursing,
Homeowners and
personal accidents and
businesses
hospitalization)
2002
2003
2002
2003
No. % No. % No. % No. %
27
127
30
26
28
60
27
57
28
-
5
5
30
43
-
3
3
16
22
12
7
5
57
92
3
2
1
14
22
-
4
0
9
24
-
4
0
10
25
3
3
5
22
56
1
1
2
10
25
-
5
6
17
52
-
2
3
8
25
44 23 95 23 25 27 67 30 45 22
Distribution of complaints that ended and were unresolved:
52
Source: Public Appeals Unit, Capital Market, Insurance and Savings Division
7
30
8
24
27
127
Legal
proceedings
Not in the
department’s
purview
Inactivity of
complainant
2003
No. %
Life (individual)
18
4
10
86
93
101
152
4
1
2
17
18
20
30
-
7
2
20
20
25
23
-
7
2
20
20
24
22
9
15
14
28
36
58
74
4
6
6
11
15
24
30
664 100 697 100 228 100 296 100 98 100 153 100 336 100 341 100 117 100 189 100
467 100 1229 100 190 100 416 100 94 100 225 100 206 100 506 100 102 100 245 100
Distribution of complaints that ended and were resolved:
39
8
24
2
11
6
21
5
6
6
9
4
24 12 42
8
5
5
11
4
2002
No. %
Vehicle (property)
Justified
Partially
justified
Unjustified
Opened
Closed
Distribution of
decisions
(see Chart J-6A)
Table J-6
Distribution of Resolved Complaints in Selected Lines of the Insurance Field, 2002-2003
Annual Report 2003
The Capital Market, Insurance and Saving Division
Public appeals
Chart J-6a
Distribution of Appeals Opened in Selected Lines in the Insurance Sphere
in 2003
No. of complaints
∂∞∞
µ∞∞
Life
¥∞∞
Property (fire and
associated risks)
Vehicle
≥∞∞
Personal accidents
≤∞∞
Nursing
Nursing
Other
Travelers
abroad
Other
Property damage
- third party
Bodily injury
Comprehensive
Business
insurance
Homeowners'
insurance
Other
Individual
insurance
∞
Managers
±∞∞
Source: Public Appeals Unit, Capital Market, Insurance and Savings Division
Chart J-6b
Distribution of Justified Decisions in Selected Lines in the Insurance Sphere
in 2003
≥∞
Life
≤∞
Property (fire and
associated risks)
±µ
Vehicle
±∞
Personal accidents
µ
Nursing
Other
Travelers
abroad
Other
Property damage
- third party
Bodily injury
Comprehensive
Business
insurance
Homeowners'
insurance
Other
Managers
Nursing
Individual
insurance
∞
Source: Public Appeals Unit, Capital Market, Insurance and Savings Division
±≥
Annual Report 2003
No. of complaints
≤µ
Annual Report 2003
The Capital Market, Insurance and Saving Division
Chart J-6c
Distribution of Partially Justified Decisions in Selected Lines in the
Insurance Sphere in 2003
No. of complaints
≥∞∞
≤µ∞
Life
≤∞∞
Property (fire and
associated risks)
±µ∞
Vehicle
±∞∞
Personal accidents
µ∞
Source: Public Appeals Unit, Capital Market, Insurance and Savings Division
±¥
Annual Report 2003
Nursing
Other
Travelers
abroad
Other
Property damage
- third party
Bodily injury
Comprehensive
Business
insurance
Homeowners'
insurance
Other
Managers
Individual
insurance
∞
Nursing
Public appeals
B. Distribution of complaints relating to provident and pension
funds
Table J-7
Distribution of Complaints in the Provident and Pension Fund Fields, 2002-2003
2002
Complaints opened in the course of the year
2003
No.
%
No.
