Treat an ombudsman referral as a second look at your own decision. The agent assembles the complete case file, checks it for gaps, drafts the firm's submission and tracks every deadline the ombudsman sets. A named case owner decides the firm's position, including whether to settle, and a person sends every submission and accepts or challenges any finding.
What happens when a complaint is referred, and who owns it?
When a customer is unhappy with the firm's final response, or the firm has not answered in time, the customer can usually take the complaint to an independent ombudsman. The ombudsman asks the firm for its file, its reasons and any further evidence, and sets deadlines. It may propose an outcome informally, which either side can accept or reject, and can make a final decision that may bind the firm if the customer accepts it.
Most firms have a small team for ombudsman cases, separate from front-line complaint handling, often within the complaints function or legal. A case owner handles each referral; a manager decides on settlements and challenges. The work is document-heavy and deadline-driven, which suits an agent, but every position the firm takes is a judgement. FCA complaints handling: what an AI agent may do sets out the UK boundary in more detail.
What does the agent prepare, and what does a person approve?
- Person, case owner: logs the referral with the ombudsman's reference and deadlines.
- Agent, depth 1: assembles the file. The original complaint, its classification, the investigation notes, evidence, call recordings or transcripts, all correspondence and the final response.
- Agent, depth 1: checks the file. Is every document the ombudsman asked for present? Did the final response address every point? Are there events after the final response, such as further contact or payments, that change the picture?
- Agent, depth 2: drafts a review note for the case owner. Where the firm's original decision looks weak against the evidence, inconsistent with similar cases, or missing a point, quoted and referenced.
- Person, case owner: decides the firm's position. Stand by the decision, offer to settle, or concede.
- Agent, depth 2: drafts the submission setting out the firm's position, reasons and evidence index, in the format the ombudsman requests.
- Person, case owner: approves and sends the submission.
- Agent, depth 1: reads the ombudsman's view when it arrives and drafts a summary with the points of disagreement.
- Person, manager: decides to accept or challenge, and approves any redress.
| Step | The agent does | Depth | Stays with a person |
|---|---|---|---|
| Log | Nothing | None | Owning the referral |
| Assemble | Gathers the full file | 1 | Supplying missing items |
| Check | Finds gaps and later events | 1 | None |
| Review note | Flags weak points | 2 | Judging the case |
| Position | Nothing | None | Defend, settle or concede |
| Submission | Drafts with evidence index | 2 | Approving and sending |
| View | Summarises and compares | 1 | Accept or challenge |
Which controls apply, and what evidence does each leave?
Deadlines tracked at depth 1, escalated early. The agent reads every ombudsman letter for deadlines and alerts the case owner well before each. Evidence: a deadline log with alert times.
A neutral review note. The note is written to test the firm's decision, not defend it. A referral is the last chance to fix a wrong outcome cheaply. Evidence: the note filed with the case owner's decision.
Evidence index. Every assertion in the submission points to a document in the file. Evidence: an index the ombudsman, or your own QA, can check.
Named decisions. Settlement offers, concessions and challenges are approved by a named person with authority to commit the firm. Evidence: the approval record.
Lessons fed back. Where the ombudsman upholds a complaint, the agent drafts a root-cause note for the complaints manager. Evidence: the note and the action taken.
What should you measure?
- Ombudsman decisions that changed the firm's outcome, by product and cause. This is the clearest sign of front-line quality.
- Settlements offered at the review-note stage that would otherwise have gone to a decision.
- Deadlines missed, which should be none.
- Requests from the ombudsman for missing documents after the first submission.
- Time spent per referral.
Where does it usually go wrong?
Defending by reflex. The agent drafts a persuasive submission for a decision that was wrong. Persuasive drafting does not help; it delays redress and the ombudsman will see the evidence anyway.
Missing later events. The customer made further contact after the final response, or a payment was reversed. The submission describes the case as it stood months ago.
Inconsistent outcomes. The firm upheld a similar complaint from another customer and is defending this one. The ombudsman may notice. The agent should search for similar cases and show the case owner how they were decided.
Complaints about agents. If the complaint concerns an AI agent's action, the file must include what the agent did and why, reconstructed from its record. See whether an AI agent can handle complaints about itself, which explains why a different handler must own such cases.
Root causes left in the file. A referral that ends in an uphold but changes nothing upstream will recur. Feed findings into how complaints are classified and answered; see classifying complaints against regulatory definitions and drafting final response letters.
Whether an AI agent can handle customer complaints sets the wider boundary, and the stance on compliance agents generally is in AI compliance agents.
Questions people ask
Can the agent communicate directly with the ombudsman?
It should not. Submissions, calls and settlement discussions are the firm speaking formally, and a named person should own them. The agent drafts and tracks.
Should the agent see how the ombudsman decided similar cases?
Where decisions are published, they are useful context, and the agent can summarise relevant ones for the case owner. Treat them as external sources, and let the case owner judge their relevance.
What if the firm missed the original complaint deadline?
The agent records the timeline as it happened. Any breach of complaint handling rules is assessed separately through your breach process, not hidden in the submission.