The call centre agent got it wrong – so now what?

IT HAS been nearly five months since I had to go for an unexpected operation, resulting in being booked off for six weeks and therefore unable to work.

I’m self-employed, meaning that not being able to work results in no income. However, in 2012, I became a Momentum client by choosing a number of their policies – temporary income protection being one of them.

As January this year was the first time I had to use my temporary income protection policy, I needed to be sure my understanding of the policy was accurate, so that I could know exactly what was to be expected and be able to make decisions and plan accordingly.

I called Momentum on two separate occasions, asking specifically to be transferred to someone who could assist with questions around this policy. My main aim, apart from understanding the claims process, was to clarify the meaning of the “waiting period”. I was clearly and confidently advised on two separate occasions that a month-long waiting period (which was the case with my policy) meant that I could not claim for any period less than a month. When asked what would happen if I was booked off for six weeks, I was again clearly and confidently advised that I would be able to claim and be paid for the full six weeks, not two (six weeks minus the month waiting period).

However, weeks later, when I finally received a payment from Momentum in early March, it was clear that the payment was only for 11 days, not for six weeks as expected.

I followed up on what I believed to be a “mistake” on Momentum’s side, and a few phone conversations and emails later, Momentum agreed that I was given incorrect information via its call centre, twice (all calls are recorded). They refused to accept any responsibility for repetitive, incorrect and misleading information given to me, the client. Momentum simply dismissed the mistakes as “bona fide errors” by their own agents.

My claim was then escalated and after more weeks of waiting, I was informed that the call centre communicated “unqualified” information and that this could not alter the contractual terms of the policy. In a later e-mail, I was also advised that it would be “unreasonable to expect that all our call centre agents must know the inner workings or the contract as well as the terms and conditions (and, more specifially, the waiting terms) of your specific policy”. I was also told that it was expected of a client and his/her financial adviser to read the terms and conditions of the policy contract . I’ve never questioned the contract or terms and conditions itself; I’ve simply tried to clarify the meaning of it. However: I would argue that phoning the insurer/company whose policy is in question, is reasonable when seeking understanding in this regard.

I find it truly remarkable and unacceptable that a company like Momentum is unable to accept any responsibility, nor show any goodwill towards the client, after admitting that incorrect, misleading information was communicated on more than one occasion.

If the call centre agents handling temporary income protection queries didn’t know the answer to my questions, wouldn’t it be reasonable to expect them to:

Admit that they did not know the answer.

Transfer the call to someone who would know the answer.

Advise me to call my financial adviser/someone else outside of Momentum to provide me with the necessary information.

None of the above happened. I had no reason to suspect that any of the information was, in fact, not to be trusted.

I therefore made decisions, both medical and financial, based on information that was clearly, on more than one occasion, communicated to me by Momentum. I don’t think the “waiting period” can be described as part of the “inner workings of the contract”. I called to clarify the meaning of the “waiting period” and not to contest the meaning of my contract.

The last e-mail from Momentum, received on April 19, promised further information to be sent to me as soon as it was available, after reverting the matter back to the Client Care team. I’m still waiting.

What should my conclusion be? That the official call centre of a respectable company, Momentum, cannot be trusted? After being diligent in trying to ensure that I correctly understood the meaning of my policy before making important health and financial decisions, I ended up misled and finding unpleasant and irreversible surprises.

I’m not asking Momentum to alter or compromise their contractual terms of the policy. I’m asking them to accept responsibility for incorrect information communicated to me, the loyal client, and at the very least, show goodwill to save the relationship, where trust has been broken. Lawrette McFarlane

A client care manager for Momentum responded: “We looked into the history of this matter and found that while Momentum acted according to the contractual terms of the policy, the correct information was not communicated to the client. Because clear communication is a component of how we aim to treat our clients fairly, we have addressed this with the service consultant and have put the required training in place. We have also been in conversation with the client and have agreed on how to resolve this matter.”

McFarlane said they had agreed to pay her the full outstanding amount (for the six weeks) as promised by the call centre, since the mistake had been on their side.