Action

TIO scheme

MPSI scheme

Level 1

Level 1 complaints are referred back to the provider, giving both parties another chance at resolution.

92.5 per cent of complaints (125 595) were resolved at level 1.

96.6 per cent of MPSI complaints (13 426) were resolved at level 1.    

Level 2

Complaints that cannot be resolved at level 1, either because we consider that the proposed outcome is not fair or reasonable, or because we have not seen enough evidence to assess whether the proposed outcome is fair or reasonable, are raised to level 2. This gives the provider and consumer a final chance at informal resolution, a process facilitated by the TIO.

6.1 per cent of complaints (8340) resolved.

3.0 per cent of complaints (415) resolved.

Level 3

Level 3 complaints require formal TIO investigation. They still allow providers and complainants to liaise with one another to achieve a fair and reasonable outcome.

Where a fair and reasonable outcome is not offered by a provider, the TIO may make a binding (on providers) determination up to $1200.

1.3 per cent of complaints (1 785) resolved.

0.4 per cent of complaints (58) resolved.

Level 4

If the provider has failed to respond to a level 3 complaint within the required time, the complaint may be raised to level 4. This is known as an administrative level 4.

Alternatively, if the TIO decides that the outcome of a level 3 complaint is not fair or reasonable, or we have not seen enough evidence from the provider to determine that it is fair or reasonable and the amount in dispute exceeds $1 200, the TIO may escalate to level 4 for further investigation and possibly determination.

0.1 per cent of complaints (123) resolved.

0 per cent of complaints (0) resolved.

Determinations and directions

Where a fair and reasonable outcome cannot be achieved through conciliation, the TIO can direct a provider. At level 4 the TIO’s binding powers are limited to determinations or directions to the value of $10 000. While determinations and directions are binding on members, complainants can elect to accept or decline them.

Five complaints, under the TIO and MPSI schemes, were determined. Details of determinations are available at www.tio.com.au.

Recommendations

In addition to binding decisions, the TIO can make non-binding recommendations to members, provided that these do not exceed $50 000. In the 15-year history of the TIO, non-binding recommendations have been rare and none has been rejected.

No recommendations were made in 2007/08

Reviews

If a person is not satisfied with the outcome of their complaint, they may request a review. A review involves an independent assessment of the investigation, along with an evaluation of whether the investigating officer requested and considered all the information before making a decision. The Review Officer reports directly to the Ombudsman.

The Review must consider whether the TIO had the power to investigate the complaint in the first place, as well as taking into account relevant law and industry codes, our position statements and whether we had regard to the principles of alternative dispute resolution. The Review Officer can be asked to review the outcome of all levels of complaints except those which have been determined.

In 2007/08, the TIO received on average 21 review requests a month. At 30 June 2008, 36 cases were awaiting review. The timeframe for these to be completed is ten to 12 weeks.

In 2007/08, 257 reviews were requested under the TIO and MPSI schemes, compared with 260 the previous year. Of these, in 181 cases, the Review Officer’s findings agreed with that of the Enquiry or Investigation Officer, so no further investigation was needed. 

In 49 cases, additional information was sought by the Review Officer before it was concluded that a fair and reasonable outcome had been achieved.

In 22 cases the findings were overturned and the complaints were returned to the relevant staff member for additional investigation and possible escalation.

In five cases, additional evidence was sought by the Review Officer before the overall finding was overturned.