The Exeter — Phase 03
Root Cause Framework
6 root cause categories used in Aptean Respond to classify upheld complaints. Process Related is the most granular — a 9-team by 12-process matrix.
IT Issue
- Highway
- SSG back office
- Website
- Broker portal
- Member portal
- Other system
Product Related
- Policy wording or T&Cs
- Policy summary / IPID
- Renewal/anniversary premium
- Mid-term adjustment in premium
- Incorrect quote
- Other literature/Marketing
- ML control factor
- Holloway bonus
Information
- Standard letters
- Life trust documents
- Other letters/emails
- Telephone
Third Party Providers
- SwissRe
- Squarehealth
- Medical Screening Solutions
Personnel
- Training
- Failure to identify vulnerable customer
- Human errors
Process Related
- 9 teams × 12 process types
- See detailed breakdown below
Process Related — Teams
| Team (Dropdown 3) |
|---|
| New Business |
| Underwriting |
| Member Support |
| Policy Admin |
| IP/Life Claims |
| PMI Claims / AXA |
| Complaints |
| Cashplan / Wessex |
| Finance |
Process Related — Sub-Categories
| Process Type (Dropdown 4) |
|---|
| Policy issue process |
| Anniversary/renewal process |
| Mid-term adjustment process |
| Payment process |
| Cancellation process |
| Delay due to SLA failures or backlogs |
| AMRA or medical evidence delays |
| AMRA or medical evidence process |
| Agency or commission process |
| Failures in internal communications |
| Underwriting decision |
| Other |
How It Works
When a complaint is upheld, the handler selects a root cause category, then a team, then the specific process type. Any of the 9 teams can be paired with any of the 12 process sub-categories — giving a detailed map of where process failures are occurring and who owns them.