The Financial Services OmbudsNetwork (FSON) became operational in Ontario on November 29, 2002. The FSON is an independent national system, funded by the industry, for handling and resolving consumer complaints about the products and services of the banking, life and health insurance, property and casualty insurance and securities industries. The Financial Services Commission of Ontario (FSCO) supports this initiative.
The Centre for the FSON provides all consumers of financial services with a single integrated access point for responding to their general inquiries and connecting them to the appropriate point in the network of company and industry ombudservices. Under the new system, individual companies have primary responsibility for resolving consumer complaints. Where a complaint remains unresolved, consumers have access to an independent, “industry-level” ombudservice which will provide complaint handling and resolution services. There are three industry ombudservices: the Canadian Life and Health Insurance OmbudService (CLHIO), the General Insurance OmbudService (GIO), and the Ombudsman for Banking Services and Investments (OBSI).
Since the establishment in Ontario of the Insurance Ombudsman and “Industry First Response” framework in 1996, consumers have come to rely on a high level of complaint handling and dispute resolution service from the insurance industry. FSCO anticipates that this commitment to consumer service by Ontario insurance companies will continue under the FSON. To reduce consumer confusion and duplication in the marketplace, FSCO is amending its complaint handling protocol requirements for FSON member companies. The Office of the Insurance Ombudsman (OIO) will continue to receive and make inquiries into complaints about companies that do not belong to the FSON.
OIO Complaint Handling During Transition
Once the FSON became fully operational with the November 29, 2002 launch of the Centre for the Financial Service OmbudsNetwork (CFSON), the OIO contacted most companies to determine whether they are planning to use the new system. For consumers whose companies have indicated their intention to use the FSON, FSCO has begun informing consumers who call with general inquiries or write without first attempting to resolve their complaints directly with their companies, about the new system.
For files received after November 29, 2002, where the complaint involves a company
participating in the FSON and the company’s final letter includes a notification to the consumer about the OIO, the OIO is giving consumers the option of having their complaints go through the FSON complaint process. Where both the company and the consumer are in agreement, the OIO will refer the matter to the appropriate OmbudService for resolution.
Consumers who contact the OIO and who have a final letter from the company notifying them about one of the new ombudservices, are being referred to the new ombudservice. The OIO is continuing to process those complaint files received and opened prior to November 29, 2002 .
Company complaint handling Protocols across the industry were first established in 1996 to improve the ability of consumers to resolve their complaints directly with their insurers and thereby increase consumer confidence in the marketplace. A Protocol provides consumers with a clear view of an insurer’s complaint handling procedures and contains information on how to file a complaint with a company, who to contact, how long the procedures might take, and the next steps for complaints which remain unresolved.
FSCO continues to require all companies to have in place a Protocol for dealing with consumer complaints. Companies who are members of one of the three ombudservices need to amend their Protocol to reflect their new commitment to advise consumers with unresolved complaints about the availability of their respective ombudservice. FSCO also expects companies to continue to make consumers aware of the Protocol and to communicate the Protocol to all their front line staff in order to assist consumers with complaints. As consumers will continue to contact FSCO with complaints and FSCO will need to work with companies to resolve market conduct issues, companies are still required to identify a Company Liaison Representative to serve as the insurer’s link with the OIO. Companies participating in the FSON may also be required to identify a contact person for FSON purposes. FSCO will work with the FSON to establish a streamlined process that eliminates duplication and meets the needs of each organization.
Accordingly, the “Complaint Handling Protocol Form” has been revised. Companies are
required to complete the revised Form (attached) and return it to FSCO by March 31, 2003. The form must be signed by an officer of the company. A copy of the form is also available online at www.fsco.gov.on.ca.
Market Conduct Inquiries
The FSON has indicated that certain market conduct issues and matters of compliance are outside its scope. Consequently, the OIO will continue its regulatory market conduct
responsibilities by making inquiries into allegations of misconduct, unfair practices and noncompliance with insurance legislation. Life insurance companies are required to continue reporting to the OIO instances of agent misconduct using the Life Agent Reporting Form. For more information about this requirement, see Bulletin LH- 01/98, Industry Protocol for Reporting Unsuitable Activities of Life Agents, Other Life Insurance-related Information.
Company Complaint Data Reporting
FSCO is currently working with other financial services regulators across Canada to identify and address issues relating to the collection of company complaint data. This may in the future result in a national streamlined approach for company data reporting. However, at this time no changes are being made to the company data reporting requirements. For more information about the company complaint data reporting requirements see Bulletin G- 10/00, New Standards for Ontario’s Consumer Complaint Handling System: Collection of Company Complaint Data and Complainant Notification about the Office of the Insurance Ombudsman. Copies of the above noted bulletins are available on FSCO’s website: www.fsco.gov.on.ca under the Ombudsman section.
If you need additional information, please contact Christina Harding, Business Analyst,
Ombudsman Services Branch, FSCO, at (416) 226-7814; fax (416) 590-8480; or via e-mail: firstname.lastname@example.org.
Bryan P. Davies
Chief Executive Officer and
Superintendent of Financial Services
March 4, 2003
Attachment: Complaint Handling Protocol Form
* French version of attachment is available upon request.