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Submit a ClaimISSUE DATE: January 1, 2022
LAST UPDATED: January 1, 2022
The purpose of this complaint examination and dispute resolution policy is to set up a free and equitable procedure for the resolution of complaints. The protocol will assist in understanding the steps Four Points Insurance will commence to resolve any formal complaint which may arise from our product or service.
The Ombudsperson or Privacy Officer depending on the nature of a complaint acts as the respondent with any provincial regulator and the complainant.
The person in charge is also responsible for:
Corresponding with the complainant; Delivering an acknowledgment of receipt and notice to the complainant;
Transferring the file to a third party (external ombudsperson or regulatory body) at the complainant’s request;
Filing reports as required in accordance with provincial regulation
For the purpose of this policy, a complaint is the expression of at least one of the following three elements:
A reproach against Four Points Insurance;
The identification of real or potential harm that a consumer has sustained or may sustain; or
A request for remedial action.
Informal steps to correct a specific problem are not considered a complaint provided the problem is resolved as part of Four Points Insurance’s normal activities and the consumer has not filed a formal complaint.
All formal complaints must be received in writing and addressed to the Ombudsperson or Privacy Officer:
Four Points Insurance Company Ltd.
A subsidiary of The Mutual Fire Insurance Company of British Columbia
9366 200A Street Langley, BC V1M 4B3
O: 604.881.1250 or TF: 866.417.2272
Attention: Ombudsperson
Email: ombudsperson@fourpointsinsurance.ca
Or,
Four Points Insurance Company Ltd.
A subsidiary of The Mutual Fire Insurance Company of British Columbia
9366 200A Street Langley, BC V1M 4B3
O: 604.881.1250 or TF: 866.417.2272
Attention: Privacy Officer
Email: privacy@fourpointsinsurance.ca
The receipt of the complaint must be acknowledged within 24 hours by mail or phone.
The acknowledgment of receipt must contain the following information:
A description of the three elements;
The name and contact information of the person examining the complaint;
In the case of an incomplete complaint, a notice requesting more information to which the complainant must respond within a set deadline, failing which the complaint will be deemed to have been abandoned;
The complaint examination policy;
A notice stating that if not satisfied with the outcome or with the examination of the complaint, the complainant can request that the complaint file be transferred to a provincial regulatory body. This notice will also mention that the provincial regulator may offer dispute resolution services, if deemed appropriate; and
A reminder to the complainant that filing a complaint with a provincial regulator does not interrupt the prescriptive period for civil remedies against Four Points Insurance.
A separate file will be created for each complaint and will contain the following:
The written complaint and its three elements (the real or potential harm, the reproach against the registrant and the requested remedial action);
The outcome of the complaint examination process (the analysis and the supporting documents); and
The final written response to the complainant with justifying reasons.
The complaint will be examined within five days of receiving all the information necessary for the examination. After examining the complaint, the person in charge will send the complainant a final response with justifying reasons.
If the complainant is not satisfied with the outcome or with the examination of the complaint, the complainant may ask Four Points Insurance, at any time, to transfer the file to a provincial regulatory body overseeing the complaint.
The transferred file must include all the information related to the complaint.
The registrant is responsible for complying with the rules governing the protection of personal information.
Our Ombudsperson Liaison Officer cannot:
Enter any investigation, negotiation, or settlement of an insurance claim.
Inquire into matters that are being, will be, or have been dealt with by a court or a dispute resolution process.
Our Ombudsperson will:
Notify Management of receipt of a formal complaint.
Begin investigation, and as appropriate
Involve specific managers
Refer to external involved parties
Refer to governing authorities
Reply in writing outlining Four Points Insurance’s formal position.
Concerns escalated to the Ombudsperson are usually resolved within five business days upon receiving all relevant documentation and materials. If the Ombudsperson thinks more time is required to properly address a complaint, they will advise the complainant of the project timeline.
