A GUIDE TO CRITICAL ILLNESS INSURANCE
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I have a complaint. Who can help?
If you are ever dissatisfied with the result of a claim or the service you've received, there
are three steps you can take:
1) Start with your agent or insurer. Start by talking it over with your agent or your
insurer. All insurance companies have an internal complaints process. Most insurers
describe their complaint process in detail on their websites. This will allow you to direct
your complaint to the right problem resolution team or to escalate it to your insurer's
internal ombuds office who will investigate and provide you with a Final Position Letter
outlining your insurer's final decision about your claim.
2) File a formal complaint. If you are dissatisfied with the Final Position Letter from your
insurer, you can file a complaint with the OmbudService for Life and Health Insurance
(OLHI), a free, independent dispute resolution service for Canadian life and health
insurance consumers. OLHI will investigate on your behalf. For more information
visit www.olhi.ca.
If you are a policyholder in Quebec you also have the option of asking your insurer
to formally transfer your complaint to the Autorité des marchés financiers for voluntary
dispute resolution. For more information visit lautorite.qc.ca/en/general-public/
assistance-and-complaints/making-a-complaint.
3) Other remedies. If you are still unsatisfied, you have the right to pursue other
remedies, such as legal action or a complaint to the insurance regulator in your
province or territory.
Policyholder protection
What is Assuris and how does it protect you?
Assuris is the independent, not-for-profit organization that protects Canadian
policyholders if their life and health insurance company were to fail. Every life and health
insurance company authorized to sell insurance in Canada is required by law to become
a member of Assuris.
For critical illness insurance policyholders, Assuris guarantees that you will retain up to
$250,000 or 90 per cent of your benefit amount, whichever is higher.
Learn more about Assuris and its protection at www.assuris.ca.
WHERE TO GO
FOR ASSISTANCE
