PIB Complaint Management

Policies and Procedures Manual

1.

Introduction The main objective of this Complaint Management Policies and Procedures Manual is to introduce PIBs Complaint Unit as well as lay down systematic measures to manage and monitor complaints made against the Company. The primary objectives of this manual are to: Maintain the integrity of the Company Ensure efficient service is provided to customer Increase the trust and confidence the public has in the Company

It is the responsibility of each of the Department Heads/Branch Managers to ensure its compliance. Any departure thereof must immediately be reported to the CEO and the Head of the Complaint Unit.

2.

Purpose This policy and procedure for complaints management (CM) has been set to ensure that all complaints made by the public are handled in a controlled and standardised condition. All CM procedures shall be carried out in a consistent manner throughout the Company in compliance with BNMs Guidelines on Complaints Handling that came into effect on 1 February, 2010. The Guidelines require PIB to comply with certain mandatory requirements and adopt best practices for effective handling of complaints with a view towards improving service standards to customers, including the establishment of a Complaints Unit by PIB and to maintain a documented procedural manual and standards for staffs reference. This policies and procedures reference manual also helps to show that the Companys activities are properly planned and executed in compliance with PIBs established policies and procedures in a consistent manner.

3.

Roles and Responsibilities The organisation structure of the Complaint Unit is attached in Appendix 1. A listing of members details is attached in Appendix 2. The Head of Complaint Unit shall be responsible for the operational requirement of the unit in line with BNM Guidelines. A copy of BNM Guidelines is attached in Appendix 3. The Complaints Unit consists of the heads of relevant Departments and their assistants as Complaint Handlers. The roles and responsibilities of the Head and Members of the Complaint Unit are described below.

Page 1

PIB Complaint Management

Policies and Procedures Manual

The responsibilities of the Head Complaint Unit includes: 1) 2) To receive all complaints from the public and policy holders. To maintain a record of all complaints received in a Complaint Register, including those via letter, e-mail, telephone and walk-in. To forward complaints received to respective Complaint Handlers to ensure necessary actions are taken to resolve the issues within the specified time frame. To ensure feedback is given within the specified time frame on complaint cases brought by Bank Negara Malaysia (BNM) or Biro Pengantaraan Insurans (BPI) (Insurance Mediation Bureau) (IMB). To provide an official reply to the complainant on Companys decision and findings. To report to Management at the Exco Meetings on the complaints received on a yearly basis including reasons for such complaints as well as recommended solutions to avoid recurrence, if any. To report to Board of Directors on the complaints received and processes at least annually to keep the Board updated and to assist the Board in their oversight functions.

3)

4)

5)

6)

7)

Mandatory requirements:PIB shall establish a centralized platform for lodging a complaint and assist customers in pursuit of resolution of a complaint. PIB has established a Complaint Unit, a single point of contact as a complaint service unit where customer complaints are referred to. The Manager (Finance) shall be the dedicated officer responsible for handling complaints. In addition, all Heads of Department and branches shall also serve as complaints handlers in their respective area of operations and these complaints shall be further referred to the Head of Complaints Unit for centralized processing and monitoring in pursuit of a speedy resolution of all complaints received. Best Practices:The Head of Complaints is all authorised to deal with and resolve the complaints effectively and expediently by ensuring a quick and effective escalation of any significant complaint by referring the matter directly to the respective Head of Departments/Branches and the CEO where necessary.
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PIB Complaint Management

Policies and Procedures Manual

The responsibilities of the Complaint Handlers are: 1) 2) To receive all complaints pertaining to their respective departments. To forward copies and details of complaints to the Head Complaint Unit for record and monitoring purposes. To issue acknowledgment letter to complainant within 2 days of receipt of complaint. To maintain a Complaint Register for complaints that were received pertaining to the respective department. To review and investigate the complaint and make a decision on the case. To provide official reply to the complainant on Companys decision and findings. To forward a copy and details of this reply to the Head Complaint Unit for record and future reference purposes. Complaint handlers shall have the necessary knowledge and experience in the respective area of operations in order to help resolve the complaint effectively and expediently.

