OLHI Standards – OLHI – Free, impartial help with your life & health insurance complaints

OLHI Standards

OLHI’s service promise

Accessibility:
OLHI can be reached conveniently and easily via national toll-free telephone numbers, online, mail or fax. Our bilingual services are free to consumers. Contact us.

Timeliness:

OLHI will respond to voice mail, web messages and emails within 48 hours. Correspondence that is mailed or faxed will be answered promptly.

Courtesy:

We treat everyone with courtesy, professionalism and respect.

Clarity:

Our goal is to communicate in plain language so that consumers fully understand anything we say or any correspondence we send.

Accuracy:

All the information OLHI collects about a complaint or an inquiry is accurate, complete and up-to-date so that we can best help resolve a complaint or answer any inquiries.

Fairness & Impartiality:

OLHI is unbiased and impartial. We are not advocate for either the consumer or the insurance company.

Consistency:

OLHI follows a rigorous, consistent complaints handling process that meets our mandate and Terms of Reference.

Knowledge:

Our staff have specialized knowledge of life and health insurance and are experienced in dispute resolution.

Privacy/Confidentiality:

All the information we collect remains confidential and proprietary to OLHI, in accordance with our Privacy Statement.

Independence & Objectivity:

OLHI is a non-profit corporation, independent of government and industry. Our Terms of Reference require us to be impartial. This means OLHI is not an advocate for either the consumer or the insurance company. To ensure impartiality, our operations are overseen by the Canadian Council of Insurance Regulators (CCIR) as well as our independent Board of Directors. Most of our Board members have no ties to the life and health insurance industry.

OLHI’s fairness standards

  1. OLHI’s recommendations on complaints are based on what is fair to both the consumer and the insurance company.
  2. OLHI uses complaint handling practices and processes that are fair to both the consumer and the insurance company.
  3. OLHI approaches complaint handling with a focus on fair business dealings and reasonable consumer expectations.
  4. OLHI’s impartial complaint handling practices require us to review all available information from both the consumer and the insurance company.
  5. OLHI aims to treat similar complaints in a similar way. However, as every complaint is unique, OLHI is not bound by any previous recommendations.
  6. OLHI’s complaint handling process ensures that neither the consumer nor the insurance company has special access to OLHI staff during a review.

OLHI’s privacy standards

The OmbudService for Life & Health Insurance (OLHI) is committed to protecting consumers’ privacy. With the authorization of the consumer that is making the complaint, OLHI will collect information from the consumer, the insurance company, and any relevant third parties, if applicable, to facilitate the review and voluntary resolution of complaints filed with OLHI.

OLHI will only collect personal information, including medical information, to the extent necessary to investigate the complaint. Unless otherwise directed by the complainant, any information that OLHI receives in connection with a complaint will remain confidential.

The files and records made or compiled by OLHI and its representatives in connection with a complaint (”OLHI Records”) are confidential and proprietary to OLHI and will not be provided directly or indirectly to the parties involved in the complaint process or to any third parties. Consumers and insurance companies will not summon, subpoena, or otherwise seek or require the production of OLHI Records in any current or future legal proceeding. OLHI Records are retained in secure areas and can be accessed only by authorized OLHI staff.

OLHI will not discuss a consumer’s concern or complaint with any third party except with the consumer’s consent. In no circumstances will OLHI discuss the consumer’s concern or complaint with the media, even with the consent of the consumer. Consumers and insurance companies agree that OLHI and its representatives will not be summoned, subpoenaed or otherwise required to testify with respect to any complaint or any matters pertaining to OLHI’s process.

OLHI may use information for the purpose of statistical reporting. Any information collected for this purpose will be on an aggregate industry basis only and will not identify the consumer or the insurer.

Personal Information Protection and Electronic Documents Act:

The Personal Information Protection and Electronic Documents Act (PIPEDA) protects the privacy of Canadians with respect to the collection, use and disclosure of personal information. OLHI abides by the ten principles (“Principles”) developed for the protection of personal information as follows:

  1. Accountability: OLHI is responsible for information provided to it and has designated an individual who is accountable for compliance with the Principles.
  2. Identifying Purpose: OLHI will identify to the consumer the purpose of collecting information before or at the time the information is collected.
  3. Consent: the collection, use and disclosure of personal information will only be done with the knowledge and consent of the consumer.
  4. Limiting Collection: the collection of personal information will be limited to that which is necessary for OLHI to review the complaint.
  5. Limiting Use, Disclosure and Retention: OLHI will only use or disclose personal information for the purpose for which it was collected. OLHI will only retain personal information for as long as it is necessary to fulfill that purpose.
  6. Accuracy: personal information will be kept as accurate, complete and up-to-date as necessary for the purpose for which it is to be used.
  7. Safeguards: personal information will be protected by security appropriate to the sensitivity of the information.
  8. Openness: OLHI will make readily available to consumers specific information about policies and practices related to OLHI’s management of personal information.
  9. Individual Access: OLHI will, upon request, inform a consumer of the existence, use and disclosure of his or her personal information. A consumer will be given access to their personal information, and will be able to challenge its accuracy and completeness. However, a consumer will not have access to any information collected or produced during the course of OLHI’s review process, and all OLHI Records will remain confidential and will not be provided directly or indirectly to the parties involved or to any third party. Consumers and insurance companies agree not to seek production of OLHI Records by summons, subpoena, or otherwise in connection with any current or future court proceedings.
  10. Challenging Compliance: a consumer will be able to challenge the compliance with the above principles with OLHI’s designated individual.

In Quebec: Act respecting the protection of personal information in the private sector.

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