Insurance Complaint Process

Thank you for your interest in helping the Insurance Council of BC ensure insurance licensees are compliant with Council Rules, Council’s Code of Conduct, and the Financial Institutions Act.

Council is provincially authorized to investigate insurance licence holders and discipline if found in breach of Council Rules, Code of Conduct, or the Financial Institutions Act. However, Council cannot order any licensee or insurance company to make payment on a claim or to refund premiums or service fees.

Complaint Process

Council takes complaints very seriously. Council values your taking the time and effort to report your concerns and strives to review all formal complaints in a timely way.

  • Initial complaint review: Council reviews your written complaint to determine whether the matter is within Council’s jurisdiction.  Some of the matters outside Council jurisdiction include:
    • Claim disputes
    • Disagreements about refunds
    • Requests for policy interpretations
    • Contractual agreements between licensees and third parties
    • Service
Council also reviews whether you have provided enough information to proceed. If necessary, Council may request more information. 
  • If Council proceeds: In most cases, Council contacts the licensee who is the subject of the complaint and requests the licensee submit a written statement along with any supporting documentation and/or come in to Council's office for an interview.

  • If a complaint or inquiry falls outside Council’s authority: If possible, Council will direct you to an appropriate organization or person that may be able to assist in resolving the problem.  You may find information on other resources here.  If you request, Council may refer the matter on your behalf to another regulator with the authority to review the matter, such as the BC Securities Commission or Financial Institutions Commission (FICOM).  Council is unable to make referrals directly to insurers.

  • After the complaint is reviewed: Council decides whether the matter should be referred for a formal investigation, or if the review should be concluded.  In making this determination, non-voting Council members may be consulted for advice on what is considered “usual practice” in the industry.
  • Submit your complaint against an insurance agent or adjuster in writing (Note: Council has no authority over insurance companies.  You may find information on other resources here):
    • Be specific
    • Include a timeline
    • Include supporting documents
            You can find prior enforcement decisions here.
 
  • Council assigns a Compliance Officer to review your complaint. The Compliance Officer will:
    • Contact you to acknowledge receipt of your written complaint
    • Request additional documentation, if needed
    • Inform the licensee(s) about whom you are complaining, to allow them to respond
    • Update you on the status of the complaint review at 60-day intervals (to ensure rigour and compliance, the complaint review process can take some time)
  • Council determines the outcome of the review, and will let you know whether your complaint will be:
    • Investigated further.
    • Dismissed due to insufficient evidence or because the matter does not constitute a breach.
    • Closed, because Council lacks jurisdiction over the specific complaint — Council will refer you to another regulatory body if appropriate.  Additional information on othe regulators can be found here.
    • Closed, with Council issuing a reminder to the licensee(s) about whom you raised concerns — on appropriate conduct or procedures, and potential consequences of any similar complaints in future.
    • Closed, with Council providing best practice advice to the licensee about whom you raised concerns — in cases where improvement in practice may have prevented the circumstances leading to the complaint, or may have put the licensee in a better position to support their actions.