3)

4)

5) 6)

7)

4.

Policies and Procedures (P & P) and Actions The P & P describes the operational procedures to be followed by the Complaints Unit in handling and resolving complaints lodged against the Company. The Complaints Management Workflow is attached in Appendix 4.

4.1 Acceptance of Complaint Received (In Person , by telephone, E-mail or through Letter) Complaints can be communicated to the company by the insured, third party claimant or their representatives (agent, broker, and solicitor) in person, by mail, e-mail or by phone/fax. The complaint may or may not be accompanied by the relevant supporting documents. For complaints made in person, request the claimant to complete the Complaint Form (attached as Appendix 5) or refer the complainant to the Head Complaint Unit for details of the complaint to be taken down. Details of the complaint are then transferred to Complaint Register. For Complaints received by mail, fax or e-mail, the Complaint Handler shall forward a copy of the complaint letter to the Head -Complaint Unit to register and record the case first in the Complaint Form and subsequently in the Complaint Register.

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PIB Complaint Management

Policies and Procedures Manual

4.2

Acceptance of Complaint Received by Phone For complaints received by telephone, the Complaint Handler shall gather as much information as possible from the complainant which can then be used to complete the Complaint Form. The basic information pertaining to the complaint will be recorded on the form, which will serve as the Official Complaint document. A copy of the Complaint Form shall be forwarded to Head Complaint Unit to record and monitor the progress of the complaint until resolved. Details of the complaints will be recorded in the Complaint Register.
N.B : The respective Head of Departments shall ensure that someone is always present to receive complaints in the absence of Complaint Handler or Head Complaint Unit. For complaints made at Branches, the Branch Manager will receive the complaints and fill the complaint form. The completed complaint form is then forwarded to Head of Branch Support, who acts as the complaint hander, and a copy extended to Head of Complaint Unit.

4.3

Acknowledgment of the Complaint An Acknowledgment letter of the complaint shall be sent to the complainant within 2 working days of receipt of the complaint with copy to the Head - Complaint Unit. If information submitted by the complainant is incomplete and thus not sufficient to fill the Complaint Form, the Complaint Handler is to inform and request by letter/fax/e-mail for this information within 2 working days of receipt of the complaint. A Reminder letter with a copy to Head Complaint Unit is to be sent by the Complaint Handler to the complainant after 2 weeks if there has been no response for PIBs request for the incomplete information. If after 2 weeks from the reminder date the complainant still has not responded to the request, PIB may proceed to set aside the complaint and classify it under a No Further Action (NFA) status. A Letter to the Complainant informing him of the case being treated as NFA is to be sent after 1 week of the case being classified as NFA with a copy to Head Complaint Unit.

4.4

Review and Investigate the Complaint The Complaint Handler shall investigate the complaint and discuss the findings with the CEO and the perspective Head of Department together with Head Complaint Unit before a final decision is made and reply given to the complainant (This includes complaint cases from BNM and IMB). In respect of complicated cases, where views from Adjusters, consultants or Solicitors opinion is required and a decision cannot be made within 30 days, the Complaint Handler shall inform the complainant on the complexity of the matter as well as the extended time frame required and to keep the complainant updated from time to time.

