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car insurance dispute resolution

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发表于 5/18/2019 16:52:49 | 显示全部楼层 |阅读模式
Dispute Resolution




​You have options when filing a complaint. Start by getting more information from your insurer. Consider contacting the company’s ombudsperson. If your dispute is not resolved, you can contact the General Insurance OmbudService (GIO).




​Consider These 4 Steps to Resolve a Dispute
If you have a complaint about your insurer or insurance professional, here’s an overview of options to help ensure your concerns are addressed. ​Please note that dispute practices vary from one province to another.
  • Get more information from your insurer.
    • Ask your broker, agent, insurance representative or claims adjuster for a more in-depth explanation regarding your concern. Insurance policies are legal contracts and the rights and responsibilities of both parties involved are written within the agreement however sometimes misunderstandings arise.
    • If you have further questions, ask to speak with the insurer’s claims manager/supervisor.
    • For general questions you can contact the IBC Consumer Information Centre (CIC). IBC's CIC staff have years of insurance experience and can answer questions about:
      • Technicalities of policy wordings and coverage
      • Factors that could impact your decisions when buying, renewing or updating insurance coverage
      • How to proceed with a complaint
      • How to find information about a Complaint Liaison Officer or Ombudsperson
  • Contact your insurance company's Complaints Liaison Officer or Ombudsperson. All licensed insurers have a dispute resolution process and the person assigned to make sure the dispute resolution process is enforced within the organization. That person is typically called Complaints Liaison Officer or Ombudsperson. Note that the role of Complaints Liaison Officer or Ombudsperson is defined by the provincial regulator.

    When you make a complaint:
    • Make your concern clear and clearly state what you expect
    • Have all pertinent information and documentation available
    • Allow time for your insurer’s ombudsperson to investigate and answer your complaint
    • Make sure you keep a record of the people you talked to and what was said.
  • Use the General Insurance OmbudService (GIO). If your matter is not resolved with your insurer's complaints liaison officer, request a final position letter and contact GIO. GIO is an independent, regionally based consumer dispute-resolution system for the insurance industry. Its members include most federally licensed and several provincially incorporated insurers. GIO helps you and your insurer resolve differences about claims-related matters and interpretation of policy coverage in a fair, independent and impartial environment

  • Contact a federal or provincial institutions listed below. If your dispute is not resolved by GIO or if your insurer is not a member of GIO, get in touch with a Financial Consumer Agency of Canada.



 楼主| 发表于 5/18/2019 17:03:03 | 显示全部楼层
How do I complain about an insurance company?

Five easy ways to complain against an insurance company
  • Write to insurer. Send a written complaint, with supporting documents, to the insurer's grievance redressal officer, and get an acknowledgement. ...
  • Time limit. The insurance company is required to address the complaint within 15 days of its receipt. ...
  • Contact Irda. ...
  • IGMS. ...
  • Ombudsman or civil court.






