
Consumer Assistance
Insurance concerns? You have options regarding consumer advocacy and
dispute resolution.
Canada’s home, car and business insurers strive to deliver the
best possible service to their customers. It’s in their best interest
to do so. With more than 200 companies competing for business, no insurer
can afford to have a reputation for poor service.
Furthermore, insurers face severe financial repercussions if they treat
a customer unfairly. Legal costs, court awards and fines stemming from
a dispute can easily exceed $1 million. As a result, insurers will not
engage in a dispute unless they believe there is a very good reason to
do so.
Nevertheless, disputes and misunderstandings do occur.
If you have a complaint about your insurer or your insurance professional,
it’s important to remember there are many options available
to you. You are NOT powerless.
Depending on the nature of your complaint and the processes in place
where you live, the steps you take can vary. Here is an overview of your
options to help you make sure your concerns are addressed.
Step 1:
Ask your broker/agent, company representative or claims adjuster
for an explanation.
Insurance policies are legal contracts that specify the rights and responsibilities
of both parties. Misunderstandings about these rights and responsibilities
can arise. Often, a simple explanation is all that is required.
You might also consult one of IBC’s Consumer Information
Centres. Find out more about these
consumer centres.
IBC's Consumer Information Centres are staffed with trained personnel who have
many years of experience in the insurance industry. They operate independently
and answer tens of thousands of consumer inquiries each year, covering
topics such as:
- the technicalities of policy wordings and coverage
- how insurance companies handle claims
- tips for buying insurance
- advice and direction for how to proceed with complaints
Step 2:
Consult your insurance company's ombudsperson.
All federally licensed home, car and business insurers have a dispute-resolution
mechanism in place, including a complaints liaison officer.
Get tips for making your complaint. 
When you make your complaint:
- Make it clear what your concern is and state clearly and simply what you expect.
- Have all the pertinent information and documentation available.
- Allow time for your insurer to investigate and to answer your complaint.
- Make sure you keep a record of whom you talked to and what was said.
Step 3:
Use the General
Insurance OmbudService (GIO), an independent, regionally-based,
consumer dispute-resolution system for the insurance industry.
Get details about the GIO. 
Most federally licensed insurers and several provincially incorporated
insurers are members of General
Insurance OmbudService (GIO). GIO helps you and your insurance
company to resolve your differences in a fair, independent and impartial
environment. GIO works to resolve disputes about claims-related matters
and about interpretation of policy coverage.
If your matter is not resolved with your insurer's complaint liaison
officer, ask for a final position letter and call GIO.
Step 4:
Consult your provincial Superintendent of Insurance.
The insurance industry is highly regulated at both the federal and provincial
levels.
Get information about regulation at the federal level. 
Get information about regulation at the provincial level. 
Each province and territory has a Superintendent of Insurance
and regulates insurance through its own rules and regulators. Provincial
regulators work together on common issues through the Canadian
Council of Insurance Regulators (CCIR). They also monitor
the solvency of insurers that are only incorporated in a province.
The main focus of provincial regulators is market
conduct - ensuring that insurers' pricing, underwriting and claims
handling practices are fair. Provincial regulators:
- handle complaints, mediations and arbitrations
- issue fines
Therefore, they are your next option if your dispute has not been resolved
by GIO or if your insurer is not a member of GIO. In Quebec, you may
go straight to the provincial regulator, Autorité des marchés financiers
(AMF), as an alternative to GIO.
Provincial governments in Alberta, Ontario, New Brunswick, Nova Scotia,
Prince Edward Island, and Newfoundland and Labrador also have provincial
rate boards to regulate auto insurance prices. These boards seek to
guarantee that the price for auto insurance is related to the costs
of providing this insurance.
Superintendents of Insurance, Advocates and Others Who Will Help Address
your Concerns
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