Complaint Resolution
Complaint Resolution
At Pembridge, we value your business and partner with our brokers to help resolve customer complaints. If you have a concern regarding your experience and need assistance with addressing your matter, please contact your broker so they can work towards restoring confidence in your choice of insurer.
To ensure efficiency please review the appropriate section and follow the steps in our Complaint Resolution Process:
Complaint Resolution Process
This three-step process is designed to ensure the efficient and effective handling of your matter. It allows the appropriate representatives to collaborate with you, providing clarity and reviewing resolution options.
Non Claims-Related Issues
Step 1: Share your concern with your Broker
As your insurance representative, your broker is here to provide advice and assess your coverage needs. Should you have any concerns, contact your broker to partner with us for the best possible solution.
Click Find my Broker to reach your broker.
If your matter remains unresolved after speaking with your Broker and you have completed Step 1, you may proceed with Step 2 by escalating your concern.
Step 2: Escalate your Concern
This level of the complaint resolution process provides an opportunity for service experts to address your concern. They will thoroughly review your case, consider additional resolution options within their authority, and provide you with a decision.
You can escalate your concern by:
- Ask the Broker to put you in contact with their manager by providing you with their name, phone number and email.
Or you can reach them by:
Clicking Find my Broker to reach a manager within a brokerage.
After you have been provided with a decision at Step 2, if you remain unsatisfied with the outcome you may proceed to Step 3 for further review and investigation.
Step 3: Engage the Complaint Management Office
At this level of the complaint resolution process, you can submit your complaint to the Complaint Management Office <need link to open outlook email>. A Senior Complaint Consultant will review and investigate it. Their goal is to ensure your concern is addressed fairly and diligently, provide further explanation regarding the outcome, and act as a liaison between you and the area where your concerns reside.
What you can expect during this process:
1. A file will be opened upon receipt of your written complaint
2. Your file will be reviewed by all appropriate and related parties
3. A formal response will be issued once the investigation is complete
Please Note:
- Senior Complaint Consultants do not have the ability to adjust claims, you are encouraged to work with a claims representative to resolve your concerns on your active claim.
- If you submit your complaint to Step 3 prior to completing Step 1 or Step 2, your matter will be redirected to the appropriate level of the Complaint Resolution Process.
- Step 3 investigations will take time to complete, they are conducted by a thorough review to ensure accuracy with the final position. A formal response will be provided within an appropriate timeframe based on complexity.
Complaint Management Office
27 Allstate Parkway Suite 100
Markham, Ontario
L3R 5P8
For additional information, call our toll-free line:
English : 1-877-7-CONSUMER (1-877-726-6786)
French: 1-866-348-5598
Claims-Related Issues
Step 1: Contact your Claims Advisor
If you have a concern with your recent claim, please contact the assigned claim advisor. Your claims advisor is your first point of contact that has the ability to review and work on your concern right away.
You will receive your claims advisor’s contact details throughout the claims process and will have their dedicated phone number and email to reach them directly.
If your matter remains unresolved after speaking with your claims advisor and you have completed Step 1, you may proceed with Step 2 by escalating your concern.
Step 2: Escalate your Concern
This level of the complaint resolution process provides an opportunity for claims experts to address your concern. They will thoroughly review your case and consider additional resolution options.
You can escalate your concern by:
- Ask the claims advisor to put you in contact with their manager by providing you with their name, phone number and email. The claims manager will provide you with claims’ decision.
OR
- Submit your concern by sending all the required details to our Escalation Desk<need link to open outlook email> The escalation desk will provide support with addressing the issue further.
After you have been provided with claims decision at Step 2, if you remain unsatisfied with the outcome you may proceed to Step 3 for further review and investigation.
Step 3: Engage the Complaint Management Office
At this level of the complaint resolution process, you can submit your complaint to the Complaint Management Office <need link to open outlook email>. A Senior Complaint Consultant will review and investigate it. Their goal is to ensure your concern is addressed fairly and diligently, provide further explanation regarding the outcome, and act as a liaison between you and the area where your concerns reside.
What you can expect during this process:
1. A file will be opened upon receipt of your written complaint
2. Your file will be reviewed by all appropriate and related parties
3. A formal response will be issued once the investigation is complete
Please Note:
- Senior Complaint Consultants do not have the ability to adjust claims, you are encouraged to work with a claims representative to resolve your concerns on your active claim.
- If you submit your complaint to Step 3 prior to completing Step 1 or Step 2, your matter will be redirected to the appropriate level of the Complaint Resolution Process.
- Step 3 investigations will take time to complete, they are conducted by a thorough review to ensure accuracy with the final position. A formal response will be provided within an appropriate timeframe based on complexity.
Complaint Management Office
27 Allstate Parkway Suite 100
Markham, Ontario
L3R 5P8
For additional information, call our toll-free line:
English : 1-877-7-CONSUMER (1-877-726-6786)
French: 1-866-348-5598
External Escalation Options
General OmbudsService
The insurance industry does offer an independent complaint resolution service. If, after following the steps outlined above and upon receiving the final position, you are still not satisfied, you can reach out to the General Insurance OmbudService (GIO), an independent dispute resolution service, toll free at 1.877.225.0446 or visit their website at http://www.giocanada.org/.
The Financial Consumer Agency of Canada
The Financial Consumer Agency of Canada also offers information on complaint resolution, you can contact the agency by visiting their website www.fcac-acfc.gc.ca or at its office at 427 Laurier Ave. West, 6th Floor, Ottawa, Ontario K1R 1B9
Quebec Residents
You can choose to reach out to the Autorité des Marchés financiers (AMF) at 1.877.525.0337 or visit http://www.lautorite.qc.ca/en/file-complaint-conso.html