%
245
100
292
100
448
100
51
29
144
23
13
64
191
4
2
85
2
1
17
8
8
3
3
1
Complaints closed in the course of the year
154
100
Distribution of resolved complaints:
Justified complaints
12
13
Partially justified complaints
7
8
Unjustified complaints
72
79
Distribution of unresolved complaints:
Complaints without resolution
53
84
Ended due to factual dispute
2
3
Ended due to legal proceedings
0
0
Complaints not in the purview of the
8
13
Commissioner of Insurance
Inactivity on the part of the complainant
Other
-
±µ
Annual Report 2003
Source: Public Appeals Unit, Capital Market, Insurance and Savings Division
Annual Report 2003
The Capital Market, Insurance and Saving Division
Chart J-7a
Distribution of Decisions Relating to Provident Funds and Pension Funds
Where a Position Was Taken, 2001-2003
(percent)
±∞∞•
∏∞•
Unjustified complaints
∂∞•
Partially justified
complaints
¥∞•
Justified complaints
≤∞•
∞•
≤∞∞±
≤∞∞≤
≤∞∞≥
Source: Public Appeals Unit, Capital Market, Insurance and Savings Division
Chart J-7b
Distribution of Decisions Relating to Provident Funds and Pension Funds
Where No Position Was Taken, 2001-2003
(percent)
±∞∞•
Other
π∞•
Inactivity of
complainant
∏∞•
∑∞•
Complaints not
in purview of
commissioner
∂∞•
µ∞•
Ongoing legal
proceedings
¥∞•
≥∞•
Factual dispute
≤∞•
Complaints without
resolution
±∞•
∞•
≤∞∞±
≤∞∞≤
≤∞∞≥
Source: Public Appeals Unit, Capital Market, Insurance and Savings Division
±∂
Annual Report 2003
Public appeals
4.
Rating insurance companies according
to the criterion of public complaints
that were resolved in 2003
The Public Appeals Unit of the Capital Markets, Insurance and Savings Division has
published a rating of insurance companies since 1999, based on public complaints that were
resolved. Until 2001 the rating dealt only with complaints in the sphere of motor vehicle
(property) insurance – comprehensive and third party insurance.
Since 2002 the rating has been expanded, and now includes four cross-sections:
A. Rating of all insurance lines
B. Rating of the life insurance line
C. Rating of general insurance2
D. Rating of motor vehicle (property) insurance – comprehensive and third party
insurance
2. Included in the "general insurance" category are all insurance lines that are not life insurance, including the
health insurance, nursing insurance and vehicle (property) insurance lines.
±∑
Annual Report 2003
The criterion used to calculate the rating is "substantial complaints." This category includes
complaints that were found to be justified, as well as complaints that were "partially justified"
and had been categorized in the past as "not refused." The main reason for doing so is
that a thorough investigation was conducted of the arguments presented in complaints that
were decided as being justified and those classified as being "partially justified," either by
the Unit or by the insurance company. Thus, even complaints that the insurance company
felt could be appealed for whatever reason, whether the Public Appeals Unit had discussed
the complaint or not, could be assumed to be substantial and partially justified. Therefore,
anywhere the term "complaints" is used below, this refers to public complaints that were
found to be substantial.
Complaints that were decided as being justified were given a double weighting. This
means that every complaint that was found to be justified was counted as two complaints.
By so doing, we hope to add an element of seriousness to the complaints classified as being
justified compared with those categorized as partially justified.
In the tables below, the number of complaints "that were justified" is the total number of
complaints after giving these complaints their double weighting.
In the first stage the ratio was calculated between the number of justified and partially
Annual Report 2003
The Capital Market, Insurance and Saving Division
justified complaints filed against each company, and the (gross) insurance premium the
company collected ("company ratio"). A similar ratio was then computed between the number
of complaints and the total number of companies in the same insurance line cross-section,
that is, the total number of justified and partially-justified complaints, and the total (gross)
insurance premiums collected by the companies included in that insurance line cross-section
("total industry ratio").
In the second stage, the ratio obtained in the first stage was standardized for the total industry
ratio by dividing company ratio by the total industry ratio. This helped define an indicator
whose numerical value was placed at 1. Now the position of each insurance company can be
defined relative to that indicator.
The lower the number obtained after standardization is than 1 – the better the rating.
The higher the number obtained after standardization is than 1 – the worse the rating.
To make the matter easier for the reader to see, a boldface line is drawn across the company
data in each table showing where the indicator is with the value of 1 in the rating. Companies
rated lower than 1 are found below the line, while companies rated higher than 1 are found
above the line.
The companies are listed in each table such that companies with a worse rating appear
at the top of the table. Although we felt it more appropriate to compute the ratings on
the basis of absolute numbers of policies and claims, this was not possible due to a lack of
available and reliable information. Therefore, we had to prepare the ratings in the manner
described.
It should be emphasized that this rating has an element of relativity, since in smaller
companies the relative effect of a small number of complaints is greater compared with the
relative effect of the same number of complaints on larger companies. This is particularly
evident when the absolute number of complaints is identical but the rating is different. We
were unable to cancel out this effect, and the reader must take this fact into account regarding
each insurance company’s position in the rating.
We reiterate that the rating should not be the sole factor one takes into account when choosing an
insurance company. The premium being charged is just as important as other factors when formulating
a decision, such as the service the company provides the insured, the scope of the different types of
insurance coverage, expansion of coverage and recommendations from relatives and friends.
