How to File an Insurance Ombudsman Complaint: The Complete Guide
When internal appeals fail, the ombudsman is your most powerful free tool. This guide covers how to file complaints with FIDReC, AFCA, FOS, OFS, and other ombudsman bodies worldwide.
Your insurer denied your claim. You filed an internal appeal. They denied that too. Most people stop here. But the ombudsman — a free, independent dispute resolution body — is often where policyholders actually win.
This guide covers everything you need to know: what ombudsmen can do, when to use them, how to file effectively across the major markets, and what to expect from the process.
What Is an Insurance Ombudsman?
An insurance ombudsman is an independent body that resolves disputes between insurers and their customers — for free. Unlike a court, the process is informal, relatively fast, and designed to be accessible to everyday consumers without legal training.
Depending on the jurisdiction, ombudsman decisions may be:
- Binding on the insurer (if you accept the award): This applies to FOS (UK), AFCA (Australia), FIDReC (Singapore), OFS (Malaysia), and ICB (Hong Kong)
- Non-binding but influential: In some markets, ombudsman recommendations carry significant weight even without binding force
Critically: you are never bound by an ombudsman decision. If you're unhappy with the outcome, you can still pursue legal action (subject to limitation periods).
Before You Can Go to the Ombudsman
Almost universally, you must first exhaust the insurer's internal complaints process before the ombudsman will accept your case. This typically means:
- Filing a formal written complaint with the insurer
- Waiting for their response (or waiting for the regulatory deadline to pass without response)
- Receiving a "Final Response Letter" (UK) or equivalent
Keep evidence of all this. When you lodge with the ombudsman, you'll need to show you've completed the internal process.
Filing with FIDReC (Singapore)
Who can use it: Any consumer with an insurance dispute worth up to SGD 100,000 against an insurer licensed by MAS.
How to file: Submit online at fidrec.com.sg. You'll need your policy number, the insurer's name, a description of the dispute, and any supporting documents.
What happens next: FIDReC will contact the insurer and attempt mediation. Most cases are resolved through mediation. If mediation fails, the case proceeds to adjudication where an independent adjudicator reviews the evidence and makes a binding decision (binding on the insurer if you accept it).
Key tips:
- Be concise and factual in your complaint submission
- Attach your denial letter, appeal letters, the insurer's responses, and key supporting documents
- FIDReC handles disputes in English; translated documents may be needed for non-English records
Filing with AFCA (Australia)
Who can use it: Any consumer or small business with a financial dispute, including all types of insurance.
How to file: Lodge online at afca.org.au. The process is entirely free and can be completed online. You'll describe your complaint, state the outcome you're seeking, and upload supporting documents.
What happens next: AFCA will contact the financial firm and give them 21 days to respond. AFCA then attempts early resolution between the parties. If that fails, a case manager investigates and may issue a preliminary assessment. If still unresolved, a final determination is made.
Key tips:
- State your desired outcome clearly and specifically (e.g., "I am seeking payment of AUD 8,500 being the full amount of my denied claim")
- AFCA's award limits are generous — up to AUD 1,000,000 for insurance claims in most categories
- If your claim involves urgent medical circumstances, note this explicitly — AFCA has expedited procedures for urgent cases
Filing with FOS (UK)
Who can use it: Any consumer or eligible small business with a complaint against an FCA-regulated insurer.
When to file: After receiving a Final Response from the insurer (or after 8 weeks have passed without one). You must file within 6 months of the Final Response date — this deadline is strict.
How to file: Submit online at financial-ombudsman.org.uk. The process is free and the website has step-by-step guidance.
What happens next: FOS allocates a case handler who reviews all the evidence and correspondence. They may ask for additional information. The case handler will issue a provisional assessment; if you or the insurer disagree, the case is referred to an ombudsman for a final decision.
Key tips:
- The 6-month deadline from the Final Response letter is hard — don't miss it
- FOS publishes the uphold rates for specific insurers, which you can use to understand how your insurer typically behaves at FOS
- FOS can award up to £415,000 in compensation, plus consequential losses in some cases
Filing with OFS (Malaysia)
Who can use it: Any consumer with an insurance or financial dispute involving a licensed institution, for claims up to MYR 250,000.
How to file: Download the complaint form from ombudsman-financialservices.org.my, complete it, and submit with supporting documents. You must include evidence that you've completed the insurer's internal complaint process.
What happens next: OFS will assess whether your complaint is within their jurisdiction. If accepted, they'll attempt mediation first. If mediation fails, the case goes to adjudication.
Key tips:
- Submit your complaint in English or Bahasa Malaysia
- Include all correspondence with the insurer, your policy documents, and the denial letter
- OFS decisions that you accept are binding on the insurer
Filing with ICB (Hong Kong)
Who can use it: Any consumer with an insurance dispute involving a member insurer of the Hong Kong Federation of Insurers, for claims up to HKD 1,000,000.
How to file: Download the complaint form from icb.org.hk and submit with supporting documents. The complaint must be made within 2 years of the insurer's final decision.
What happens next: ICB will assess your complaint and attempt mediation. If mediation fails, an adjudicator reviews the case and issues a decision. Adjudication decisions are binding on member insurers if you accept them.
Filing with CBUAE (UAE)
Who can use it: Any consumer with an insurance complaint against a UAE-licensed insurer.
How to file: Submit your complaint online via the CBUAE portal at cbuae.gov.ae after completing the insurer's internal complaint process (the insurer has 15 business days to respond).
What happens next: CBUAE's Consumer Protection Department reviews the complaint and may require the insurer to provide a formal response. CBUAE has enforcement powers and can direct insurers to comply with their obligations.
Tips That Apply Everywhere
Be specific. Describe your complaint factually and state the exact outcome you want. "I want justice" is not an outcome. "I am seeking payment of [currency][amount] being the total denied claim" is.
Submit organised documents. Number your attachments and reference them clearly in your complaint narrative. A well-organised file gets faster, more careful attention.
Follow up. Ombudsman services handle high volumes. If you haven't heard anything in 4 weeks, follow up by phone or email and note the date of your follow-up.
Don't exaggerate. Ombudsman case handlers see thousands of complaints. Exaggerated or inconsistent accounts undermine your credibility. Stick to the facts.
Accept a reasonable outcome. Sometimes a partial win is the right decision — especially if the alternative is prolonged litigation. Know your bottom line before the process begins.
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