 楼主| 发表于 5/18/2019 21:38:41 | 显示全部楼层
ConsumerInfo – Have a Complaint?Who ya gonna call – when you have a complaint?By Sally Praskey, Editor, Insurance Canada ConsumerInfo
You have a claim that you thought would be covered by your insurance. That's why you bought your policy in the first place, right? Yet your insurance provider is insisting that your claim is not covered under your policy. What do you do?
First, ask your insurance provider to show you exactly where in the policy it states that this particular peril is not covered. It may be that once you have read your policy, you will realize that you have no argument. (That's why it's so important to ask your insurance provider what is not covered before you buy your policy.)
However, many claims are not so cut-and-dried. Perhaps, having checked your policy, you still disagree with the insurer's decision. If so, try to resolve your problem within the company first. Discuss your case with a senior official in the claims department, the claims manager, if possible. This official may make an allowance if there is a grey area, particularly if you are a good long-term customer. But don't count on it.
If you're still not satisfied, find out if the insurance company (not the broker) has an ombudsperson or an employee who deals with consumer complaints. If so, contact that person.
General Insurance OmbudService
If you have followed these steps and your complaint still has not been resolved, there are other avenues to pursue. If your complaint concerns a licensed property and casualty insurance broker in Ontario, contact the Registered Insurance Brokers of Ontario (RIBO). Otherwise, contact one of the three members of the Financial Services OmbudsNetwork (FSON), a national, independent dispute-resolution system.
In the case of home, automobile, and business insurance, contact the General Insurance OmbudService (GIO). This service is available free of charge, in both English and French, to any policyholder in Canada. The majority of issues GIO deals with concern claims, interpretation of policy coverage, and policy processing and handling. Policyholders who have a dispute with one of GIO's member companies (which comprise most of the general insurance companies operating in Canada) can initiate the process by contacting GIO with the details of their complaint after they have first tried to resolve the problem directly with their insurance company. Consumers can access GIO's services by telephone (1-877-225-0446), mail, e-mail, fax, or through its Web site.
For more information, visit www.giocanada.org.
OmbudService for Life and Health Insurance
If you have a complaint about your life or health insurance, contact the OmbudService for Life and Health Insurance (OLHI). Like GIO, OLHI is an independent service to help consumers with complaints that they are not able to resolve by dealing directly with their insurance company. For more information, visit www.olhi.ca/.
Ombudsman for Banking Services and Investments
The third member of FSON is the Ombudsman for Banking Services and Investments (OBSI), an independent service for resolving banking services and investment disputes. For more information, visit www.obsi.ca.
Other options
In the case of property-claim disputes, you could also retain a public adjuster, a licensed adjuster who acts on your behalf to settle your loss with the insurance company, taking a percentage of the final settlement as payment. While public adjusters are not as common in Canada as they are in the United States, and the insurance industry – not surprisingly! – tends to shun them, they represent yet another avenue for dissatisfied consumers.
Finally, you may have to resort to legal action. If you retain a lawyer, choose one who specializes in insurance litigation, and ask in advance about fees. Lawyers' fees for bodily-injury lawsuits are usually payable upon settlement of the case, rather than on an hourly basis.
Communication the key
Most insurance disputes arise from a lack of communication upfront, when the insurance was purchased. Who can blame consumers for crying foul when, for example, they are penalized for making small claims that they probably wouldn't have made had they known the rules by which insurers play? It's the responsibility of the insurance provider, not only to explain these practices, but also to inform the consumer what is, and isn't, covered in the policy. Simply handing over a brochure to the consumer will not do the trick.
But policyholders must also learn to ask the right questions and make the effort to understand what they are buying. If your insurance provider is not willing to take the time to assess your needs, answer your questions, and explain your policy to you, find one who will. Ask trusted friends or relatives for recommendations, especially if they have experienced a recent claim. Insurance is a big expenditure, and you need to be sure you are getting what you're paying for – the peace of mind that comes from knowing you have the right insurance protection.






 楼主| 发表于 5/18/2019 21:41:47 | 显示全部楼层
Auto Insurance
In Canada, motor vehicle insurance (including cars, trucks, motorcycles) is mandatory for the combination of the owner and the operator.
Vehicle insurance falls under provincial jurisdiction. Although the basics of liability, personal injury and property damage are all covered, insurance is different in every province. In B.C., Manitoba and Saskatchewan, most coverage is provided solely by a government insurer. In Quebec, bodily injury coverage is a government offering but the remainder is provided by the insurance industry, as is all auto insurance in the remaining provinces and territories. The features and characteristics of the insurance varies dramatically among these jurisdictions, but in all cases the insurance product is very highly-regulated.
Insurance by an appropriately licenced insurer and distributor is recognized as valid in all the Canadian provinces and territories and the United States. Drive safely; be properly insured.







 楼主| 发表于 5/18/2019 22:14:55 | 显示全部楼层
本帖最后由 郭国汀 于 5/18/2019 22:24 编辑

Raising your complaints
If you're not happy with the service you've received from us, we want to work with you to make it right.
If you want to dispute a decision related to your claim, such as a responsibility (fault) assessment, find out about how to proceed on our Appeals and disputes page.
Fairness process
When you have unresolved questions or concerns, talk to us. We'll look into your issue and do our best to find a solution.
Here are the steps that can help get the dialogue started.

