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What To Know Before Calling Your Insurer: There Are Resources Available To You

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Is a particular loss covered? What's it worth? What does that clause really mean?

If you encounter misunderstandings, disagreements or other problems with a claim:

  • Get clarification from the broker or agent who sold you the policy.
  • Talk to the adjuster or claims specialist, or this person's supervisor.
  • Ask for the insurance company's internal ombudsperson. Every federally licensed insurance company must have one.
  • For home, auto and business, contact the General Insurance OmbudService (www.giocanada.org) or the OmbudService for Life and Health Insurance (www.olhi.ca). They can help cut through the red tape and impartially resolve disputes between you and your insurers.

Don't worry about a claim being denied, seeing your premiums rise or being blacklisted if you raise a fuss. It's your right to complain-and it's often necessary. "An insurance policy is proof of a legal contract, but there can be grey areas when it comes to settling claims," says Sherman, from The Co-operators Group. "Every claims settlement is to some extent a negotiation."

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