Making a Complaint

The Insurance Council of BC works to ensure insurance licensees are compliant with Council Rules, Council’s Code of Conduct, and the Financial Institutions Act.
 

What and Who We Regulate

The Insurance Council licenses and regulates insurance agents, salespersons, independent adjusters, agencies and firms. 

We do not have authority over insurers—the insurance companies that pay policy holders’ insurance claims and underwrite the risk. In BC, these are regulated by the BC Financial Services Authority (BCFSA).
 

What We Can Do

The Insurance Council has the authority to investigate insurance agents, salespersons, independent adjusters, agencies and firms, and discipline them if they are found to have breached Council’s Rules, Code of Conduct, or the Financial Institutions Act.
 

What We Can’t Do

Council cannot order any licensee or insurance company to make payment on a claim or to refund premiums or service fees. Nor do we have the authority to order a disciplined licensee to pay restitution to a client. 

Other matters outside of our authority include:

  • Settling claims disputes
  • Mediating or ruling on disagreements about refunds
  • Providing policy interpretations

What is the Process for a Complaint About an Insurance Licensee?

  • Initial complaint review: We review your written complaint to determine whether the matter is within the Insurance Council’s jurisdiction, and whether there is enough information to proceed. If necessary, more information may be requested. Some of the matters outside the Insurance Council jurisdiction include:
    • Claim disputes
    • Disagreements about refunds
    • Requests for policy interpretations
    • Contractual agreements between licensees and third parties
    • Service 
  • If the Insurance Council proceeds: In most cases, the licensee or former licensee who is the subject of the complaint is contacted to submit a written statement along with any supporting documentation and/or attend an interview.

  • If a complaint or inquiry falls outside the Insurance Council’s authority: If possible, you will be directed to an appropriate organization or person that may be able to assist in resolving the problem. You may find information on other resources here. In some cases, we may refer the matter to another regulator with the authority to review the matter, such as the BC Securities Commission or BC Financial Services Authority (BCFSA). Insurance Council is unable to make referrals directly to insurers.

  • After the complaint is reviewed: Insurance Council decides whether the matter should be referred for a formal investigation or if another action should be taken. 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, salesperson or adjuster in writing. (Note: Council has no authority over insurance companies. You may find information on other resources here.) Written complaints should include as much information as possible:
    • Be specific
    • Include a timeline
    • Include supporting documents

  • Complaints can be sent to practice@insurancecouncilofbc.com or mailed to:

    Insurance Council of BC
    c/o Practice and Quality Assurance Department
    1400-745 Thurlow Street
    Vancouver, BC V6E 0C5

    If you require help to file a complaint, contact us at 604-688-0321 or 1-877-688-0321 (toll-free within Canada.)

    Accessibility for individuals with disabilities: If you have a disability that requires accommodation, the Insurance Council will consider alternative methods of receiving the complaint.
           Prior enforcement decisions can be found here
  • Council assigns a Compliance Officer to review your complaint. The Compliance Officer will do one or more of the following:
    • Contact you to acknowledge receipt of your written complaint.
    • During the review, the Compliant Officer will consider whether potential breaches to the Financial Act, Insurance Council Rules or Code of Conduct exist and, in most cases, will inform the licensee or former licensee of the complaint and potential breaches.
    • Request additional information and documentation from you and/or licensee or former licensee, as necessary.
    • Inform the licensee(s) about whom you are complaining, to allow them to respond.
    • Periodically update you, and the licensee or former licensee on the status of the complaint review (to ensure rigour and compliance, the complaint review process can take some time).
  • 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.
    • Closed, because the Insurance Council lacks jurisdiction over the specific complaint — we will 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,
    • Request the 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.

For more detailed information on the disciplinary process:
view our guidelines