Insurance Complaint Handling Protocol
Compliant handling has always been an issue that insurance brokers have had to deal with. For years Scrivens has had a formal complaint handling protocol. This protocol provides customers with a formal internal process through which they can lodge complaints and have them reviewed and resolved at the broker level.
Certain provinces have now formalized compliant handling protocols through their respective provincial legislation. The Province of Ontario has introduced new legislation concerning the handling of complaints.
Scrivens has deciphered these new obligations and has fine tuned its complaint handling protocol so that it respects the demands of the new legislation.
Notwithstanding any Protocol governing our actions, Scrivens and its employees will, at all times when dealing with a person who has a complaint, act with respect, courtesy and will always respond in a highly professional manner.
If you have any questions concerning the Scrivens compliant handling protocol, please do not hesitate to contact:
Peter Scrivens
Corporate Governance Office and Ombudsman
613-236-9101 ext 1100
pscrivens@scrivens.ca
Scrivens complaint handling protocol
What is a reportable complaint?
A reportable complaint consists of:
- When a complaint:
- Expresses a reproach
- Identifies a potential or suffered prejudice
- Claims a corrective measure
If all three elements are not included in the complaint letter, we must insist that the complainant modify his complaint letter and indicate the missing elements.
It is also necessary that all three elements be put in written form by the complainant in order that he can submit his complaint. The complainant can either send his complaint in a letter or by e-mail.
We must offer support to a complainant that is unable to write. The content of the letter must afterwards be validated by the complainant by obtaining his signature on it.
Responsibility of the person in charge of managing the Complaint handling policy
The person responsible for managing the Complaint handling policy must respond to the legislative authorities when need be. The person responsible for managing the Complaint handling policy must maintain a register of complaints. The complaints need to be classified as per the categories of complaint set forth by the National Agency.
The person responsible for managing the Complaint handling policy must proceed to send an annual report to the National Agency within two months after the closing date of its fiscal year.
The acknowledgment of receipt and notice
The person responsible for managing the Complaint handling policy must proceed to send a letter acknowledging receipt of the complaint and a notice to the complainant without delay.
The acknowledgement of receipt must:
- Give the name and coordinates of the person responsible for the Complaint handling policy
- Give the delay for the receipt of a final position letter and give the delays for subsequent communications
- Give the principal elements of the Complaint handling policy.
The Notice must:
Advise the complainant that if he is dissatisfied with the complaint examination procedure or its outcome, he may request the firm to forward a copy of the complaint file to the Agency. Advise the complainant that he must wait until he has received a final position letter or until the expiration of the delay to send a final position letter prior to referring this file to the National Agency.
Advise the complainant that he has 1 year to ask that his file be transferred to the National Agency for a review following the expiration of the three month delay that the Firm has to send their final position letter.
Advise the complainant that he can ask the National Agency to review his complaint and that the National Agency can, if it is so inclined, suggest mediation if both parties consent to it.
Mention that the statute of limitations before the civil courts are not interrupted because the complainant has asked for a review of his complaint by the National Agency
Content of the Complaint file
A complaint file must be maintained by the person responsible for managing the Complaint handling policy.
The complaint file should contain the following elements:
- Reproach
- Prejudice (potential or suffered)
Corrective measure
The detailed analysis completed by the firm
A written and motivated response from the firm to the complainant
*Do not forget to transfer the complaint file to the National Agency within a reasonable timeframe.
Agree |