Speak to a manager or supervisor
If you're not happy with the service you've received, we encourage you to start by contact the manager or supervisor at the ICBC office you've been dealing with.
The manager or supervisor can:
  • Listen to your complaint and try to resolve the problem.
  • Discuss the reasons for a decision and give them in writing, if that's what you want.
  • Explain the review and appeal processes that may apply to your situation.
  • Provide information you may need if you want to escalate your concern.

In many cases, they'll be able to resolve your issue quickly.


Contact our customer relations department

If the manager/supervisor wasn't able to resolve your issue, or you used an appeal process but aren't satisfied, our customer relations department can help.
A customer relations advisor can:
  • Explain the details of our products and services.
  • Help you understand the decisions and actions related to your concern.
  • Refer you to alternatives that you may not know about or haven't tried.
  • Investigate a decision or process that you believe was unfair and help resolve the issue, if possible.

We also work with these agencies to help resolve ICBC-related complaints and questions:
  • ICBC's fairness commissioner
  • B.C.'s Office of the Ombudsperson
  • MLA constituency offices
  • Better Business Bureau

How to reach us
Phone1-800-445-9981
604-982-6210
Monday to Friday:
8:30 a.m. - 4:15 p.m​
EmailCustomer Relations
Fax604-661-2896​
MailCustomer Relations
151 West Esplanade
North Vancouver BC V7M 3H9


Write to the fairness commissioner

If you're not satisfied with our responses after going through the channels above, you may want to write to Peter Burns, Q.C., ICBC's fairness commissioner.
The fairness commissioner can:
  • Help you and ICBC resolve the concern.
  • Make recommendations to ICBC to resolve the complaint.
  • Recommend mediation or arbitration.
B.C. Ombudsperson review and recommendation


If the fairness commissioner can't resolve your concerns, there's still another step to consider. The B.C. Ombudsperson may look at your issue and make recommendations to ICBC.


Supplier complaints
Do you supply goods or services to ICBC? If you have a complaint, please let us know so we can try to address your concerns.








 楼主| 发表于 5/18/2019 22:31:02 | 显示全部楼层
Fairness commissioner
The fairness commissioner gives you another opportunity to be heard if your issue hasn't been resolved through a manager or the customer relations team.  
Peter Burns, Q.C., ICBC's fairness commissioner
Peter Burns, Q.C. is ICBC's fairness commissioner. He assesses complaints from a neutral, fairness perspective to decide whether you've been treated fairly based on our policies and procedures.
Mr. Burns was appointed as fairness commissioner because of his experience and expertise in the legal field. He was appointed Queen's Counsel in 1984 and was formerly a professor at the University of British Columbia, where he was Dean of Law from 1981-1992.



  






What can the fairness commissioner do?
The fairness commissioner could:
  • Help you understand and/ or resolve your issue with ICBC
  • Make recommendations to ICBC to resolve your complaint
  • Recommend mediation or arbitration (if necessary)
  • Dismiss the complaint.

What can't the fairness commissioner review?
There are some issues that are outside the fairness commissioner's jurisdiction, including:
  • Disputes about the amount of a final payment or the assessment of fault for a crash
  • The issuance of traffic tickets
  • Complaints regarding a court decision or an issue that's being disputed in court
  • Complaints about the action of lawyers
  • Complaints that may be resolved by RoadSafetyBC, Human Rights Commission or another government agency.

How to submit your request
Before writing to the fairness commissioner, make sure you've gone through the earlier steps in our fairness process. You can submit your request online or by mail.
If you mail in your request, include your:
  • contact information, including full name, phone number, and address
  • driver licence number and licence plate
  • claim number, if applicable, and
  • documentation to support your issue.
Mailing address:
ICBC Customer Relations
Attn: ICBC Fairness Commissioner
151 West Esplanade
North Vancouver BC
V7M 3H9
More information
Please read the fairness commissioner terms of reference. If you have questions or would like to follow up on your submission, please contact us.


 楼主| 发表于 5/19/2019 00:12:17 | 显示全部楼层
本帖最后由 郭国汀 于 5/20/2019 13:44 编辑

Basic coverage
ICBC Basic Autoplan insurance is the mandatory coverage you need for a vehicle in B.C.  It helps ensure that you and all British Columbians who own and drive a motor vehicle here are protected with a basic level of coverage.
You can also choose to buy extra coverage for you, your family and your car with Optional Autoplanproducts.
Protection if you’re responsible for a crash​
Third Party Liability coverage protects you when you're at fault in a crash and another motorist makes a claim against you. Your Basic Autoplan covers up to $200,000 of their injury costs and vehicle damage.
Here's an example
Jay drove into another car as he was turning. That car was badly damaged, and both people in it were hurt. Jay felt awful about the crash, but he knew that his third party liability coverage would look after the costs to repair the other car, and for the medical costs and wage losses for the people who were in it.

