Complaint Process – Insurance

The Office of the Superintendent of Insurance’s involvement in a complaint is limited to our authority under insurance legislation. This limitation does not provide us with the authority to settle civil matters where determining liability (e.g. who is at fault) or restitution (e.g. award damages) is the issue.

It is recommended clients first go through all avenues available through their insurance company including the ombudsman or complaints division of the insurance company for resolution of a complaint. You can find a list here.

After contacting the insurance company, if you are still not satisfied with the response to your complaint, you may be able to contact one of the industry ombudsman’s services. Not all companies are members, to check to see if your insurance company is a participant of the General Insurance OmbudService, click here or a participant of the OmbudService for Life & Health Insurance, click here.

When the Office of the Superintendent of Insurance receives a complaint, the first point of contact is with the ombudsman/complaints division to ensure a complaint has been filed and the outcome. Therefore, it is in the best interest of clients to contact the complaints division/ombudsman of their insurance company as a first step to resolving a complaint.

If you have exhausted all avenues with your insurance company and you are still not satisfied with the outcome, to file a complaint with the Office of the Superintendent of Insurance, a complaint must be sent in writing. We require written documentation to have a record of the complaint.

Once a complaint is filed, you have consented to share the complaint with the other parties involved and the Office will contact the other parties for their response to the complaint. Again, the Office is limited to our authority under insurance legislation which does not provide us with the authority to settle civil matters where determining liability or restitution is the issue.

The following is required when filing a complaint:

  1. Your contact information
  2. An account of the issue including everything which has been done up to the point of submitting your complaint, who you have spoken with, and their contact information
  3. A copy of all relevant documentation – policy(including terms and conditions), letters received from the insurance company, emails, etc.
  4. If a complaint is being sent in on behalf of someone else, the complainant must write and sign a Consent of Authority giving the representative permission to speak on their behalf along with their contact information so consent can be confirmed. If consent is not given, the Office will deem the complaint retracted.

Complaints can be emailed directly to Digital Government and Service NL at Servicenlinfo@gov.nl.ca or faxed Attention: Complaints at (709)729-3205

Review and response to a complaint depend on the complexity of the issue and response from all parties involved. The Office of the Superintendent of Insurance will send out a final position letter outlining the outcome of your complaint.

Please note: there are instances due to the nature of a complaint it is forwarded to the Investigation Division. If this occurs, the complainant will be notified and the Investigation Division will contact you if required. It is the policy of the investigation division not to divulge there is an active investigation nor divulge information regarding the investigation to the public.

If you are still unsatisfied with the decision of the Office of the Superintendent of Insurance, you may contact the General Insurance OmbudService, an independent dispute resolution service.