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PIB Complaint Management

Policies and Procedures Manual

The complaints handler shall call and meet the complainant to discuss on complicated cases. In such meetings, Adjusters or consultants may be required to attend to give a clearer picture to the complainant 4.5 Basis of Decision on the Complaint Decision on the complaint shall be on the basis of proper and fair underwriting or claims service and with regard to the relevant guidelines and market norms as well as after taking into consideration the opinions of independent professional consultants such as through Adjusters report and/or Medical/Specialist report. 4.6 Convey Companys Decision on the Complaint Decision on the complaint shall be conveyed to the complainant by official letter within 14 days of lodging the complaint with a copy to Head- Complaint Unit. The letter shall contain a clear and concise explanation on the basis of the final decision. If the decision is in favour of the Company, then the letter should include an advise to the complainant that they may make a further complaint to the Financial Mediation Bureau (if the issue is within the ambit and purview of FMB) or directly to Bank Negara Malaysia. 4.7 Acceptance or Rejection of Companys Decision by Complainant Where the complainant accepts the companys decision then the case is considered closed and completed. If the complainant does not accept the companys decision, then the Head Complaint Unit shall advise the complaint and to refer their complaint to FMB or BNM depending on the circumstances of the case and that a copy of PIBs final reply shall be included when forwarding the complaint case to IMB or BNM. If the matter is referred to FMB, PIB shall inform the complainant in writing that the complainant may seek redress as follows and enclose a copy of FMBs leaflet for reference:Notice of Avenue to Seek Redress: Any person who is not satisfied with the decision of PIB may refer to the procedure of appeal as stated in the leaflet issued by the FMB. Avenue to Seek Redress

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PIB Complaint Management

Policies and Procedures Manual

4.8

Reports on Complaint Received A report based on the format as in Appendix 6 shall be forwarded to Bank Negara Malaysia on a half yearly basis (period ending 30 June and 31 December) within 21 days from the end of these periods. (To be reported by Head Complaint Unit). The report shall include data about complaints received including actions taken and decisions made. A report on the number of complaint received, the status of outstanding cases, findings and recommendations shall be tabled at the Exco Meeting for management information. (To be reported by Head Complaint Unit).

4.9

Accessibility To allow easy accessibility for customers to lodge complaints. PIB shall make available information on how to make a complaint, claims handling procedures and processes including details of the Complaints Unit at PIBs Office and on its website. A detailed listing of the Complaint Unit including contact details are shown in Appendix 2.

4.10

Internal Audit The Internal Audit shall carry out an independent review of the effectiveness of PIBs complaints handling functions and processes on a regular basis both at Complaint Unit and Branches with a view to improving the quality of complaints handling and PIBs customer service delivery.

4.11

Review and Reporting There shall be regular reporting to the Management at the Exco Meetings on the effectiveness of PIB complaints handling function and processes, at least once a year. The report should highlight the types of complaints received, effectiveness in PIB handling the complaint and the speed at which the complaints were resolved. The same forum shall be used to obtain management assessment and management on complaint handling processes and outcomes that will help improve the quality of future complaints handling.

4.12

Other Matters Changes to the structure of the Complaint Unit shall be advised by the Head Complaint Unit to BNM and PIAM as and when a change has taken place.

XXXXXXX
Dated : 9/5/2002 03/03/2010 (Amended)

