Do you hear what I hear?

Listening to your members, via your Complaint Management System (CMS), is not only a good business practice, it is expected by your regulators. Having an effective program in place is another arrow in your quiver of solid risk management practices. Unfortunately, the devil is in the details, and keeping good records seems daunting. You don’t have to build the Taj Mahal of systems, you just need to put a solid structure in place in order to hear what your members are telling you.

There are four main objectives for your CMS:

1. Complaints and inquiries are recorded and categorized
2. Complaints and inquiries are addressed and resolved promptly
3. Data and case information drive adjustments to business practices
4. Complaints raising legal issues are appropriately escalated

First, let’s focus on objectives #1. In a former life, I took over the management of the CMS for my organization. The individuals responsible for recording the complaints and reporting to management did a nice job of documenting details. They recorded who made the complaint, how the complaint was received, who they assigned for resolution, and the status of the complaint (open/closed). What they didn’t do was document the details of what they did to resolve a complaint, and they didn’t categorize the complaints. Let me give you an example of what was captured.  The names and details below have been changed to protect the innocent:

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