Complaint Handling Protocol

Complaint Handling Protocol

Yarmouth Mutual Insurance Company is committed to providing customers with exceptional service.  This protocol ensures that the policyholder concerns are handled fairly and efficiently.

Step 1: Resolve the Problem at the Source

When the policyholder has a concern, it is recommended that they start at the source and speak to their Agent. It is usually quicker and easier to have them help the policyholder check the facts and find a solution at the point where the problem occurred.

Gather the Facts

  • To speed up the process, we recommend that the policyholder have all relevant information handy prior to contacting Yarmouth Mutual Insurance Company.

The information needed includes:

  • details of your complaint including your policy and/or claim numbers;
    • any supporting documents and important dates; and
    • the names of any employees you have dealt with.

Step 2: Escalation to Manager

If the policyholder’s Agent is unable to satisfy the issue, the policyholder is welcome to escalate to the immediate manager of the department at issue; i.e. Underwriting Manager, Claims Manager, etc.

Step 3: Escalation to the President & CEO/Complaints Officer

If the policyholder feels their concern has not been met to their expectations by either their Agent or Department Manager, they are welcome to escalate to the President & CEO/Complaints Officer of Yarmouth Mutual Insurance Company for an independent review. 

The role of the President & CEO/Complaints Officer is to conduct an independent investigation of the policyholder complaint. The objective of this investigation is to examine whether the policyholder file was handled fairly and appropriately – in conjunction with Yarmouth Mutual Insurance Company guidelines for liability coverage.

Any complaint escalated to the Complaints Officer must be made in writing. This may be submitted either by email (a.kuron@yarmouthmutual.com) or by letter.

Yarmouth Mutual – Complaint Handling Protocol Letter Form

Please include the following information:

  • summary of policyholder complaint;
  • list of all unresolved concerns;
  • the reason the policyholder feels their concerns have not been resolved at Step 1;
  • any documentation/information that the policyholder would like to have reviewed; and
  • what the policyholder would like to see happen (the desired outcome).

Please note that the Complaints Officer will not review a complaint that has not gone through the steps listed above, and a written complaint has not been submitted.

What the policyholder can expect

The Complaints Officer will work to resolve the policyholder complaint in a fair and impartial manner.

For complaints that are not easily resolved or require a full investigation, the Complaints Officer will provide the policyholder with a formal written response. A written response is usually completed within 30 business days; however, depending on the complexity of the issues and the case load, more time may be necessary to complete a thorough review of the file. The policyholder will be updated on the progress of their complaint if more time is required.

When the Complaints Officer has reviewed the complaint and provided the policyholder with a response, the file will be considered closed. The policyholder file will not be reopened unless they can present new and relevant documentation or information for further consideration.

Step 4: External Resources

If the policyholder remains dissatisfied following the Complaints Officer’s investigation, the policyholder may contact the Insurance Ombudsman at the Financial Services Regulatory Authority of Ontario.  There is no charge for their service.  FSRA may be reach at:

 

Financial Services Regulatory Authority of Ontario

25 Sheppard Avenue West, Suite 100

Toronto, ON  M2N 6S6

Telephone:         (416) 250-7250

Toll free:              1-800-668-0128

Fax:                        (416) 590-8480

TTY:                        1-800-387-0584

Email:                    contactcentre@fsrao.ca

Website:              https://www.fsrao.ca/submit-complaint-fsra