- Insurance Council determines the outcome of the review, and based on the evidence collected during the initial review, will let you know whether your complaint will be:
- Investigated further.
- Concluded, if a determination is made that the Insurance Council lacks jurisdiction over the specific complaint — we may refer you to another regulatory body, if appropriate. Additional information on other regulators can be found here.
- Closed, with the Insurance Council issuing a Reminder letter to the licensee(s) about whom you raised concerns. The letter outlines appropriate conduct or procedures, and potential consequences of any similar complaints in future.
- Closed, with the Insurance Council issuing a Best Practices letter. The letter provides best practice advice to the licensee or former licensee about whom you raised concerns. It outlines 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.
- Dismissed due to insufficient evidence or because the matter does not constitute a breach.
- Take other reasonable action.
The licensee or former licensee will be informed when the complaint is referred to Investigations for further examination, a Review Committee, or Full Voting Council. They will also be informed of the outcome of the complaint.
Further investigation:
- If the course of action is to investigate the matter further, an investigator will contact the licensee or former licensee and do one or more of the following:
- Request further information from the licensee or former licensee,
- Request the licensee or former licensee attend an interview with the investigator,
- Contact the complainant for more information,
- Collect evidence from witnesses, or
- Take other reasonable action necessary for ensuring all relevant information is gathered.
- Based on the evidence collected during the investigation, the investigator will do one of the following:
- Refer the matter to a Review Committee of Council and invite the licensee or former licensee to attend,
- Refer the matter to the full voting Council,
- Issue a Reminder letter,
- Issue a Best Practices letter,
- Close the complaint with no action, or
- Take other reasonable action.
Review Committee:
- Based on the evidence presented, the Review Committee will do one of the following:
- Direct Insurance Council staff to investigate further which may entail contacting or interviewing the complainant, the licensee or former licensee, and any other witnesses as required, to gather additional evidence for Council to determine an outcome.
- Dismiss due to lack of evidence.
- Close because the Insurance Council lacks jurisdiction and refer you to another regulatory body, if appropriate.
- Direct Insurance Council staff to issue a Reminder letter to the licensee or former licensee on appropriate conduct or procedures, and potential consequences of any similar complaints in the future.
- Direct Insurance Council staff to issue a Best Practices letter providing advice to the licensee or former licensee in cases where improvement in practice may have prevented the complaint or may have put the licensee or former licensee in a better position to defend their actions.
- Make a recommendation to full voting Council to discipline the licensee or former licensee.
Full Voting Council:
- Based on the report of the Review Committee, voting Council will do one of the following:
- Accept the Review Committee’s recommendation, or
- Decide a different outcome.
Or
- If the complaint is referred directly to the Insurance Council without being considered by a Review Committee, then based on the evidence provided by staff, voting Council will decide on an outcome.