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Appendix 1

PROGRESSIVE INSURANCE BHD COMPLAINT UNIT

FRANCIS LAI
Chief Executive Officer

AGUSTIN SANDANANAZAN
Manager Head of Complaint Unit

HJ. JOHARI NORDIN

Assistant General Manager

BENEDICT MAJIN Manager

(Sabah Operations) Complaint Handler

KATHLEEN CHAN
Assistant General Manager

KAN POH YEE

Assistant General Manager

JAIMIN KAMIN Senior Manager

(Human Resource) Complaint Handler

NG CHEE HONG Assistant Manager

(Internal Audit) Complaint Handler

NG SING CHEONG Senior Manager

(KL/Branch Operations) Complaint Handler

ELAINE LEE Senior Manager

(MIS) Complaint Handler

LUM SAU MEI Manager

(Hospital & Surgical) Complaint Handler

(Claims) Complaint Handler

(Technical) Complaint Handler

(Finance) Complaint Handler

GURDEV KAUR
Manager (Claims) Complaint Handler

CHEW SAU LIN

Assistant Manager (Technical) Complaint Handler

MANUVEL RAJAN
Assistant Manager (Finance) Complaint Handler

SUSAN LEE
Assistant Manager (Human Resource) Complaint Handler

NOORUL AMMAMAH
Executive (Internal Audit) Complaint Handler

TAN HAN HUI

Executive (MIS) Complaint Handler

TAY LI MAY
Assistant Manager (Hospital & Surgical) Complaint Handler

BARBARA LIGADU
Manager (Kota Kinabalu) Complaint Handler

DENES SANGHAN
Assistant Manager (Sandakan) Complaint Handler

JESSICA THONG
Senior Manager (KL Operations) Complaint Handler

TAN WEE GIEE

Manager (Kuching)
Complaint Handler

HJ. MOHD DAHLAN

Senior Manager (Butterworth)
Complaint Handler

LEE YAT CHOY

Manager (Johor Bharu)
Complaint Handler

KAN KIM SAN

Manager (Melaka)
Complaint Handler

NG SIEW CHAI
Manager (Kota Kinabalu) Complaint Handler

JOANNE PANG
Executive (Sandakan) Complaint Handler

ANGELA NG MEI SIM

Manager (KL Agencies) Complaint Handler

SYLVIA CHIN
Executive (Claims) Complaint Handler

NORIZAN AHMAD
Senior Executive (Marketing) Complaint Handler

ZABEDAH MOHD NOR

Executive (Admin) Complaint Handler

YEAP BEE BEE

Executive (Admin) Complaint Handler

Date: 20/12/2011

Appendix 2

PROGRESSIVE INSURANCE BHD

Complaint Unit Listing of Members Details
No 1. Name Francis Lai Vun Sen Div/Department CEOs office Designation CEO Address Progressive Insurance Bhd 7th, 9th & 10th Floor, Menara BGI, Plaza Berjaya No. 12, Jalan Imbi 55100, Kuala Lumpur Progressive Insurance Bhd 7th, 9th & 10th Floor, Menara BGI, Plaza Berjaya No. 12, Jalan Imbi 55100, Kuala Lumpur Progressive Insurance Bhd 7th, 9th & 10th Floor, Menara BGI, Plaza Berjaya No. 12, Jalan Imbi 55100, Kuala Lumpur Progressive Insurance Bhd 7th, 9th & 10th Floor, Menara BGI, Plaza Berjaya No. 12, Jalan Imbi 55100, Kuala Lumpur Progressive Insurance Bhd 7th, 9th & 10th Floor, Menara BGI, Plaza Berjaya No. 12, Jalan Imbi 55100, Kuala Lumpur Progressive Insurance Bhd 7th, 9th & 10th Floor, Menara BGI, Plaza Berjaya No. 12, Jalan Imbi 55100, Kuala Lumpur Progressive Insurance Bhd 7th, 9th & 10th Floor, Menara BGI, Plaza Berjaya No. 12, Jalan Imbi 55100, Kuala Lumpur Telephone 2118 8000 ext. 8080 Fax 2142 3195 E-mail
francislai@progressiveinsurance.com.my

2.

Hj. Johari Nordin

Claims

Assistant General Manager

2118 8000 ext. 8119

2118 8100

johari@progressiveinsurance.com.my

3.

Kan Poh Yee

Finance

Assistant General Manager

2118 8000 ext. 8006

2118 8101

pykan@progressiveinsurance.com.my

4.

Kathleen Chan

Technical

Assistant General Manager

2118 8000 ext. 8134

2118 8101

kathleen@progressiveinsurance.com.my

5.

Ng Sing Cheong

KL/Branch Operations

Senior Manager

2118 8000 ext. 8003

2118 8098

scng@progressiveinsurance.com.my

6.

Jaimin Bin Kamin

Human Resource & Administration

Senior Manager

2118 8000 ext. 8189

2118 8103

jaimin@progressiveinsurance.com.my

7.

