Complaints Handling Procedure

Beneple recognises that there may be occasions when the service or treatment you have received falls short of what you might reasonably expect. This procedure explains how to tell us, what we will do about it, how long each step takes, and how to take the matter further if you are not satisfied with our answer.

Our aim is to resolve dissatisfaction as close as possible to the point where it arises, and to investigate thoroughly and fairly so that decisions are based on the facts of your case.

Complaining is free, and it will not affect the service you receive from us.

What counts as a complaint

A complaint is any expression of dissatisfaction — made directly or indirectly — relating to a product or service provided by Beneple, by one of our employees, or by an intermediary or business partner acting for us.

You do not need to use the word "complaint". Any of the following tells us you have one:

• An explicit statement, such as "I want to make a complaint"
• An expression of dissatisfaction, such as "I am not happy with…" or "this policy does not meet my need"
• A statement that expectations were not met, such as "I was told that… but this has not happened"

Matters we will refer to your insurer

Some matters are for the insurer or policy provider rather than for us. Where your complaint concerns any of the following, we will tell you that it needs to be raised directly with the provider, and we will let the provider know you have an issue to raise:

• Denial of coverage, or rejection of a claim
• The accuracy of documentation issued by the provider
• Delays by the provider — refunds, reimbursements, approvals, membership cards, or adding and removing members
• The provider's administrative or operational processes
• Product dissatisfaction or suitability
• Changes to policy terms — exclusions, conditions, renewal, premiums or network coverage
• The service given by the provider's own staff

Separately, a complaint about a medical policy that concerns treatment clearly not covered by the policy, or a cost exceeding the policy limits, falls outside this procedure — because the answer is set by the policy itself.

There is an important exception. Where your dissatisfaction is caused wholly or partly by vague wording or unclear definitions in the policy, the terms and conditions, or the table of benefits, that **is** a complaint and we will treat it as one.

Time limit for raising a complaint

Please raise your complaint within six months of first becoming aware of the problem. Beyond six months we will use our discretion in how the time limit is applied, and we will consider a complaint outside it where there are special circumstances.

How to complain

You can raise a complaint in whichever way is easiest for you:

• Email complaints@beneple.com
• Telephone +971 (0) 4 567 4500
• In writing to Beneple, 1604 Ubora Tower, Business Bay, Dubai, UAE, PO Box 50685
• Directly with your Beneple advisor, or any of our people you deal with, who will pass it on

It helps us if you can tell us your name and how to contact you, the policy or membership it concerns, what happened and when, and what you would like us to do to put it right — but do not hold back a complaint because you do not have all of that.

What happens next

Stage 1 — initial assessment and response

Your complaint is reviewed and assessed by our Stage 1 complaint handler, who will try first to resolve it informally.

Where the complaint is substantive and cannot be resolved informally, the Stage 1 handler will give you an initial formal response **within five working days**.

Stage 2 — escalated investigation

If the Stage 1 handler cannot resolve your complaint to your satisfaction, it is escalated to our Stage 2 handler, who will investigate further. This may involve approaching your insurer for more information about the case.

You will receive a response **within fifteen working days** of the complaint being escalated to Stage 2.

Stage 3 — independent referral

If the Stage 2 handler cannot resolve your complaint to your satisfaction, the matter is referred to the Dubai Health Authority or the Central Bank of the UAE for independent consideration, because no internal resolution has been found. We will keep open channels of communication with both you and the regulator throughout.

A complaint is never handled by the person it is about, or by a department that is the subject of it. Everyone who responds to or investigates a complaint does so impartially, and no one may act on a case in which they have a material interest or a possible conflict of interest.

Confidentiality

Your complaint is handled with an appropriate level of confidentiality, and information is released only to those who need it in order to investigate or respond. No third party will be told any more about the investigation than is strictly necessary to obtain the information required from them.

Please note that making a complaint does involve some disclosure: limited disclosure of all or part of what you have told us is necessary for the investigation to proceed.

How we use complaints

Every complaint is recorded in our complaints register, along with what we did and how it was resolved. Complaint reports go to management monthly, and the complaints log and this procedure are reviewed annually so that lessons from complaints are built back into how we work.

We also submit an annual complaints report to the Dubai Health Authority, Health Funding Department.