Complaint Resolution Process

Complaint Resolution Process

We know any medical emergency can be taxing, but we want this process to be as smooth as possible. Claims outcome not to your satisfaction? Here's how you can escalate your concern.

Please provide your claim or policy number at all times when contacting us.

First Stage

We make all claims decisions based on the information we receive. If you have questions or concerns regarding the decision taken on your claim, please contact Allianz Global Assistance using the contact information on the explanation of benefits or claims decision letter you received.

Second Stage

If you believe our decision is incorrect you may appeal. If you receive new information that supports your claim, please send it to us for review. We will review any new information we receive as part of your appeal. 


To appeal, please note that you must submit this in writing with any new supporting documentation to:
 

By mail: Allianz Global Assistance 

             c/o Appeals Department 

             P.O. Box 277 

             Waterloo, ON N2J 4A4 

Email: appeals@allianz-assistance.ca

Third Stage

Should your complaint or claim still remain unresolved following the internal appeals process with Allianz Global Assistance, you may request additional consideration of your complaint or claim in writing to the relevant Ombuds Office.

Please note that the Ombuds Office will only review concerns that have gone through the appropriate steps above so you will want to indicate who you have already spoken with Allianz Global Assistance and provide a copy of our final position letter to the relevant Ombuds Office: 


For products underwritten or insured by CUMIS General Insurance Company or Co-operators Life Insurance Company:

By mail: Ombudsperson
             c/o The Co-operators Group Limited.
             130 Macdonell Street Guelph, Ontario N1H 6P8 

Email:    Ombuds@cooperators.ca
Phone:   1-877-720-6733 

Fax:       519-823-9944



For products underwritten or insured by Allianz Global Risks US Insurance Company (Canadian Branch): 

By mail: Ombudsperson 

             Allianz Global Risk US Insurance Company (Canadian Branch) 

             1600-130 Adelaide Street West 

             Toronto, ON, Canada M5H 3P5 

Email:    ombudscanada@agcs.allianz.com 

Phone:   416-915-1956 

Fax:       416-849-4555



For products underwritten by all other insurers, please refer to your policy document for more details.


After the Ombuds Office’s review, you will receive a written response, except in the case where a simple concern can be cleared up over the phone. Most investigations are completed within 30 business days of receiving your complaint and all supporting documentation. If this deadline cannot be met, you will be contacted as to why extra time is required and when you can expect a response.

The written response from the Ombuds Office is considered the insurance company’s final position. Unless you subsequently present any new and relevant information that was not already previously reviewed, your case will not be reopened.

External Recourse Options

If we have not been able to resolve your concerns to your satisfaction and you wish to pursue the matter further, you may contact the General Insurance OmbudService (GIO). GIO is an independent service that offers recourse to consumers who have not been able to resolve their complaint by dealing with their insurance company. The OmbudService can be reached at 1-877-225-0446 or through their website at www.giocanada.org.

Note: You must follow the Company’s Complaint Resolution Process (described above) before GIO will become involved.

For Quebec clients; if you are not satisfied with how your concern was handled, or the results of our investigation, the law  gives you the right to request, in writing, that a copy of your file be transferred to the Authorité des marches financiers (AMF). You can reach the AMF by calling 1-877-525-0337 or by email at: renseignement-consommateur@lautorite.qc.ca.

The Financial Consumer Agency of Canada
 The Financial Consumer Agency of Canada (FCAC) provides consumers with accurate and objective information about financial products and services, and informs Canadians of their rights and responsibilities when dealing with financial institutions. FCAC also ensures compliance with the federal consumer protection laws that apply to banks and federally incorporated trust, loan and insurance companies.  

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