Questions and Complaints involving personal information, privacy, or transcripts should be directed to our Privacy Officer in writing:
Our Privacy Officer will:
Notify Management of receipt of the formal complaint
Begin investigation, and as appropriate
Involve specific managers
Refer to external involved parties
Refer to governing authorities
Reply in writing outlining Four Points Insurance’s formal position
Include in the reply that more information can be found on our website
Our digital presence is monitored daily by our Communications Officer and includes LinkedIn, Twitter, Facebook, Yelp, Google Business, Bing Business, and other digital outlets.
Our Communication Officer will:
Notify Management of digital comments and online reviews (both positive and negative)
Notify Management of any media story naming Four Points Insurance
Begin investigation, and as appropriate
Involve specific managers
Refer to external involved parties
Refer to governing authorities
Reply in writing using the same medium as the sender and outlining MFI’s formal position.
Responses should be posted as soon as possible and within 6-12 hours with management approval.
Replies to the sender will include a suggestion that they send a direct message to our Ombudsperson or Privacy Officer for further handling.
While complaints may be addressed via our service concerns channel, a customer may complain to the:
Applicable provincial Insurance council or an
External dispute resolution body
General Insurance OmbudService (GIO) – (AB & BC only)
Mutual Insurance Companies OmbudService (MICO)
The Insurance Council or external resolution body may investigate and enact disciplinary measures if they determine a breach of legislation, rules, or code of conduct occurred.
The Insurance Council or external resolution body cannot intervene in claim disputes or disagreements about refunds.
When there is a disagreement about Statutory Condition 11, or another condition of the policy, this must be resolved via the dispute resolution clause under the applicable provincial Insurance Act.
Dispute resolution process
Either the insured or the insurer can demand in writing the other’s participation after the proof of loss has been delivered
Within 7 days after demand, the insured and the insurer must each appoint a dispute resolution representative:
Representative cannot be the insured or the insurer, or an employee of either
Representatives must determine the matters in dispute by agreement, and failing to agree, must submit their differences to the umpire
Within 15 days after appointing the representatives, the two representatives must appoint an umpire
If either party fails to appoint a representative, or the representative does not or cannot act, and another representative is not appointed within seven days of that failure, the court may appoint a representative
If a representative fails to appoint an umpire, or the umpire does not or cannot act, the Superintendent can appoint an umpire
Statutory Condition 11
Refers to disagreement regarding any of the following, and regardless of whether the insured’s right to recover is under dispute:
Value of insured property
Value of property saved
Nature and extent of the repairs or replacements required
Adequacy of repairs or replacements, if made
Amount of loss or damage
Where there is a policy condition providing for an appraisal for specified matters to resolve disagreements:
The insured and the insurer each appoint an appraiser, and the appraisers appoint an umpire
Appraisers will determine matters in disagreement, and if they fail to agree, will submit their differences to the umpire
Where a party fails to appoint an appraiser within seven days after written notice, the appraisers fail to agree upon an umpire within 15 days, or an appraiser or umpire does not or cannot act, the court can appoint an appraiser or umpire
Insureds generally always have the right to commence a lawsuit, even when their claim does not appear reasonable or likely to be successful, or when rules and procedures have not been followed
The court can dismiss claims or order compliance, but this still requires going through the court process
Example: if an insured refuses to go through the dispute resolution process under the Insurance Act and sues instead, the court may order that the dispute resolution process be undertaken
The court has broad jurisdiction to address issues and make orders
Example: courts can reverse an insurer’s denial of claim, undo a cancellation/voiding of policy on the grounds of imperfect compliance with the proof of loss statutory condition, not enforce policy terms if the court considers them unfair, etc.
Policy clauses requiring arbitration instead of court may or may not be held enforceable if challenged in court, depending on circumstances.
Our Complaint Handling Procedure, Ombudsperson, Consumer Rights and Privacy Policy are on our website at fourpointsinsurance.ca