Medical costs, wage loss and more​
Autoplan Accident Benefits help you, your passengers and members of your household with medical costs, wage loss and more if you’re injured in a motor vehicle crash, even if you’re at fault.
To help you on the road to recovery, Accident Benefits provide up to $300,000 in medical and rehabilitation costs for crashes that occurred on or after January 1, 2018.
This could include costs like hospital care, chiropractic treatments, dental care, medication, physiotherapy, and more.
Here's an example
Karen’s car slid on an icy patch and went off the road. She had some bad injuries, and she was relieved to learn that her accident benefits covered her medical costs, including physiotherapy and prescriptions. She had to miss a few weeks of work too, but her coverage helped pay for some of her lost earnings.

If the other driver doesn’t have enough insurance  ​
Even if the person who’s responsible for a crash doesn’t have enough insurance to pay for your claim, Underinsured Motorist Protection (UMP) covers you.
Here's an example
Vic and his son were in a crash caused by a driver who didn’t have any insurance. Vic was worried until he found that his Underinsured Motorist Protection (UMP), which is part of Basic Autoplan, would look after their costs.

Basic UMP covers you and members of your household:
  • when you own or lease a vehicle
  • when injured or killed in a motor vehicle crash as a driver, passenger, or as a pedestrian or cyclist
  • for claims of up to $1 million per insured person.
Many buy Extension Underinsured Motorist Protection to increase that protection up to a total of $2 million, $3 million, $4 million or $5 million.
Hit-and-run damage and injuries​
Hit-and-run coverage protects you and your vehicle. It's available to every B.C. resident, even if you don't own or insure a vehicle. If you're eligible, up to $200,000 is available to anyone whose property is damaged, or who is injured or killed in a crash on a roadway in B.C.
Protection where local laws can affect your claim
Inverse liability protection covers you in parts of Canada or the U.S. where local laws don't let you claim against the person who caused your crash.
Your vehicle repair costs are covered up to 100 per cent (less if you were partly at fault for the crash). For example, if you were 25 per cent at fault, you'll receive 75 per cent of the cost of repairing your car.
Talk to your Autoplan broker
For more details on what Basic Autoplan covers, talk to your Autoplan broker or refer to your Autoplan insurance brochure.
What could affect your Basic Autoplan coverage​
Here are some things you can do to help ensure your coverage stays valid:
  • Your vehicle must be rated correctly. It’s important that you tell your broker how you use your vehicle (that is, your rate class), and who will be driving it the majority of the time.
  • If you have a claim, provide correct information.
  • Never drive if your driver’s licence is expired or suspended, and make sure that anyone who drives your vehicle has a valid driver's licence.
  • Don’t drive when you’re impaired by alcohol or drugs.
  • Be aware your Basic Autoplan insurance only covers you in Canada and the U.S.



 楼主| 发表于 5/20/2019 13:51:04 | 显示全部楼层
Extended Third Party Liability coverage
If you're at fault in a crash, it could cost more than you think. Third Party Liability insurance protects you from the financial risk of an at-fault crash.
If you're found responsible for a crash, you could be liable for damages, lost income, care expenses and more – for both the other driver and their passengers.
Your Basic Autoplan includes up to $200,000 in Third Party Liability coverage. But the costs of a crash could be much higher – and you could be responsible for the difference.
It's simple: the lower your coverage, the higher your risk.
How does Extended Third Party Liability coverage help you?
Extending your Third Party Liability protects you from having to pay costs that go above your Basic Autoplan limit.
Extended Third Party Liability means:
  • you'll be protected against paying for injury and damage costs up to the limit of your coverage
  • the equity in your home or other assets won't be at risk
  • for a relatively small percentage of your overall premium, you get peace of mind
You can increase your coverage to a limit of $5 million.
Talk to your Autoplan broker today about increasing your Third Party Liability insurance.
Find a broker









