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Balance is Key for Insurance & Savings Ombudsman Karen Stevens

Karen Stevens’ presence in a room will not go unnoticed. Strikingly tall and meticulously dressed, Karen is professional and considered. And she has to be.

For 16 years, Karen has held the title of Insurance & Savings Ombudsman, a role which requires commitment, precision, and most importantly, balance.

“I must have balance in my life, and in my work it is critical,” says Karen. “Balance is the backbone of dispute resolution. I love my job – for the subject range, the variety, and the legal analysis.
“But what I really love is the process. Effective dispute resolution is about bringing two parties together. And the ultimate outcome is settlement, which is when both sides have reached an agreement, rather than a decision being imposed on one party.

“Of course, this isn’t always possible. But the process itself gives people access to this kind of justice. They have the opportunity to be heard and to gain a better understanding, and it’s entirely free.”

The Insurance & Savings Ombudsman Scheme (ISO Scheme) has provided free and independent support for consumers for 19 years. Each year the ISO Scheme responds to over 3000 complaint enquiries and investigates about 280 formal complaints.

“In any one day we could be looking at lost luggage claims for travel insurance to claims about stolen jewellery, vehicle damage or a house rebuild in Christchurch. There could be a problem with financial advice, a credit contract, or superannuation. The scope is enormous.

“Health insurance claims range from the cost of a doctor’s visit to heart bypass surgery. People are often stressed and emotional. It’s our job to listen and to mediate. We consider the facts, interpret contracts and apply the law. We then make fair and reasonable decisions based on the facts.”

Some cases stand out as being especially memorable, says Karen. “A few years ago, a woman’s insurance company refused to cover the costs of breast cancer surgery and treatment. It was really distressing for her and her family, and we were able to uphold her complaint as the company’s analysis was unreasonable. They had to pay up.

“It can be immensely satisfying to know you can make a difference to peoples’ lives. However, sometimes there’s nothing we can do, because, for example, there is simply no cover under the policy. We can’t champion a particular cause, or make a decision on the basis of sympathy.”

Unlike litigation, says Karen, dispute resolution is not about advocating for one side.
“Litigation is a necessary component of access to justice. But I left civil litigation because in the end it is about winning and losing, and there are better ways.”

Consumers who have had their case heard by the ISO Scheme can still go through the courts or Disputes Tribunal if they wish. “Our decisions are binding on insurers and financial services providers, but not on consumers,” says Karen.

As many complaints arise due to misunderstandings or a lack of information, Karen is keen to make more information available up front.

“Financial services providers can have customers who haven’t understood what they have signed up to, or what they have been paying for over a number of years. That presents a real problem for both parties.

“Knowledge is power. We know some people think insurance is boring, or too difficult. But the fact is insurance has a major impact on peoples’ lives. People need to understand how it works, read their policies and make informed choices. I think Christchurch has opened the public’s eyes to this.

Karen says people can contact the ISO Scheme office with any question or issue. “Although we cannot give advice on what decisions to make, we can provide information.”

When Karen takes off her Ombudsman hat, she runs a tight ship as mother to two busy boys. “Life is a fine balance, and I can’t say dispute resolution is always so clear at home!” says Karen.
“I’m really involved in my sons’ activities, their sports and their music. It is busy but that’s life as a parent.
“We all play tennis, and I even do karate with my youngest! I also swim twice a week, and walk whenever I can. And we love to go on holiday as a family.

“It’s important to have things to look forward to, and it’s important to have thinking space – time to clear my head and reflect on what I do. We could all probably do with a little more time!”

Karen Stevens’ top five tips to success at work and home

1. Belief in what you do
2. Balance
3. Order
4. Thinking space
5. Family time out

By Zoe Priestley