What to do if I disagree with my insurer

​We live in Beacon Hill with homes burned all around us. Our home needs new siding and windows, a new roof, etc., but our insurer said all it needs is a good cleaning. Can we appeal our insurer's decision?

If siding or roofing has been compromised, it must be repaired or replaced. If it has not been compromised, it may be feasible to simply clean it. If you disagree with your insurer, take the following steps to resolve the issue.

  1. Get more information from your insurer.
    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 – sometimes misunderstandings arise.
    2. If you have further questions, ask to speak with the claim supervisor.
    3. You might also contact the IBC Consumer Information Centre. Their staff have years of insurance experience and can answer questions about:

      • Technicalities of policy wordings and coverage
      • How insurance companies handle claims
      • Buying, renewing or updating insurance coverage
      • How to proceed with a complaint.
  1. Contact your insurance company's ombudsperson. All licensed insurers have a dispute resolution process and a complaints liaison officer. When you make a complaint:
      • Make your concern clear and clearly state what you expect
      • Have all pertinent information and documentation available
      • Allow time for your insurer to investigate and respond to your complaint
      • Make sure you keep a record of the people you talk to and what is said.
  1. Use the General Insurance OmbudService (GIO). If your matter is not resolved with your insurer's complaints liaison officer, request a final position letter and contact GIO. GIO is an independent, regionally based consumer dispute-resolution system for the insurance industry. Its members include several provincially incorporated insurers and most federally licensed insurers. GIO helps you and your insurer resolve differences about claims-related matters and the interpretation of policy coverage in a fair, independent and impartial environment.

  2. The Province of Alberta's Treasury Board and Finance offers information and support for consumers who have complaints about the resolution of their claims, as well as a process for dispute resolution. Visit their website for information: http://www.finance.alberta.ca/publications/insurance/info_consumer_complaints.html.