Insurance Complaint Letter Template (Canada)

Having issues with your insurance company in Canada? Whether it's a denied claim, delayed payment, or policy dispute, a formal written complaint is your first step toward resolution. This tool generates a professional insurance complaint letter tailored to Canadian regulations.

Want this as a clean, formal letter instantly? Use the Free Complaint Letter Generator to generate an insurance complaint letter.

What This Letter Is

An insurance complaint letter is a formal written notice to your insurance company documenting a dispute about your policy or claim. In Canada, insurance companies are required to have internal complaint handling processes. Filing a written complaint starts this formal process and creates the documentation needed if you later escalate to the General Insurance OmbudService (GIO), OmbudService for Life & Health Insurance (OLHI), or your provincial insurance regulator.

How This Works

1
Describe your issue
Enter your policy details, claim information, and what went wrong.
2
Generate your letter
A structured letter is created based on your inputs with Canadian regulatory references.
3
Submit and track
Send to your insurer's complaints department and document their response.
Generate Your Letter

Trusted by Canadian consumers resolving insurance disputes.

When This Letter Works

  • Your insurance claim was denied and you disagree with the decision
  • Your claim payment is significantly delayed without explanation
  • Your premium increased unexpectedly or incorrectly
  • You were not properly informed about policy coverage or exclusions
  • Your policy was cancelled without proper notice or valid reason
  • The adjuster's damage assessment seems unfair or incomplete
  • You're having trouble getting a response from your insurer

When It May Not Be Enough

  • Your claim involves suspected fraud (contact police and your insurer's fraud unit)
  • You need immediate emergency coverage (contact your broker or insurer directly)
  • The dispute is about an insurance agent's conduct (contact your provincial regulator)
  • You're seeking damages beyond your policy limits (consult an insurance lawyer)

What to Include

  • Your full name and contact information
  • Policy number and type of insurance (home, auto, life, health)
  • Claim number if you filed a claim
  • Clear timeline of events (dates of incident, claim filing, communications)
  • Specific description of the issue and why you disagree
  • Reference to policy terms or coverage you believe applies
  • Supporting documentation references (photos, receipts, correspondence)
  • What resolution you are seeking (claim approval, payment, policy correction)
  • A reasonable deadline for response (30 days is standard)

Legal Context (Canada)

Insurance in Canada is regulated at the provincial level for most consumer policies. Each province has an insurance regulator that licenses insurers and sets conduct standards. Additionally, all insurance companies must participate in independent dispute resolution through approved ombudservices.

The General Insurance OmbudService (GIO) handles complaints about home, auto, and business insurance. The OmbudService for Life & Health Insurance (OLHI) handles life insurance, disability, and health insurance complaints. Both services are free to consumers and provide impartial investigation of disputes.

Before escalating to an ombudservice, you must first file a formal complaint with your insurance company and give them opportunity to resolve it (typically 90 days or until they provide a final response). This written complaint letter is your first step in that process. This information is general and does not replace advice specific to your situation.

Escalation Options in Canada

If your insurer does not resolve your complaint satisfactorily, you may escalate to:

  • Home/Auto/Business Insurance: General Insurance OmbudService (GIO) - giocanada.org
  • Life/Health/Disability Insurance: OmbudService for Life & Health Insurance (OLHI) - olhi.ca
  • Provincial Regulators:
    • Ontario: Financial Services Regulatory Authority (FSRA)
    • BC: BC Financial Services Authority (BCFSA)
    • Alberta: Alberta Superintendent of Insurance
    • Quebec: Autorité des marchés financiers (AMF)
  • Legal Action: Small claims court for disputes under provincial limits, or civil litigation for larger amounts

Types of Insurance Complaints

  • Claim Denial: Your claim was rejected and you believe coverage applies
  • Underpayment: The settlement amount is less than your actual loss
  • Delay: Unreasonable time to process or pay your claim
  • Cancellation: Your policy was cancelled improperly
  • Premium Dispute: Unexpected or incorrect premium increases
  • Coverage Dispute: Disagreement about what your policy covers

Frequently Asked Questions

Start by filing a formal written complaint with your insurance company's internal complaints department. If unresolved after 90 days (or sooner if they give a final response), escalate to GIO for home/auto insurance or OLHI for life/health claims.

GIO (General Insurance OmbudService) is the independent ombudservice for home, auto, and business insurance complaints in Canada. It provides free, impartial dispute resolution when consumers cannot resolve issues directly with their insurer.

Insurance companies must acknowledge complaints promptly and typically have 30-90 days to provide a final response through their internal process. If you don't receive a satisfactory response within this timeframe, you can escalate to the appropriate ombudservice.

Yes, you can pursue legal action, but it's usually a last resort after exhausting internal complaints and ombudservice options. Small claims court handles disputes under $25,000-$50,000 (varies by province). For larger claims, consult an insurance litigation lawyer.

Request a detailed written explanation of the denial, including the specific policy terms cited. Review your policy to understand if the denial is correct. If you disagree, file a formal complaint and provide any additional documentation supporting your claim.
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