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

FAQ’s

Do I have to join OLHI?
Canadian law requires most life and health insurance companies to be members of an independent complaint resolution service. Ninety-nine per cent of all Canadian life and health insurers are OLHI members.

Is OLHI membership free?
We are funded by our member companies that pay fees based on their size or volume of business. Our budget and membership fees are set each year by our Board of Directors.

If insurers pay to join, do they have a say in how OLHI operates?
OLHI’s independence and impartiality are crucial to our mandate and so member companies do not control our operations. The Canadian Council of Insurance Regulators (CCIR) and OLHI’s Board of Directors oversee our operations.

Is OLHI a consumer advocate?
No. 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.

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

Are there limits on the amount of compensation OLHI can recommend?
No. 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 there any circumstances where you can not handle a complaint?
OLHI is unable to review some types.

Do OLHI members have to tell their customers about OLHI?
Yes. Insurers must advise consumers about OLHI on two occasions: when a consumer first makes a written complaint to the insurer and when the insurer issues its final position letter to the consumer.

Can OLHI take on a complaint if the insurer hasn’t provided a final response to the consumer?
Yes, if it’s been 90 days since the consumer complained to the insurer and a final position letter hasn’t been issued by the insurer.

What information does the insurer have to provide to OLHI as a part of the complaint review?
Insurers are required to disclose all relevant non-privileged information and documents.

How long does OLHI take to handle a complaint?
OLHI aims to close 80% of complaints received within 120 days.

Are there any timeframes insurers must meet during OLHI’s complaints process?
Insurers are required to disclose all relevant non-privileged information and documents to OLHI within 30 days and to respond to any settlement recommendations within 30 days.

How does OLHI’s process affect the statutory limitation period?
When a consumer files a complaint with OLHI, the statutory limitation period is suspended until the complaint is closed – unless the consumer resides in Quebec. Quebec law does not permit limitation periods to be suspended.

What is OLHI’s protocol for public disclosure?
If an insurer does not accept OLHI’s final non-binding recommendations, OLHI is required to publish our report and recommendations. The name of the insurer is revealed but all consumer-identifying information is omitted.

Where can I find additional information about OLHI’s complaints process?
See our process section of our website. Also, additional information about the insurer’s role in OLHI’s complaints process is set out in Part V of CLHIA’s Complaint Handling Reference Guide available to member companies on CLHIA’s intranet site.

Does OLHI also answer general questions about life and health insurance – or are you only in place to handle complaints?
Yes. We offer a free information service.