We at Health Shield take great pride in our high levels of customer service, but from time to time things can still go wrong. If you feel the need to complain to us, our Internal Complaints Procedure will ensure that your problem is dealt with quickly, fairly and impartially.
You can complain to us by doing one of the following:
- Write to us at our head office address
- Telephone us on 01270 617723
- Contact us via email at – email@example.com
- Contact us via our website at – www.healthshield.co.uk
- Speak directly to a member of our sales team or call in to our head office.
If we can’t resolve your complaint immediately, we'll strive to do so by the close of three business days following the date of receipt. Where this is not possible, we'll send you a written acknowledgment of your complaint within five business days, to inform you of who is investigating your complaint.
Below are our timescales and your options should you be unhappy with the outcome of the final response letter:
- We aim to respond to your complaint within four weeks. However, if we're not able to provide you with our response after four weeks, we'll write to you to explain why.
- We'll keep you updated throughout the whole process, but if we still can't give you our response after a further four weeks, we'll write to you again with a full explanation.
- If you're unhappy with our response, or we fail to respond to your complaint within eight weeks, you can refer your complaint to the Financial Ombudsman Service. The details of the Financial Ombudsman Service will be included within the final response letter. However, if you don’t have this to hand you can refer to the Financial Ombudsman Service – details below.
Financial Ombudsman Service
If you joined the Health Shield Connect scheme online, you can also submit a complaint via the EU Online Dispute Resolution Platform at www.ec.europa.eu/consumers/odr. However, the complaint will still be dealt with by the Financial Ombudsman Service.
Health Shield Friendly Society Ltd is authorised by the Prudential Regulation Authority and regulated by the Financial Conduct Authority and the Prudential Regulation Authority.
Treating customers fairly
We’re totally committed to the Financial Conduct Authority’s ‘Treating Customers Fairly’ initiative. We’ve even developed 10 codes of conduct to make sure we always treat our customers fairly.
1. We’ll put you first in everything we do
2. We’ll strive to identify your needs
3. We’ll create products to meet your needs
4. We won’t provide our employees with incentives that may put you at risk of being sold an unsuitable product
5. We won’t hide behind any small print and will always be open and clear in all our dealings with you
6. We’ll be courteous, responsive and consistent
7. We’ll listen to what you have to say
8. We’ll keep you informed of any product changes
9. We’ll deal with any complaint promptly and impartially
10. We’ll treat you as we would want to be treated ourselves
Committed to protecting our customers, we take a firm stance against fraud. We aim to ensure all claims are genuine, so we can continue to provide our customers with sustainable and competitively priced products.
We’re committed to Treating Customers Fairly. Our customers’ interests are at the forefront of everything we do. So, we’ll take action against any customer who attempts to make a fraudulent claim. If we don’t, fraud can have a negative impact on Health Shield and our customers.
Safeguarding our members
We employ a Claims Investigator and Health Shield is an Associate Member of the Health Insurance Counter Fraud Group. This group aims to stamp out fraud across the industry through joint working and sharing intelligence. It also provides a technical platform to pass on information to prevent and detect fraudulent behaviour within the healthcare market. Members of the group regularly meet up to highlight issues, such as medical negligence, benefit cheats and new scams.
Ending your membership
We’ve a section in our terms & conditions that safeguards against misuse and fraud. In line with our Memorandum & Rules it makes sure that all our customers are protected.
Our Board of Management may end your customer status:
- You’ve broken our rules
- Your continued customer status will have a negative impact on the interests of our customers
- You have failed to act with utmost good faith, including:
- Repeatedly making claims that threaten our financial wellbeing
- Deliberately providing misleading or false information (or not providing information specifically asked for)
- Behaving in a threatening or abusive way towards our team
- Making a claim that is fraudulent or that we believe to be deliberately false, misleading or exaggerated.
Role of the Audit Committee
Our Audit Committee helps to ensure we’re managed ethically, fairly and for the benefit of our members.
Reporting to our Board, they take a close look at our operations to check we’re effectively run in line with our ethos, vision, internal controls and compliance procedures.
They also make sure that we meet our statutory requirements and follow our Society’s principles, policies and practices when we prepare our annual accounts and financial statements.
The Audit Committee monitors the way that Health Shield is run and provides independent assurance to the Board of Management. It is free to act independently of the Executive Team and to investigate and advise on any issue that has been highlighted or it feels needs closer inspection. The Audit Committee is also empowered to obtain information from any officer or employee of the Society and can also seek out independent advice.
Audit Committee responsibilities:
- Liaise with external auditors and the management team to make sure that the accounting principles, policies and practices used to prepare Health Shield’s accounts and annual financial statements comply with all statutory requirements and accounting standards. A particular focus is on where judgement is exercised to reach conclusions.
- Ensure that Health Shield has an effective risk management system in place.
- Recommend ways that the Board of Management can optimise Health Shield’s accounting and financial controls within the risk management framework and policy. It can also recommend the appointment of external and internal auditors, the terms of appointment and the audit fee.
- Review the performance of Health Shield’s internal control systems.
- Agree and review the planned internal audit programme with the internal audit team, making sure it fully addresses the key risks in the risk register.
- Examine and review reports from the internal auditors about internal controls and make sure all recommendations are reviewed and acted on where necessary
- Provide advice to the Board of Management about the internal control environment, taking into account Health Shield’s risk management framework and the appropriateness of policies and procedures designed to maintain control over transactions and events.
- Examine and review accounting, risk management and financial controls with internal and external auditors. Also, the Committee must ensure that the planning and co-ordination of internal and external audits provides an appropriate, efficient and cost-effective service.
- Review and examine audit findings with the external auditors and review and agree the scope of their audit for the following year.
- Consider summaries of audit findings and request any specific reports.
- Ensure that Health Shield complies with all relevant sections of the Annotated Corporate Governance Code for Mutual Insurers.
- Receive the Compliance Manager’s report.
- Consider FCA and PRA regulatory matters, including the timely submission of statutory returns.
- Review the draft annual report and accounts to ensure that it presents a fair view of Health Shield’s financial position and that it is clear, balanced and understandable Note: All recommendations made by the Audit Committee will be subject to the approval of the Board of Management unless the Board of Management has given prior delegated authority for the Audit Committee to act on its behalf.
Who’s on the Audit Committee?
The Audit Committee consists of seven members of the Board of Management. Either the Deputy Chair of the Board of Management or the Senior Independent Director will act as Chairman of the Audit Committee.
Health Shield’s Audit Committee usually meets four times per year. At one of these meetings the Committee will meet separately with both the internal auditor and external auditor. The Actuarial Function will attend at least two meetings per year, as well as other Audit Committee meetings as judged appropriate by the Chairman of the Committee. A quorum of four members is required, at least 50% of which must be non-executives. The non-executive members of the Audit Committee may elect to hold a meeting without any executive representation.
Our Internal Audit Charter shows how we’re committed to improving the operations of Health Shield Friendly Society.