The consumer’s vehicle was stolen and recovered but was damaged.
The insurer denied the claim on the basis that the consumer did not advise them that the vehicle was a modified vehicle.
The consumer pointed out that they had provided their insurance agent with photos of the vehicle showing it was modified prior to the agent insuring the vehicle.
The agent agreed the photos showed the vehicle was modified and that the policy should not have included physical damage coverage, but since it was the agent’s error, the agent requested the claim be paid.
The insurer continued to deny the claim but changed their reason for denial from the vehicle being physically modified to it being performance modified.
As part of GIO’s informal conciliation, the CSO contacted the insurer to discuss the fact that they agreed to insure the vehicle even after the agent and underwriting staff had the opportunity to review photos that very clearly showed the vehicle was physically modified.
The CSO asked the insurer how they could justify accepting one type of modification but deny the claim based on a different modification. Once the physical damage coverage was placed on a modified vehicle, any other modification should not matter if the modification occurred prior to coverage being placed.
The insurer reviewed the matter further with underwriting and claims and ultimately agreed to pay the claim to the consumer.
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.
General Insurance OmbudServiceService de conciliation en assurance de dommages
4711 Yonge Street, 10th floorToronto, ON M2N 6K8Tel 1-877-225-0446Fax 416-299-4261
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