Frequently Asked Questions
How do I start the process of resolving my problem with my insurance company?
Just call or e-mail your local General Insurance OmbudService office.
How much is it going to cost me?
Nothing. The insurance company involved pays all mediator costs.
I'm having a problem with my group disability insurance at work. I made a claim and my insurance company isn't paying. Can you help?
The General Insurance OmbudService can only help with your dispute with your home, car or business insurance company. If you have problems with your life, health or disability insurance, please contact Consumer Assistance Centre at the Canadian Life and Health Insurance Association.
So, in a nutshell what is the General Insurance OmbudService?
It's an opportunity for insurance companies and insurance customers to resolve differences. Professional mediators will work with the parties, in a fair, independent and impartial environment, to arrive at a solution that is in the best interest of all.
What happens when I call the General Insurance OmbudService?
A consumer services officer will explain the process for resolving your complaints. Find out how to make a complaint.
What is mediation and how does it work?
Mediation is a process to help the insurance customer and the insurance company resolve their differences in an informal way. Mediation involves the help of a neutral third party mediator who guides and supports the parties to help them reach a mutually agreeable solution to their dispute. The process is confidential and impartial and conducted without prejudice.
What is the Financial Services OmbudsNetwork? Who are the Network's members?
The Network is an industry-based, consumer assistance and referral system that builds on long-established consumer redress mechanisms in the financial services industry. Members represent the entire financial service community nationwide. The Network has three components:
- Individual financial services companies are at the heart of the Network. Their own consumer complaint management activities provide the first level of recourse for consumers with concerns or complaints. These companies are represented by: Canadian Bankers Association, Canadian Life and Health Insurance Association, Insurance Bureau of Canada, Investment Dealers Association of Canada, Investment Funds Institute of Canada, and the Mutual Fund Dealers Association.
- Financial Industry OmbudServices are the Network's second component. They include: Ombudsman Banking Services and Investments, General Insurance OmbudService, and the Canadian Life and Health OmbudService are the network's next component. These independent ombudservices provide impartial and independent resolution of complaints, based on fairness and good industry practice, for consumers whose complaints have been dealt with at the company level, but have not been resolved.
- The Centre for the Financial Services OmbudsNetwork is the umbrella organization for the ombudservices, including the General Insurance OmbudService. Through its consumer assistance and referral service and website, the Centre guides consumers to the point in the system which matches the nature and stage of their concern. The Centre also develops and promotes industry best practices and standards relating to financial consumer complaint-handling.
What kinds of problems with the insurance company will the GIO help with? What areas won't they get involved in?
Mandate and role of the GIO.
What's the difference between the FCAC, the Centre for the Financial Services OmbudsNetwork (CFSON) - formerly the NFSO - and the General Insurance OmbudService?
The Financial Consumer Agency of Canada (FCAC) is a regulatory agency created by the federal government to ensure that federally-regulated financial institutions meet their legal obligations to deal with consumer complaints.
The FCAC is not a dispute resolution body for consumers in their dealings with financial institutions. The dispute resolution mechanism required of these companies is a result of changes to the Insurance Companies Act.
The consumer dispute mechanisms required of home, car and business insurers are:
- the establishment of internal procedures for dealing with consumer complaints
- designation of an officer or officers within the companies to receive and deal with complaints
- membership in an organization dealing with complaints not resolved to the satisfaction of the consumer through the company's complaint handling procedures
The Centre for the Financial Services OmbudsNetwork (CFSON) formerly the National Financial Services OmbudService --- was created by the IBC and the trade associations of four other financial services - banks, life and health insurers, investment dealers and the mutual fund industry - to help members meet their new legal obligations to be a member of a third party organization which deals with complaints.
The Centre provides bilingual, integrated, national consumer assistance and referral for financial services consumers who don't know who to approach to get resolution to their concerns or complaints relating to banking, life and health insurance, general insurance, securities and mutual fund products and services.
CFSON has been endorsed by the Secretary of State (International Financial Institutions) the Joint Forum of Financial Market Regulators, the Canadian Council of Insurance Regulators, the Canadian Association of Pension Supervisory Authorities and the Canadian Securities Administrators.
Why use mediation?
Savings in cost and time are the primary reasons, but there are other important reasons. For example, mediation:
- aims to preserve business relationships
- is a simple process
- is confidential
- offers the customer an alternative to legal action
- is non-binding; the outcome is within the control of the parties