Learn more about OLHI by exploring answers to the questions we hear most often:
What is a final position letter?
It’s a written decision from your insurer that explains its final position on your complaint
Is OLHI a consumer advocate?
No. OLHI is impartial. Our findings and recommendations are based on our impartial review of all the relevant facts, so both you and the insurer know our conclusions are from an unbiased perspective.
What is a reviewable complaint?
We can review a complaint if:
- It involves a participating company.
- You have received a final position letter from your insurer.
- The issues raised fall within the scope of OLHI’s mandate.
What does it cost to use your services?
Nothing. OLHI’s services are free for consumers across Canada, in English and French.
How does OLHI determine if a case has merit?
A complaint has merit if we find the insurer did not follow the terms of your life or health insurance policy. We may also consider other factors outside the policy.
What can you do for me?
OLHI can work with your insurer to try to resolve your complaint. If we find that your complaint has merit, we can ask your insurer to reconsider its decision.
Sometimes this leads to a negotiated settlement that works for both sides.
Are OLHI’s recommendations binding?
No. Our settlement recommendations are voluntary. When they are accepted, they can help avoid costly, long, and complex court proceedings.
What does non-binding mean?
It means both you and your insurer can choose whether to accept our recommendation, and it cannot be enforced by OLHI.
How do I submit a complaint?
If you have a final position letter from your insurer, you can submit your complaint online or call us.
After I complete my insurer’s complaints process, will they tell you about me and my case so that you can help me?
No. You must submit your complaint to OLHI yourself.
What if my friend or relative contacts you about me and asks you to call me?
We can’t take any action until we hear from you directly. You must submit your complaint and an authorization form.
If you want someone to represent you, let us know on your authorization form.
How long will it take to handle my complaint?
We aim to review and conclude most complaints within 120 days, starting from the date we acknowledge your complaint in writing.
Are there any circumstances where you cannot handle my complaint, even after I complete my insurer’s process?
Yes. OLHI is always available to discuss a complaint, but we cannot review certain types of complaints. For more details, consult Our process.
Can I skip the Complaints Analyst step and have my complaint immediately dealt with by an OmbudService Officer (OSO)?
No. Every complaint begins with a review by a Complaints Analyst. This step ensures your complaint is handled as quickly and efficiently as possible.
The Complaints Analyst will review all the information and may try to resolve the issue informally with your insurer. If further action is needed, the complaint will be escalated to an OmbudService Officer (OSO) for a formal investigation.
What if I am not satisfied with the outcome of my complaint?
If we find your complaint does not have merit or we cannot settle it, you can pursue other options, such as legal action or contacting a regulator.
Should I speak to my lawyer before making a complaint to OLHI?
You may speak to a lawyer before making a complaint, but you are not required to do so. Our process is designed to be accessible without legal representation. However, if you would like legal advice – for example, to better understand your rights or the implications of your situation – you may choose to consult a lawyer.
We do not provide legal advice. You can consult a lawyer anytime during our process, but if you start legal action, you must notify OLHI immediately and we will withdraw from the process.
Please note that you and your insurer will be asked to sign an agreement suspending the limitation period while OLHI reviews your complaint. However, in Québec, this is not legally allowed. If you have questions about limitation periods, you should speak to a lawyer.
How can you be impartial and independent when OLHI is funded by life and health insurance companies?
OLHI is a federal not-for-profit corporation, and we are independent and impartial, even though we are funded by the industry. This funding model is common in Canada and internationally for financial services dispute resolution organizations, and it does not affect how we review complaints. OLHI’s independence is protected by several safeguards:
- Regulatory Oversight: We are overseen by the Canadian Council of Insurance Regulators (CCIR).
- Independent governance: We are governed by an independent board of directors, with a majority of directors who are not affiliated with the industry.
- Independent decision-making: Our complaint reviews and recommendations are made independently, based on the facts and applicable standards – not on the interests of OLHI or the insurer.
- Structural separation: Our operations and decision-making are separate from the participating companies that fund us.
- Leadership independence: Our Executive Director and Ombudsman and leadership team have no ties to the life and health insurance industry.
- Professional, impartial staff: Our teams are trained to assess complaints fairly and objectively, and are not influenced by funding sources.
- Transparent processes: We follow clear procedures designed to ensure fairness for both consumers and insurers.