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how we prioritise cases

Consumers – each with their own individual needs and concerns – bring complaints to the ombudsman service about a wide range of financial products and services, from pensions to pet insurance, critical illness insurance to credit cards. These complaints involve hundreds of different businesses – from sole traders to global financial-services groups. 

We are a "demand-led" organisation – which means we have little or no control over the number and type of complaints that consumers refer to us.

The complaints we deal with can change suddenly and unexpectedly – both in terms of the numbers of complaint and their subject matter. The challenge is to make sure we have the right number of staff – with the right skills and training – exactly when we need them.

Receiving unexpected volumes of complaints can sometimes mean it takes time for our case handlers or ombudsmen review cases. Most cases are resolved quickly, once they have been reviewed by a case handler – although complex cases can take longer (for example, where they involve entrenched arguments or difficult legal issues).

Our general approach is to review new cases in the order in which we receive them – depending on the type of complaint involved. But there are some circumstances where we may need to change the order in which cases are received.

These circumstances include where we need to:

  • Obtain further information, legal advice or specialist technical guidance, before we can start our formal consideration of a complaint.
  • Handle a group of cases together, where they have similar features. This might occur, for example:
    – in complaints that raise issues which might lead to large numbers of other complaints;
    – in cases where regulatory action is being considered; or
    –     where we have adopted a "lead case" approach.
  • Review particular types of cases to meet other operational needs – for example, to deal with more urgent cases or because of staff changes.

In deciding when to review cases, we will – wherever possible – take into account any special circumstances we know about that may affect the consumer and/or the business involved.

We are mindful that both sides in a dispute will want to know as soon as possible how their case should be resolved. Consumers could be facing financial hardship linked to the complaint referred to us. If matters are delayed this might involve significant inconvenience or distress. And businesses could have particular needs that mean they also want a complaint about them sorted out as soon as possible.   

Of course, we can’t prioritise every case. But we will make special efforts to minimise delays where it is clear to us that:

  • The consumer would face particular financial difficulties because of any delay.  This might occur, for example, where:
    – the consumer is already experiencing severe financial hardship that would be alleviated by a positive outcome to their complaint;
    – there is an imminent threat of a lender taking possession of the consumer’s home;
    – a significant and damaging financial loss is expected to occur in the near future; or
    –     the outcome of the complaint will decide the consumer’s main source of income.
  • Any delay would add significantly to the distress and inconvenience suffered by a consumer – or would have an adverse effect on their health. This might occur, for example, because:
    – the consumer is seriously ill;
    – the outcome of the complaint will decide whether important medical treatment should be continued;
    – the consumer has been in temporary accommodation for an extended period – awaiting satisfactory repairs to their home; or
    –     the viability of the consumer’s business is under real threat – as a result of issues that will be settled when the complaint is decided
  • Any delays would add significantly to the distress and inconvenience suffered by the proprietors of a financial business. This could be of particular relevance in the case of a sole trader or other small business – where a decision to uphold a complaint could have a material impact on the continuing viability of the business.
  • Our decision is significant to impending legal action.
  • There is a risk of significant prejudice to the interests of the financial business or the consumer. This might occur, for example, because:
    – there is a debt that is not being repaid while we consider the case; or
    –     the consumer is unable to obtain an important service as long as the dispute remains unresolved.

We are unlikely to be able to prioritise cases where the losses involved are modest – or where losses are not due to materialise for some time (for example, in many investment-related cases such as endowment mortgage complaints).

If you believe any of these circumstances apply to your case, please let us know as soon as possible – and we will see what we can do to help.

To help us deal with cases promptly, it is important that consumers and businesses continue to provide us with information as soon as possible when we ask for it. We will usually ask you to reply to our enquiries by a particular date. If you think you will have difficulties meeting any deadline we give you, please try to tell us straight away. In some circumstances, we may be able to give you more time to reply.

Once a case handler or ombudsman has reviewed the case, the time it takes to resolve a dispute largely depends on:

  • whether both sides agree, at an early stage, to any recommendation or informal settlement that we may suggest;
  • whether requests we make for any additional information are met with promptly; and
  • how complex the issues involved are.

If neither side agree to any recommendation or informal settlement we may suggest, or only one of the sides agrees, then the case may need to be referred to one of our ombudsmen for a formal decision. This is the final stage of our process.