OFS Malaysia: How to File an Insurance Complaint with the Ombudsman

The Ombudsman for Financial Services (OFS) — previously known as the Financial Mediation Bureau (FMB) — is Malaysia's independent dispute resolution body for complaints against banks, insurers, and Takaful operators. It is the single most important resource available to Malaysian insurance consumers who have been treated unfairly, and it is completely free.

This guide explains everything you need to know about filing a complaint with OFS Malaysia.

What Is OFS Malaysia?

OFS was established to provide an accessible, affordable, and independent alternative to litigation for resolving financial services disputes. It operates under the Financial Services Act 2013 (FSA 2013) and the Islamic Financial Services Act 2013 (IFSA 2013), overseen by Bank Negara Malaysia (BNM).

OFS handles disputes involving:

• Life insurance (conventional and investment-linked)
• Family Takaful (Islamic life insurance)
• General insurance (motor, fire, travel, personal accident, commercial)
• General Takaful (Islamic general insurance)
• Banking and financial services (not covered in this guide)

Who Can File with OFS?

You are eligible to file with OFS if:

1. You are an individual or a sole proprietor / small business with annual turnover under RM3 million
2. Your complaint is against a BNM-licensed insurer or Takaful operator
3. You have completed the insurer's internal complaint process (or waited at least 60 days for a response)
4. The amount in dispute is RM25,000 or less per complaint
5. The complaint has not been filed in court or previously adjudicated by OFS

For disputes exceeding RM25,000, OFS may still assist with mediation but cannot issue binding awards beyond its jurisdiction limit.

Step 1: Complete the Internal Complaint Process

Before filing with OFS, you must:

1. Submit a formal written complaint to your insurer
2. Give the insurer at least 60 days to respond (or confirm in writing that the internal process is exhausted)
3. Keep copies of all correspondence — your complaint letter, the insurer's responses, any supporting documents submitted

If the insurer does not respond within 60 days, you can proceed directly to OFS.

Step 2: Prepare Your Documents

You will need:

• Your insurance policy or Takaful certificate
• The claim submission and any supporting documents originally provided
• The insurer's denial or rejection letter (quoting the specific clause)
• All correspondence between you and the insurer (emails, letters, call logs)
• For health/life claims: medical reports, discharge summaries, specialist letters, bills
• For motor claims: police report (Laporan Polis), photographs, repair estimates, accident report
• For property claims: fire brigade report, surveyor's report, photographs, receipts

Step 3: File Your Complaint with OFS

Online: Visit ofs.org.my and use the online complaint portal.

By mail: Download and complete the complaint form from ofs.org.my, then mail it to:

Ombudsman for Financial Services Level 14, Main Block, Menara Takaful Malaysia No. 4, Jalan Sultan Sulaiman, 50000 Kuala Lumpur

By phone: 03-2272 2811 (Monday–Friday, 9am–5pm)

There is no filing fee.

Step 4: OFS Assessment

OFS will:

1. Review your complaint for eligibility
2. Notify the insurer and request its response
3. Assess whether the complaint falls within OFS jurisdiction
4. Attempt informal resolution first — often, the insurer settles once OFS becomes involved

If informal resolution fails, OFS proceeds to formal review.

Step 5: Mediation

OFS will invite both parties to mediate. A case manager facilitates a structured negotiation. Many disputes settle at this stage. Mediation outcomes are non-binding unless both parties sign a settlement agreement.

Step 6: Adjudication

If mediation fails, an adjudicator reviews the case and issues a formal determination. OFS adjudicators are independent experts in insurance law and financial services regulation. They apply both the terms of the policy and the standards of fair dealing required under FSA 2013.

The determination is:

• Binding on the insurer if you accept it (up to RM25,000)
• Advisory if your claim exceeds RM25,000 (you may still need to litigate the excess)
• Non-binding on you — you are free to reject the determination and pursue court action

Typical OFS Timelines

What OFS Can Award

• Monetary compensation up to RM25,000 per case
• Policy reinstatement or amendment
• Directions to the insurer to correct procedural failures
• OFS cannot award compensation for legal costs, pain and suffering, or consequential losses

Tips for a Strong OFS Complaint

• Be specific: Reference the exact policy clause you are disputing and explain clearly why you disagree
• Keep emotional language out: Stick to facts, dates, amounts, and document references
• Provide a timeline: A clear chronological summary of events helps the case manager understand your situation quickly
• Get specialist support: For medical claims, a letter from your specialist directly addressing the denial grounds is invaluable
• Act promptly: There is a limitation period for OFS complaints — file within 6 years of the event giving rise to the dispute

Key Contacts

• OFS Malaysia: ofs.org.my | 03-2272 2811
• BNM LINK: bnm.gov.my/complaint | 1300-88-5465
• Life Insurance Association Malaysia (LIAM): liam.org.my
• Persatuan Insurans Am Malaysia (PIAM): piam.org.my
• Islamic Insurance Association of Malaysia (IIAM): iiam.com.my

Fight Back With ClaimBack

ClaimBack helps you prepare a compelling, well-organised OFS complaint — from structuring your case narrative to compiling the right evidence. Start your appeal before filing with OFS, and go in with the strongest possible submission.

Start your appeal with ClaimBack

Related Reading

• How to Write an Insurance Appeal Letter
• What Is Medical Necessity?
• Insurance Ombudsman: A Complete Guide