Why get it? Here's an example
Helen only had Basic Autoplan coverage on her vehicle. She thought it was a good way to save some money. But when she caused a crash that hurt Amy, the driver of the other car, she learned the costs of a claim can add up. Amy was a young person with a well-paying job, and her injuries prevented her from continuing with her career.  The costs for her lost income and future care came to well over a million dollars.
The $200,000 liability limit on Helen's Basic Autoplan didn't meet those costs, and she was responsible for Amy's future expenses.
Stories like this are why most people choose to buy Extended Third Party Liability coverage: the peace of mind of knowing their personal assets won't be at risk due to one unfortunate event.


 楼主| 发表于 5/20/2019 14:06:46 | 显示全部楼层
Extension Underinsured Motorist Protection
Getting into a collision is stressful enough. Finding out the other driver doesn't have enough coverage is even worse.
When it comes to auto insurance, it's a good idea to look out for yourself rather than rely on other drivers to have enough coverage. A serious crash could leave you with medical costs for the rest of your life. Extension Underinsured Motorist Protection (UMP) increases the protection provided under your Basic Autoplan, if the other driver doesn't have enough insurance.
Top up your Basic Autoplan with four coverage options
With Extension UMP, you can now get a total UMP limit of up to $2 million, $3 million, $4 million or $5 million (includes $1 million Basic UMP). You can also change, add or cancel your coverage at any time.  

How does Extension Underinsured Motorist Protection help you?
If you're in a crash where the driver at fault doesn't have enough insurance, your total UMP limit will cover things like medical costs, rehabilitation and lost wages for:
  • you and all members of your household in the vehicle with Extension UMP coverage*
  • you and all members of your household who are injured as pedestrians or cyclists, or in a vehicle other than your own.

Get coverage for each vehicle in your household
*For complete protection, each vehicle in your household must have Extension UMP added to the vehicle coverage so that you and your loved ones will be covered in all the vehicle(s) that you own.
Note: Underinsured Motorist Protection coverage doesn't apply to crashes in provinces or states where the law doesn't allow you to sue and recover damages for injury or death caused by a vehicle crash.
For more information about Extension Underinsured Motorist Protection, talk to your Autoplan broker.
Find a broker









Why get it? Here's an example​
John is in sales and he's on the road a lot for his job. If he’s hurt in a crash, he doesn't know the other driver may not have enough insurance to cover the costs of his recovery.
That’s why he bought Extension Underinsured Motorist Protection. The added cost is a small price to pay for knowing that he and his family will be protected, even if the at-fault driver’s policy runs short.


 楼主| 发表于 5/20/2019 14:12:57 | 显示全部楼层
Loss of Use coverage
Can you afford to be without your car? Loss of Use coverage will help you stay mobile if you can't use your vehicle after a claim.
Without your vehicle, you're going to need another way to get to work or school and keep on track with your busy life. Loss of Use coverage can help cover the extra costs.  
How does Loss of Use coverage help you?
While your vehicle's being fixed, Loss of Use covers your expenses to rent a vehicle, use taxis and take public transit.
Loss of Use coverage applies from the time of your claim until
  • your vehicle is repaired
  • you're offered a total loss settlement, or
  • you reach the limit of your coverage—whichever happens first
To qualify for Loss of Use coverage, you need to also have Collision, Comprehensive or Specified Perils coverage. You can also get Loss of Use coverage as part of the RoadStar or Roadside Plus packages, along with other popular coverages.
Limits of coverage
The amount paid for rental vehicles is limited to vehicles of a similar size to your own. We reimburse up to the daily limit purchased, however any amount in excess of this limit will have to be paid to the rental company.
Drivers under 21 may not be eligible to rent a vehicle at most rental companies, but Loss of Use will still cover expenses for taxis or transit.
Why get it? Here's an example
Gail had just dropped her son off at school when she had a crash. Her car needed a lot of repairs—it was going to take almost a week. That could have been a real inconvenience, but she'd chosen to buy Loss of Use coverage. It paid her costs to rent a substitute vehicle. She was able to pick up her son after school, and had none of the hassle of trying to get around for days without a car.


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