Case Study

CASE

Borrowed vehicle insurance denial

Synopsis of Complaint:

Consumer’s son borrowed the family vehicle and was involved in an accident. The consumer put in a claim, which was denied due to misrepresentation. Consumer contacted GIO for assistance after receiving a final position letter from his insurer maintaining the decision to deny his claim.

The insurer had determined that the consumer had not advised that his son was fully licensed, preventing the insurer to properly assess and rate the risk. The misrepresentation also resulted in the consumer receiving a notice of policy cancellation.

The consumer explained that he disclosed the driving status of his son to his agent but unfortunately there was nothing noted in the agent’s file regarding this. The agent had since left the company.

Review by GIO:

The Consumer Service Officer (CSO) handling the file asked the consumer to review all of his records (emails, text) to see if there was anything recorded in writing. The consumer had not thought to look for this information and was not sure he would find anything as many months had gone by.

A few days later the consumer shared an e-mail with the CSO showing that his agent was aware of his son’s license status.

Resolution:

The CSO contacted the company Ombudsman and shared the new information. The insurer agreed to postpone the cancellation of the policy until the matter was further reviewed. In the end, the insurer was satisfied that there was a miscommunication and honored the consumer’s claim and maintained the policy in force.

GIO is an independent body set up to help Canadians find a fair resolution to disputes with insurance providers. GIO can provide advice on dealing with your insurance company as a first step. If you are not satisfied with the decision from your provider on your claim, GIO can help resolve your claim. 

If you’d like to submit a claim visit here.

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