Case Study

CASE

Coverage for Lost Cell Phone

Synopsis of Complaint:

The Consumer believed that the claim for the loss of her daughter’s cell phone should be honoured by the Insurer. She wanted a full reimbursement for the cell phone because her credit card provided coverage for theft.

The Consumer used her Insurer’s complaint escalation process and felt the Insurer’s Ombudsman did not understand her situation in maintaining the denial of her claim.

The Insurer’s Final Position Letter directed the Consumer to GIO.

Review by GIO:

After a review of her complaint, GIO advised the Consumer that it appeared as though the claim could not be paid because she had not met the policy conditions and timeline for contacting the Insurer.

The Consumer provided further documentation to GIO and GIO contacted the Insurer’s Ombudsman to discuss the situation.

Resolution:

Upon further review, it was determined that the Consumer had provided proof of the purchase of the cell phone, and she had contacted the Insurer within the eligible timelines for coverage. The Insurer paid the claim up to the maximum policy limitation. The Consumer was delighted by the outcome.

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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