Elaine Lee

MIS

Senior Manager

2118 8083

2118 8101

elaine@progressiveinsurance.com.my

Appendix 2

PROGRESSIVE INSURANCE BHD

Complaint Unit Listing of Members Details
No 8. Name Jessica Thong Div/Department KL Operations Designation Senior Manager Address Progressive Insurance Bhd 7th, 9th & 10th Floor, Menara BGI, Plaza Berjaya No. 12, Jalan Imbi 55100, Kuala Lumpur Progressive Insurance Bhd 2755, Ground Floor & 1st Floor, Jalan Chain Ferry Taman Inderawasih, 13600 Prai, Seberang Prai Tengah Pulau Pinang Progressive Insurance Bhd 7th, 9th & 10th Floor, Menara BGI, Plaza Berjaya No. 12, Jalan Imbi 55100, Kuala Lumpur Progressive Insurance Bhd 7th, 9th & 10th Floor, Menara BGI, Plaza Berjaya No. 12, Jalan Imbi 55100, Kuala Lumpur Progressive Insurance Bhd Ground & 7th Floor Wisma Perkasa, Jalan Gaya 88845 Kota Kinabalu, Sabah Progressive Insurance Bhd 7th, 9th & 10th Floor, Menara BGI, Plaza Berjaya No. 12, Jalan Imbi 55100, Kuala Lumpur Progressive Insurance Bhd Ground & 7th Floor Wisma Perkasa, Jalan Gaya 88845 Kota Kinabalu, Sabah Telephone 2118 8000 ext. 8092 Fax 2118 8098 E-mail
jess@progressiveinsurance.com.my

9.

Hj. Mohd Dahlan Mustaffa

Butterworth

Senior Manager

04 3977128

04 3977126

dahlan@progressiveinsurance.com.my

10.

Angela Ng Mei Sim

KL Agencies

Manager

2118 8138

2118 8098

angela@progressiveinsurance.com.my

11.

Gurdev Kaur

Claims

Manager

2118 8078

2118 8100

gurdev@progressiveinsurance.com.my

12.

Benedict Majin

Sabah Operations

Manager

088 244216

088 218004

bmajin@progressiveinsurance.com.my

13.

Lum Sau Mei

Hospital & Surgical

Manager

2118 8168

2118 8098

saumei@progressiveinsurance.com.my

14.

Barbara Ligadu

Sabah Operations

Manager

088 244216

088 218004

barbara@progressiveinsurance.com.my

Appendix 2

PROGRESSIVE INSURANCE BHD

Complaint Unit Listing of Members Details
No. 15. Name Agustin Sandananazan Div/Department Finance Designation Manager Address Progressive Insurance Bhd 7th, 9th & 10th Floor, Menara BGI, Plaza Berjaya No. 12, Jalan Imbi 55100, Kuala Lumpur Progressive Insurance Bhd Ground & 7th Floor Wisma Perkasa, Jalan Gaya 88845 Kota Kinabalu, Sabah Progressive Insurance Bhd Ground Floor Lots 216 & 217, Jalan Haji Taha 93400 Kuching, Sarawak Progressive Insurance Bhd No. 17-01, Jalan Kebun Teh 1, Pusat Perdagangan Kebun Teh, 80250 Johor Bahru, Johor Progressive Insurance Bhd 13-A, Jalan Melaka Raya, Taman Melaka Raya, 75000 Melaka Progressive Insurance Bhd 7th, 9th & 10th Floor, Menara BGI, Plaza Berjaya No. 12, Jalan Imbi 55100, Kuala Lumpur Progressive Insurance Bhd 7th, 9th & 10th Floor, Menara BGI, Plaza Berjaya No. 12, Jalan Imbi 55100, Kuala Lumpur Progressive Insurance Bhd 7th, 9th & 10th Floor, Menara BGI, Plaza Berjaya No. 12, Jalan Imbi 55100, Kuala Lumpur Telephone 2118 8111 Fax 2118 8101 E-mail
agustin@progressiveinsurance.com.my

16.

Ng Siew Chai

Kota Kinabalu

Manager

088 244216

088 218004

ng@progressiveinsurance.com.my

17.

Tan Wee Giee

Kuching

Manager

082 251272

082 423960

wgtan@progressiveinsurance.com.my

18.

