Unhappy Customer
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Customer expresses dissatisfaction via phone, email, website, or in person.
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2
Identify Complaint
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First point of contact recognizes and logs the issue as a complaint.
Transfer to Manager
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Direct the complaint to the Client Manager for handling.
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4
Contact Customer
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Gather detailed information from the customer about the issue.
5
Open CCR
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Create a Complaint Case Record and share the reference number with the customer.
Categorize Issue
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Identify if it’s underwriting, claims, or other, and link to NIB, insurer, or TPA.
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7
Investigate & Resolve
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Analyze and resolve the issue within 5 working days.
Customer Happy?
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Confirm if the resolution satisfies the customer.
8
Close Case
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Mark the complaint as resolved if the customer is happy.
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10
Escalate
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If unresolved, escalate the complaint to the CEO.
Brief CEO
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Complaint Manager updates the CEO on actions and remedies taken.
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12
CEO Actions
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CEO seeks additional solutions with relevant personnel or providers.
13
Resolve Quickly
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Resolve the complaint within 10 working days post-escalation.
Final Check
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Verify customer satisfaction with the final resolution.
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15
Close Complaint
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Close the case after final resolution and customer approval.
DHA Complaints
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Dubai residents can lodge complaints
View Site
16
Evaluate KPIs
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Review complaint satisfaction, turnaround times, and process effectiveness annually.
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18
Submit DHA Report
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File the annual report with DHA by January 7th.
THE END
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