Complaints Process.

1. Our Commitment to You

MVIA is committed to treating all customers fairly and resolving complaints in a transparent, efficient and outcome-focused manner, in line with the Policyholder Protection Rules, Treating Customers Fairly (TCF) principles and applicable FSCA conduct standards.

We recognise that concerns may arise from time to time, particularly in relation to claims outcomes, service delivery or administration. When this happens, we encourage customers to raise the issue with us first so that we can investigate it fully and, where appropriate, put things right as quickly as possible.

Our complaints process is designed to:

be accessible, fair and proportionate;
resolve complaints objectively and within reasonable timeframes;
keep customers informed throughout the process;
ensure decisions are supported by clear reasons and evidence;
avoid unreasonable barriers to lodging or pursuing a complaint; and
learn from complaints to improve our products, services and processes.

There is no cost to you for using our complaints process.

2. What is a Complaint?

A complaint is an expression of dissatisfaction submitted in writing by a customer (or someone acting on their behalf) relating to a product, service or claims outcome, where the customer believes that:

MVIA has breached a legal, contractual or regulatory obligation;
MVIA has acted unfairly, negligently or unreasonably; or
The customer has suffered loss, inconvenience or distress as a result of MVIA’s actions or omissions.

This does not include general enquiries or routine service requests that can be resolved immediately.

3. How to Submit a Complaint

Customers are encouraged to submit complaints in writing to ensure that we fully understand the nature of the concern and can investigate it properly.

A complaint may be submitted via:

Email: Complaints@mvia.insure
Any official MVIA communication channel where the complaint can be recorded.

Please include:

Your full name and contact details;
Policy or claim reference number (if applicable);
A clear description of the issue;
Any relevant supporting documents; and
Your preferred method of communication.

4. Accessibility and Support for Vulnerable Customers

The complaints process is designed to be accessible, fair and responsive to the needs of all customers.

Some customers may be vulnerable due to factors such as age, disability, language barriers, financial distress or personal circumstances. Where a customer is identified as vulnerable, MVIA will take reasonable steps to provide additional support, which may include:

allowing extra time for responses or submissions;
providing explanations in clear, simple language;
offering alternative communication methods where appropriate; and
escalating the complaint internally to ensure appropriate oversight and care.

Customers will not be penalised, prejudiced or treated unfairly for raising a complaint or for requiring additional support during the complaints process.

5. How We Handle Complaints

MVIA follows a structured, transparent and step-by-step complaints handling process that allows for meaningful engagement with the customer before an outcome is reached.

Step 1: Receipt, Logging and Acknowledgement

All complaints are logged on MVIA’s complaints management system (CIMS – Cardinal 360) and acknowledged in writing within 1 business day of receipt.

The acknowledgement will confirm:

Receipt of the complaint;
The reference number; and
Indicative turnaround times.

Step 2: Initial Review and Enquiries

An initial review is conducted to understand the nature of the complaint and the relief sought.

Relevant internal and third-party enquiries (including insurer, administrator, repairer or service provider enquiries) are initiated.

MVIA aims to provide an initial substantive response within 5 business days of receipt.

Step 3: Customer Engagement and Additional Information

Where the initial outcome is disputed, unclear or capable of being supplemented, the complainant may submit additional information or representations.

This may include information that contradicts, clarifies or supplements the initial findings.

Upon receipt of additional information, MVIA will:

acknowledge receipt within 1 business day; and
reassess the complaint in light of the new information.

Step 4: Further Investigation and Alternative Outcomes

Where appropriate, MVIA may conduct further enquiries and consider alternative outcomes, which may include:

maintaining the original outcome;
providing a revised explanation; or
offering an alternative resolution (including correction or goodwill measures, where appropriate).

MVIA will provide a further written response within 5 business days of receiving the additional information or advise if more time is required.

Step 5: Outcome

Once all reasonable enquiries and representations have been considered, MVIA will issue an outcome. This outcome will be communicated in writing and will:

clearly state whether the complaint is upheld, partially upheld or rejected;
set out the reason for the decision;
reference the relevant contractual terms, policy provisions, service standards or regulatory requirements relied upon (as applicable);
explain any change in outcome, where applicable; and
confirm any actions taken, including any corrective steps or remedial measures.

MVIA aims to finalise complaints within 10 business days, unless the matter is complex or dependent on third-party information, in which case the complainant will be kept informed of progress and revised timelines.

6. Escalation and Review

If you are not satisfied with the initial outcome, you may request an internal escalation.

The complaint will be reviewed by a senior decision-maker who was not involved in the initial handling.
The review will consider whether the complaint was handled fairly, whether the decision was reasonable and whether all relevant information was properly considered.
Additional information or representations may be requested or submitted.
A final internal decision will be communicated to you in writing, together with clear reasons and details of any further recourse available.