Joseph Lee Yat Choy

Johor Bahru

Manager

07 2270991

07 2270996

joseph@progressiveinsurance.com.my

19.

Terence Kan Kim San

Melaka

Manager

06 2883831

06 2883832

kanks@progressiveinsurance.com.my

20.

Ng Chee Hong

Internal Audit

Assistant Manager

2118 8185

2118 8100

cheehong@progressiveinsurance.com.my

21.

Chew Sau Lin

Technical

Assistant Manager

2118 8183

2118 8101

slchew@progressiveinsurance.com.my

22.

Susan Lee

Human Resource & Administration

Assistant Manager

2118 8180

2118 8103

susan@progressiveinsurance.com.my

Appendix 2

PROGRESSIVE INSURANCE BHD

Complaint Unit Listing of Members Details
No 23. Name Richard Manuvel Rajan Div/Department Finance Designation Assistant Manager Address Progressive Insurance Bhd 7th, 9th & 10th Floor, Menara BGI, Plaza Berjaya No. 12, Jalan Imbi 55100, Kuala Lumpur Progressive Insurance Bhd 7th, 9th & 10th Floor, Menara BGI, Plaza Berjaya No. 12, Jalan Imbi 55100, Kuala Lumpur Progressive Insurance Bhd st 1 Floor, Lot 1, Block 3 Bandar Indah Mile 4, North Road 90000 Sandakan, Sabah Progressive Insurance Bhd 7th, 9th & 10th Floor, Menara BGI, Plaza Berjaya No. 12, Jalan Imbi 55100, Kuala Lumpur Progressive Insurance Bhd 7th, 9th & 10th Floor, Menara BGI, Plaza Berjaya No. 12, Jalan Imbi 55100, Kuala Lumpur Progressive Insurance Bhd Ground Floor Lots 216 & 217, Jalan Haji Taha 93400 Kuching, Sarawak Progressive Insurance Bhd st 1 Floor, Lot 1, Block 3 Bandar Indah Mile 4, North Road 90000 Sandakan, Sabah Telephone 2118 8010 Fax 2118 8101 E-mail
richard@progressiveinsurance.com.my

24.

Tay Li May

Hospital & Surgical

Assistant Manager

2118 8169

2118 8098

may@progressiveinsurance.com.my

25.

Denes Sanghan

Sandakan

Assistant Manager

089 238810

089 237709

denes@progressiveinsurance.com.my

26.

Tan Han Hui

MIS

Executive

2118 8081

2118 8101

jeff@progressiveinsurance.com.my

27.

Noorul Ammamah Abdul Jamaludin

Internal Audit

Executive

2118 8182

2118 8100

noorul@progressiveinsurance.com.my

28.

Sylvia Chin

Kuching

Senior Executive

082 251788

082 423960

sylvia@progressiveinsurance.com.my

29.

Joanne Pang Sheau Yann

Sandakan

Executive

089 238810

089 237709

joanne@progressiveinsurance.com.my

Appendix 2

PROGRESSIVE INSURANCE BHD

Complaint Unit Listing of Members Details
No 30. Name Norizan Ahmad Div/Department Butterworth Designation Senior Executive Address Progressive Insurance Bhd st 2755, Ground Floor & 1 Floor, Jalan Chain Ferry Taman Inderawasih, 13600 Prai, Seberang Prai Tengah Pulau Pinang Progressive Insurance Bhd No. 17-01, Jalan kebun Teh 1, Pusat Perdagangan Kebun Teh, 80250 Johor Bahru, Johor Progressive Insurance Bhd 13-A, Jalan Melaka Raya Taman Melaka Raya 75000 Melaka Telephone 04 3977128 Fax 04 3977126
E-mail norizan@progressiveinsurance.com.my

31.

Zabedah M. Nor

Johor Bahru

Executive

07 2270991

07 2270996

zabedah@progressiveinsurance.com.my

32.

Yeap Bee Bee

Melaka

Executive

06 2883831

06 2883832

bbyeap@progressiveinsurance.com.my

Dated: 20.12.2011