Company Complaint Guide

OLHI offers an independent, free of charge dispute resolution process. Before you can use our process you must first try to resolve your complaint directly with your insurance company. This Guide is designed to assist you in dealing with your insurance company.

Act quickly. Start with the person or the office you dealt with.  When you call make sure you have all the appropriate documents such as brochures, account statements, copies of contracts and medical information, if appropriate. If this person can not resolve the situation, ask to whom you should address your complaint.

Know the process.  Each company has its own formal complaints handling process. Ask for your company’s written complaints procedure and follow the required steps. Many insurance companies have this information available on-line on their website.

Do it in writing. It is usually best to send your complaint in writing.  Ask to whom you should address your letter and what documentation should be enclosed.  Put “Complaint” at the top of your letter.  Set out the problem clearly.  Be clear about what went wrong and when.  Tell them what you expect as a solution.  Enclose all required documents.

Call OLHI. Before sending your complaint letter, you may wish to talk with an OLHI Complaints Counsellor to receive guidance on what facts and documentation would be helpful to include in your letter.

Ask for a Final Position Letter.  There will always be someone in your company’s formal complaints process who has authority to make a final decision in respect of your complaint and to issue a “final position letter” on behalf of the company. Ask for a final position letter from this decision maker.

Use OLHI’s Independent Process. If your company’s final position letter does not resolve the complaint to your satisfaction, or your insurer fails to provide you with their final position within 90 days of their letter acknowledging receipt of your complaint, you are free to use OLHI’s independent complaints resolution process, subject to limited restrictions.
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Helpful Tips

Be Calm and Courteous . Although trying to resolve a complaint can be frustrating and stressful, our experience is that a courteous manner facilitates communications and promotes a quicker resolution of your complaint.

Be Patient and Persistent. Depending on the situation, you may need to escalate your complaint to more senior people if you are not satisfied with how your insurance company is responding to your complaint. 

Follow the Process.  Member companies have designated specialized resources for handling complaints. Trying to “jump the cue” will usually result in your complaint being redirected back to the designated person in your company’s complaint process.

Keep Records. Take notes of any important details of your conversations as well as names and dates of the persons you talked to. Keep copies of all correspondence sent or received by you. Send copies of any supporting documents, such as contracts or medical reports;keep your originals.