This internal review process is intended to satisfy the requirements of the PPR by ensuring impartiality, fairness, transparency and appropriate senior oversight.

7. Complaints Relating to Products, Services and Claims

The complaints process applies to all complaints relating to MVIA’s products, services, administration, information provided to customers and claims outcomes, including complaints about how a previous complaint was handled.

Where a complaint relates to a claim decision, MVIA will review the matter against the applicable policy wording and available evidence. Any outcome will clearly explain the reasons for the decision, reference the relevant policy or contractual provisions and set out the customer’s options for further escalation where applicable.

This ensures a fair, consistent and transparent approach to all complaints.

8. External Escalation – Ombud Referral

If, after you’ve exhausted MVIA’s internal complaints and escalation process, you remain dissatisfied with the outcome, you may refer the matter to an appropriate external dispute resolution body.

MVIA supports the principle that complaints should, wherever possible, be resolved internally first. This allows us to fully investigate the matter, correct errors and provide explanations or remedies without the need for external escalation.

National Financial Ombud Scheme South Africa (NFOSA)

The NFOSA has jurisdiction over complaints relating to:

Insurance products and claims;
Financial advice and intermediary services; and
Other financial services matters previously dealt with by sector-specific ombud schemes.

Customers may contact the NFOSA as follows:

Website: www.nfosa.co.za
Email: info@nfosa.co.za
Telephone: 0860 800 900

Referral to the NFOSA is subject to its rules, including applicable time limits and jurisdictional requirements. Customers should approach the NFOSA only after MVIA has been given a reasonable opportunity to resolve the complaint internally.

Customers remain free to pursue other lawful remedies, including legal action, subject to applicable law.

Please note that different time limits apply depending on the forum approached. Customers are encouraged to act promptly once an internal outcome has been communicated.

Office of the FAIS Ombud

Where a complaint relates specifically to financial advice or intermediary services rendered under the Financial Advisory and Intermediary Services Act (FAIS Act), and the matter has not been resolved through MVIA’s internal complaints process, customers may refer the complaint to the Office of the FAIS Ombud.

The FAIS Ombud considers complaints involving alleged breaches of the FAIS Act, including improper or negligent advice, failure to act in the customer’s interests or unfair treatment in rendering of intermediary services.

Customers may contact the FAIS Ombud as follows:

Website: www.faisombud.co.za
Email: info@nfosa.co.za
Telephone: 012 762 5000 or 0860 066 3274

Complaints to the FAIS Ombud are free of charge and are subject to the Ombud’s rules, time limits and jurisdictional requirements.

Legal time limits applicable to claims and other complaints are explained in Section 9 (Time Limits and Prescription) below.

9. Time Limits and Prescription

This section explains how time limits apply to complaints, representations, Ombud referrals and legal action. These time limits are prescribed by law, policy terms and regulatory rules, and are intended to ensure matters are dealt with fairly and without unreasonable delay.

9.1 Internal Representations and Complaints

Where a complaint relates to the rejection of a claim, the quantum of a claim or another final decision communicated by MVIA, customers are entitled to make representations to MVIA.

Customers are afforded a single representation period of 90 days from the date of notification of MVIA’s decision to submit representations or lodge a complaint.
This 90-day representation period is intended to allow customers a reasonable opportunity to engage with MVIA and does not extend or suspend the overall time limits applicable to legal action beyond what is permitted by law.
The 90-day representation period may not be counted when calculating a policy time-bar, but no further representation periods will be granted once MVIA has issued its final internal outcome.

9.2 Policy Time-Bar Clauses

Some insurance policies contain time-limitation (time bar) clauses regulating when legal action may be instituted against an insurer.

In accordance with the Policyholder Protection Rules, applicable policy terms, and the Prescription Act:

For policies entered into on or after 1 January 2011, customers may be afforded at least six months after the expiry of the 90-day representation period to institute legal action.
A policy time-bar will only begin to run after the internal representation or complaint process has been completed.
Where a customer believes that a policy time-bar is unreasonable or unfair, the customer may apply to a court for condonation.

9.3 Prescription

For purposes of the Prescription Act, a claim (debt) is generally regarded as becoming due only after the 90-day representation period has expired and the insurer has communicated its final decision.

This means that the prescription period does not run while the customer is still exercising their right to make representations or pursue the internal complaints process.

9.4 External Escalation and Ombud Referrals

Nothing in this section limits or overrides a customer’s right to refer a complaint to an appropriate Ombud in accordance with the Ombud’s own rules and jurisdictional time limits.

Customers are nevertheless encouraged to act promptly after receiving MVIA’s internal outcome to avoid the risk of prescription or time-bar provisions becoming applicable.