±∏
Annual Report 2003
Public appeals
Table J-8
Rating of Insurance Companies by Substantial Complaints in All Insurance
Lines, 2003
Company name
Number of substantial
complaints7
Rating
Dikla
44
39
27
77
128
225
89
40
103
3.823
2.953
2.391
2.104
1.283
1.220
1.178
1.077
AIG
Shirbit
ILDC
Menorah
Harel
Hadar
Eliahu
Phoenix
Average
Shomera
Aryeh
IDI Direct Insurance
Ayalon
Migdal
Clal
Hamagen
Agricultural Insurance
Total
6
38
21
40
138
123
11
3
1152
1.064
1.000
0.865
0.847
0.792
0.780
0.712
0.585
0.281
0.229
Source: Based on data from the insurance companies and the Public Appeals Unit, Capital Market, Insurance and Savings Division
±π
Annual Report 2003
Footnotes:
9. Justified complaints = 2 complaints.
Annual Report 2003
The Capital Market, Insurance and Saving Division
Table J-9
Rating of Insurance Companies by Substantial Complaints
in Life Insurance, 2003
Company name
Number of substantial
complaints8
Rating
Menorah
57
2.297
ILDC
12
2.282
Harel
60
1.674
Hadar
23
1.249
Average
1.000
Phoenix
22
0.888
Aryeh
6
0.842
Clal
31
0.565
Migdal
41
0.565
Hamagen
4
0.323
Total
256
Source: Based on data from the insurance companies and the Public Appeals Unit, Capital Market, Insurance and Savings Division
Note: For statistical reasons, this rating includes insurance companies whose premium rates in this line are at least 2%. For
this reason, the following companies are not included in this rating: AIG, IDI – Direct Insurance, Ayalon and Eliahu. The
total number of substantial complaints regarding these companies was 10.
10. Justified complaint = 2 complaints.
≤∞
Annual Report 2003
Public appeals
Table J-10
Rating of Insurance Companies by Substantial Complaints in Non-Life
Insurance, 2003
Company name
Number of substantial
complaints9
Rating
Dikla10
44
38
65
27
97
81
66
165
2.728
2.132
1.768
1.706
1.365
1.205
1.200
AIG
ILDC
Shirbit
Migdal
Phoenix
Hadar
Harel
Average
Menorah
Eliahu
Aryeh
Clal
Ayalon
Shomera
IDI Direct Insurance
Hamagen
Agricultural Insurance
Total
71
34
32
92
39
6
19
7
3
886
1.035
1.000
0.996
0.768
0.741
0.643
0.634
0.617
0.549
0.340
0.163
Source: Based on data from the insurance companies and the Public Appeals Unit, Capital Market, Insurance and Savings Division
≤±
Annual Report 2003
Footnotes:
11. Justified complaint = 2 complaints.
12. The Dikla Insurance Company handles health insurance only, and her share in this line was about 16% of the total
insurance premiums. In contrast, Dikla’s share in the total insurance premiums in the general insurance line was only
some 1.8%. Furthermore, the number of insured with the company is particularly high compared with the number of
insured with other companies. The company is included in this rating due to the high number of substantial complaints
filed against it. This should be taken into account when examining Dikla’s relative position in the rating.
Annual Report 2003
The Capital Market, Insurance and Saving Division
Table J-11
Rating of Insurance Companies by Substantial Complaints in Vehicle
(Property) Insurance - Comprehensive and Third Party, 2003
Company name
Number of substantial
complaints11
Rating
AIG
33
2.917
Aryeh
27
1.702
Shirbit
18
1.500
ILDC
38
1.478
Menorah
53
1.459
Migdal
24
1.142
Average
1.000
Eliahu
31
0.975
Hadar
36
0.961
Ayalon
30
0.905
Harel
58
0.846
Clal
37
0.731
Shomera
5
0.664
Phoenix
18
0.556
IDI Direct Insurance
15
0.516
Agricultural Insurance
3
0.407
Hamagen
3
0.340
Total
451
Source: Based on data from the insurance companies and the Public Appeals Unit, Capital Market, Insurance and Savings Division
Footnotes:
13. Justified complaint = 2 complaints.
≤≤
Annual Report 2003
Public appeals
≤≥
Annual Report 2003
Appendices
Annual Report 2003
The Capital Market, Insurance and Saving Division
Appendix
Explanations for the decision categories in public complaints3
A. Justified complaints
The category of "justified complaints" includes specific complaints filed against supervised
bodies that were found to be justified following an investigation by the Public Appeals Unit.
