Complaint review policy and procedure
In accordance with its obligations, Karma Insurance has adopted a complaint review policy.
The policy’s purpose is to ensure that any complaint filed by a dissatisfied consumer is fairly dealt with and at no cost.
At Karma Insurance, we believe that client complaints are important and that our duty is to deal with any expressed dissatisfaction promptly and courteously.
If you are dissatisfied with a decision or the way in which your file was handled, you may proceed as follows :
Before contacting us
- have all your documents on hand so you can refer to them easily;
- determine why you are dissatisfied, the questions you wish to ask, the arguments you wish to make, and the desired solution (if you are seeking financial compensation, you should say so);
- write it all down in a letter and don't hesitate to provide as much detail as possible;
- attach photocopies rather than the original versions of your documents.
If, after the steps described above, you have still not received a satisfactory response at the operational level, you may file a formal complaint with the Complaints Officer. He will handle your complaint with impartiality.
Below is the contact information for our company's Complaints Officer :
Filing a formal complaint
A complaint must express at least one of the three following elements, which persists despite being addressed at the relevant operational level in order to be considered a complaint within the meaning of the policy :
- A reproach made to the company;
- The identification of potential or actual harm to an insured;
- A request for corrective measures.
Please note that an initial expression of dissatisfaction, whether in writing or not, does not constitute a complaint. Nor is an informal step taken to correct a specific problem, to the extent that the problem in question is dealt with in the process of regular operations.
Your complaint must be made in writing, and "Complaint" must be written at the top of your letter; alternatively, you may use the downloadable complaint form at the end of this document.
Provide your contact information (address and telephone numbers) and describe the reason for your complaint, the steps you have taken, and the response you received.
Explain your arguments and identify the solution you are seeking.
Receipt of formal complaint
Upon receiving a client’s formal complaint, the file is remitted to the Complaints Officer :
- An acknowledgement of receipt will be sent to the client within five (5) days following receipt of a written complaint in order to inform him of the turnaround for complaint review.
- The response to the complaint will indicate :
a) the outcome of the impartial review of your complaint;
b) the procedure for requesting that your file be transferred to regulatory authorities.
The Complaints Officer will ensure that the Company’s decision and the bases for it are communicated to you in writing.
If an offer is made to you, the offer must be clearly expressed in the letter, along with the time limit for accepting or refusing the offer. Otherwise, you will be deemed to have refused the offer and it will be withdrawn permanently.
If you are still dissatisfied with the process or your answer, you can ask our Complaints Officer to send a copy of your file to :
- in Quebec, the regulatory body for health insurance companies is the Autorité des marchés financiers (AMF). You may request, within a year of receiving the final answer, that your file be transferred to the AMF. You can contact the AMF at the toll-free number 1-877-525-0337 or visit www.lautorite.qc.ca.
- elsewhere in Canada, you may contact the OmbudService for Life & Health Insurance (OLHI) at the toll-free number 1-888-295-8112 or visit www.oapcanada.ca. Please note that the OLHI can transfer your complaint to a provincial or territorial regulatory body if your complaint is not within its mandate.
The client may exercise this right only upon expiry of the period identified for obtaining a final answer, not to exceed a period of one year from the date that answer is received.
Registry creation and maintenance
A complaint registry has been created for the purposes of applying the Policy. The Complaints Officer records and updates the information concerning complaints that meet the definition of that word.
The Complaints Officer files a quarterly complaints report to the regulatory authorities.
This policy was last updated in July 2017.