OLHI – OmbudService for Life & Health Insurance | Resolution of your Canadian Insurance Concerns | OLHI

FAQs

Are you a consumer advocate? OLHI does not advocate for either the consumer or the insurance company. Any recommendation we make is based on our impartial review of the relevant facts, so that both sides know they are getting a fair, unbiased perspective.

What does it cost to use your services? All OLHI’s services are free of charge to consumers across Canada, in either English or French.

Are there limits on the amount of compensation you can recommend? There is no limit. However, whether compensation is warranted and the appropriate amount will depend on the facts of each case. Also, we do not consider claims for interest, costs, punitive damages or damages for pain and suffering.

Are OLHI’s recommendations binding? No. We provide voluntary settlement recommendations which avoid costly, complex court proceedings.

When and how do I initiate a complaint? A Dispute Resolution Officer can guide you through OLHI’s process or your insurance company’s process at any time. OLHI can formally review your complaint any time after you’ve received your final position letter. If it’s been 90 days since you’ve complained to your insurance company and you haven’t received a final position letter, we can urge them to review your case.

After I complete my insurance company’s complaints process, will they tell you about me and my case so that you can help me? Or, what if my friend or relative contacts you about me and they ask you to call me? Work with OLHI must be initiated by the consumer. For example, an insurance company will never tells us about you or your complaint. The company will tell you about OLHI – and it is always up to you whether you decide to contact us. If your friend or family member contacts us, we can’t take any action until we hear from you directly. You must submit your complaint, along with an authorization form. If you want a representative to work with us on your behalf, you must advise us of this on your authorization form.

How long will it take to handle my complaint? Most consumers will receive the results of our initial review within 90 days from the date we receive all the documents we need from you. We aim to close 80% of our cases within 120 days.

Are there any circumstances where you cannot handle my complaint, even after I complete my company’s process? OLHI is always available to discuss a complaint but we are unable to review some types.

Can I proceed directly to have my complaint dealt with by an OmbudService Officer, skipping the Dispute Resolution Officer? Our complaints handling process has been specifically designed to handle your complaint in the quickest and most efficient way. Since most complaints are capable of early resolution, it must first be reviewed by one of our Dispute Resolution Officers.

What if I am not satisfied with the outcome of my complaint? If we find your complaint does not have merit or we are unable to settle the complaint, you have the right to pursue other remedies, such as legal action or a complaint to a local regulator.

Should I speak to my lawyer before making a complaint to OLHI? You and the insurance company will be asked to sign an agreement suspending the limitation period while OLHI reviews your complaint. However, in Quebec, it is not legally permissible to make such an agreement. You should speak with a lawyer if you have any questions about this or about how working with OLHI impacts your limitation period. We do not provide legal advice.

How can you be impartial and independent when OLHI is funded by life and health insurance companies? In Canada and around the world, regulators and OmbudServices in the financial services sector are typically funded by the industries they cover, as opposed to the general tax payer. OLHI’s independence is safeguarded by ensuring that the insurance companies do not control our operations. To ensure impartiality, our operations are overseen by the Canadian Council of Insurance Regulators (CCIR) as well as our independent Board of Directors. Our budget is set by OLHI’s Board, based only on the recommendations of the independent directors. Our Executive Director, who manages day-to-day operations, has no ties to the life and health insurance industry.

Can you answer my general questions about life and health insurance? Yes. We offer a free information service.