In these cases, the supervised body is required to correct the irregularity, usually according
to operative instructions given with respect to the specific case in question. Sometimes the
supervised body is required to correct a general irregularity brought to light in the complaint
and which pertains to all its clients. Supervised bodies subject to the Regulation of Insurance
Business (Control) Law – 1981 are required to comply with the operational instructions
unless they have appealed to the District Court, as specified in Section 102 of the Law.
Findings arising from the investigations of justified complaints may, at times, yield general
decisions that apply to all supervised bodies.
B. Partially-justified complaints
The category of "partially justified complaints" was introduced in the beginning of 1998,
when new system for handling public complaints was adopted. It includes all cases in
which the complainee, after being notified of the complaint and reviewing it, undertook to
implement the results of the complaint without a decision from the Insurance Commissioner
and without a determination as to the corrective measures to be taken.
The purpose of this category is to encourage insurance companies to correct the irregularities
revealed by the complaints without waiting for a ruling from the Commissioner of
Insurance.
One of the main accomplishments of the Public Appeals Unit is the change that has taken place
in the companies’ attitude towards complaints and those who file them. Today, the companies
attempt to investigate the complaints on their own and offer a quick solution to the client’s
satisfaction. The appointment of ombudsmen in the insurance companies has greatly expedited
the handling of complaints, since there is now a single party who is authorized to handle
public complaints for the company, and who notifies the relevant departments or agents and
coordinates all actions to be taken. This ombudsmen handle all contact both with the client and
with the Public Appeals Unit of the Capital Market, Insurance and Savings Division.
3. See Chapter One for explanations for additional decision categories added this year
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Annual Report 2003
Public appeals
Many complaints that are classified as "partially justified" ("not rejected") are cases that
were handled by the company after receiving notice from the Insurance Commissioner. The
company often handles complaints pertaining to a matter that was addressed in one of the
Unit’s "general rulings" as part of its attempts to comply with these general rulings.
Frequently, after receiving the response of the insurance companies, the Public Appeals
Unit holds discussions with company representatives, legal advisors and the company
ombudsmen. Following these discussions, the companies often agree to comply with the
insured’s request even before the investigation is completed. This type of complaint is also
categorized as "partially justified."
C. Unjustified complaints
This category includes cases where it was found that the supervised body complied with the
law, the circulars sent out by of the Insurance Commissioner or instructions contained in the
general rulings.
After it is determined that the complainee has complied with all relevant laws and regulations,
the complaint is ruled as unjustified.
D. Answered questions and clarifications
The Public Appeals Unit also receives appeals that do not contain a complaint about a specific
insurance transaction or about actions of a specific supervised body, but general questions
regarding rules or principles. These queries do not require notification of the supervised
body since the answers are based on the law, the regulations, the Commissioner’s circulars,
or previous general rulings regarding the issue in question.
F. Complaints involving a factual dispute
These are complaints that cannot be resolved without accepting one version of the facts
and rejecting the other. If it is impossible to accept the version of the complainant over the
≤µ
Annual Report 2003
E. Complaints that are not in the Insurance Commissioner’s purview.
These complaints are forwarded to the party authorized to handle them. For example:
complaints against financing companies regarding terms of a contract between the company
and the financing recipient (leasing transaction) are transferred to the Ministry of Industry
and Trade or to the Ministry of Justice. Complaints regarding the professional actions of a
vehicle adjustor are transferred to the Ministry of Transport, and complaints against banks
are forwarded to the Bank of Israel.
Annual Report 2003
The Capital Market, Insurance and Saving Division
version of the complainee due to lack of evidence, the case is classified as "irresolvable
due to a factual dispute," and the complainant is advised to file a legal claim or to initiate a
process of mediation with the complainee.
G. Complaints regarding matters being adjudicated
These are cases that are closed by the Public Appeals Unit when it emerges that they are in
process of being adjudicated between the complainant and complainee (by a court of law
or an arbitrator), and the Unit has no reason to interfere in these proceedings, according to
Section 60(b) of the Regulation of Insurance Business (Control) Law – 1981.
H. Unresolved complaints
This category includes cases that were closed. More precisely, it includes several types
of complaints that were not resolved, and which are difficult to classify in any other
subcategory.
I. Cases that were closed due to inactivity on the part of the complainant
These are cases in which the complainant was requested by the Unit to produce additional
documents in order to resolve his complaint, but the complainant failed to do so, thereby
preventing the Unit from completing its investigation.
≤∂
Annual Report 2003