Complaint Process

• Initial complaint review: Council reviews the complaint to determine whether the matter is within Council’s jurisdiction, and whether there is enough information to proceed. If necessary, Council may request more information from the complainant.
• If Council proceeds: In most cases, Council contacts the insurance licensee or former licensee who is the subject of the complaint and requests the individual either come in to Council's office for an interview or submit a written statement along with any supporting documentation.

If a complaint or inquiry falls outside Council’s authority: Council will try to direct the complainant to an appropriate organization or person that can assist in resolving the problem — including a company ombudsman, an industry association, or a lawyer referral service. In some cases, Council may refer the matter to another regulator with the authority to review the matter, such as the BC Securities Commission or BC Financial Institutions Commission (FICOM). 

• After complaint review: Council decides whether an investigation is warranted, or if the matter can be resolved. Non-voting Council members may be consulted for advice on what is considered “usual practice” in the industry.

If you have additional questions or concerns about the complaint process or disciplinary process for insurance licensees, please contact us.

• Council receives a complaint against an insurance agent, salesperson, or adjuster (Note: Council has no authority over insurance companies). Written complaints can include the following information:
• Specific complaint details
• A timeline of events
• Supporting documents from the complainant, if any

If you have additional questions or concerns about the complaint process or disciplinary process for insurance licensees, please contact us.

• A Compliance Officer from the Regulatory Services Department conducts an initial review of the complaint. The Compliance Officer will do one or more of the following:
• Contact the complainant to acknowledge receipt of the written complaint.
• Request additional documentation from the complainant, if needed.
• Inform the licensee or former licensee and request their input.
• Update the complainant and licensee on the status of the review, as necessary (to ensure rigour and compliance, the complaint review process can take some time).
• Based on the evidence collected during the initial review, do one of the following:
• Refer the matter to Investigations for further review, 
• Issue a reminder letter, or
• Close the complaint with no action. 
• If the matter is referred to Investigations, an investigator will contact the licensee and do one or more of the following:
• Request further information from the licensee,
• Request the licensee attend Council’s office for an interview,
• Contact the complainant for more information, or
• Collect evidence from witnesses.

If you have additional questions or concerns about the complaint process or disciplinary process for insurance licensees, please contact us. 

The licensee or former licensee will be informed when the complaint is referred to Investigations, a Review Committee, or Council; and the outcome of the complaint.

• The Compliance Officer:
  • Based on the evidence collected during the initial review, the Compliance Officer will do one of the following:
    • Refer the matter to Investigations for further review, 
    • Issue a reminder letter, or
    • Close the complaint with no action.
• The Investigator:
  • 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 to attend  
    • Refer the matter to full voting Council.
    • Issue a reminder letter, or
    • Close the complaint with no action.
• The Review Committee:
  • Based on the evidence presented, the Review Committee will do one of the following:
    • Direct 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 Council lacks jurisdiction and refer the complainant to another regulatory body if appropriate.
    • Close with a reminder to the licensee or former licensee on appropriate conduct or procedures, and potential consequences of any similar complaints in the future.
    • Close providing best practice advice to the licensee in cases where improvement in practice may have prevented the complaint, or may have put the 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 Council without being considered by a Review Committee, then based on the evidence provided by Council staff, voting Council will decide on an outcome.

If you have additional questions or concerns about the complaint process or disciplinary process for insurance licensees, please contact us.