Complaints regarding your
Insurance Claim or Policy
If you have a complaint about insurance, there are steps you can take on your own or with a lawyer to find a resolution.
- Step 1: Contact your insurance agent, broker or adjuster. Make sure you have your details and policy papers ready before you call. Your agent, broker or adjuster will discuss the situation with you as you work towards a resolution.
- Step 2: If you are not able to reach a resolution with your agent, broker or adjuster, your next step would be to contact the management of your insurance company. Someone from management or a senior representative will discuss your issue with you, and attempt to reach a resolution. Some insurance companies have an internal ombudsman who you can contact for an additional level of review. Click here for the list of Insurers, Reciprocal Insurance Exchanges, and Fraternal Societies Licensed in Alberta, which includes contact information for the Complaint Liaison Officer/Ombudsperson. Again, have your details and policy papers ready.
- Step 3: If you still have not reached a resolution, the final step is to contact an external body for assistance. There are two groups to assist you depending on your type of insurance:
There is a separate dispute resolution process for when you and your insurer cannot agree how to settle a claim.
If you want assistance, you can contact a lawyer at any point in time to obtain additional information or protect your rights. For information on finding a lawyer, contact the Law Society of Alberta.
(Source: Canadian Council of Insurance Regulators)
If you think there's a problem, ask for an explanation as soon as possible.
- Often, problems arise due to misunderstanding or miscommunication between individuals. If addressed early, many problems can easily get sorted out. However, if you are not satisfied with the response you receive make a formal complaint.
Be clear about the problem and what you would like to see happen in the future.
- A formal complaint often requires that you make a complaint in writing. You need to identify the problem, state why you think it's a problem and set out what you would like to happen. Put down the facts in a logical order and provide relevant information and copies of documents. Avoid unnecessary detail and repetition. Avoid bringing new issues forward while the complaint is going through the process. Often this confuses matters and results in unnecessary delays.
Ask for information when necessary.
- Know your rights about filing a complaint. Keep in mind that some companies are required to have a complaint process that includes providing information on how to make a complaint, how long the process will take and the next steps if the complaint remains unresolved.
Keep a complaint file.
- Make copies of all correspondence and official documents you send to the company. Always send copies of official documents and keep the original for your file.
Keep records of conversations.
- If you phone a company or attend a meeting, keep a record of the date, the name of the person you spoke to and the main issues raised by both of you. If there is an action expected following a conversation, send a confirmation letter to the company. Be specific about the agreed action and the timelines.