Consumer Complaints

Trisura’s complaint handling policy

As a federally incorporated insurance company that is licensed in all provinces and territories of Canada, Trisura is regulated by the Office of the Superintendent of Financial Institutions (“OSFI”) and by the equivalent bodies in each of the provinces and territories.

The Insurance Companies Act (Canada) (“ICA”) is the primary legislation that governs all federally incorporated insurance companies and the ICA requires that Trisura establish procedures for dealing with complaints, designate an officer or employee to be responsible for implementing those procedures, designate one or more officers or employees to be responsible for receiving and dealing with complaints and file a copy of its procedures with the Commissioner of the Financial Consumer Agency of Canada.

The Financial Consumer Agency of Canada (“FCAC”) is responsible for administering certain consumer related provisions of the ICA. FCAC requires Trisura to put in place procedures for handling complaints, to file a copy of these procedures with FCAC, to join complaints resolution organizations as required and to provide information to customers on contacting FCAC when necessary.

Trisura must also abide by the complaint handling requirements of several provincial regulators. In Ontario, the Financial Services Commission of Ontario (“FSCO”) requires Trisura to establish a protocol that identifies the company’s complaint handling procedures and the process involved, to communicate the policy to consumers and staff and to appoint a Consumer Complaint Officer. In Quebec, the Autorité des marchés financiers (“AMF”) requires that Trisura handle each complaint in a fair manner, implement a complaint management policy, acknowledge receipt of a complaint to the consumer, transfer the complaint file to the AMF at the consumer’s request and prepare and send a semi-annual complaint report to the AMF. Other provinces are expected to establish similar requirements over time.

Generally, a complaint is an expression of dissatisfaction made by a person about a product or service requested or received from the company. Note that the person does not have to be a customer; the applicable statutes cover all consumers.
FCAC, FSCO and the AMF recognize that certain complaints can be dealt with at the front line, without having to be escalated to a higher level for review and resolution. In order to satisfy the requirements, these routine complaints must be dealt with promptly without unreasonable delay.

Federally, for FCAC’s purposes, a “reportable complaint” is one that has escalated at least one level higher than the operational level OR was received at a level higher than the operational level (even if then sent to the operational level for resolution) AND pertains to one or more “consumer provisions” in the ICA. Details of these consumer provisions are not provided here because none have application to Trisura except for those covered by the Privacy Policy. In the unlikely event that we do have such a reportable complaint, FCAC has mandated that we must report these complaints to them within 60 days of being elevated above or received above the operational level. Other types of complaints need not be reported to FCAC.

In Ontario, if a complaint is escalated beyond the front line (that is, above the“level that routinely handles and makes operational decisions about the subject matter of the complaint”) and is not of a nature that it can be referred back to the front line for resolution then it automatically becomes a “reportable complaint”. FSCO stipulates that Trisura establish procedures to handle consumer complaints and that all reportable complaints must be reported to FSCO semi-annually within 30 days of June 30 and December 31. Similarly, in Quebec, a complaint that persists after being considered and examined at the operational level becomes a reportable complaint. As in Ontario, reporting is semi-annual and must be made to the AMF within 30 days of June 30 and December 31.

The Ombudsman has been appointed the Complaints Liaison Officer (“CLO”) for Trisura. He will be responsible for implementing our Complaint Handling Procedure and receiving and dealing with complaints as they arise. Trisura’s policy will be to investigate and respond effectively to any complaints in accordance with our Complaint Handling Procedure and to comply with the applicable legislation and requirements of the various regulatory bodies.

Requests for further information should be directed to Trisura’s Complaints Liaison Officer, as follows:

Ombudsman
Trisura Guarantee Insurance Company
333 Bay Street, Suite 1600
Toronto, Ontario M5H 2R2
Email:ombudsman@trisura.com

Please refer to the attached Complaint Handling Procedure document which will be filed with the requisite regulatory and governing bodies.