A report made available to the General Insurance Ombudservice (GIO) in November 2022 is being made public in March 2023 after an independent evaluation found that the GIO was generally compliant with all of its prescribed guidelines.
Established under federal legislation in 2002 to provide independent dispute resolution services for consumers, the GIO’s board of directors appoints an independent, third-party evaluator to conduct a review of governance and operations, in order to comply with guidelines developed by regulators.
Specifically, guideline 7 was developed by the Joint Forum of Financial Market Regulators and endorsed by the OmbudService oversight standing committee with the Canadian Council of Insurance Regulators (CCIR). “Guideline 7 of this framework specifies that the independent evaluation should assess the extent to which the operations of the OmbudService has achieved its public interest purpose,” the evaluators write in the Report of the Independent Evaluators to the Board of Directors of The General Insurance OmbudService. “Where the evaluator concludes that shortfalls exist, the evaluator should make recommendations for improvement.”
The evaluation included extensive work consulting the service’s executive director, manager of complaints, most of the GIO’s customer service officers, directors, representatives from the industry and the CCIR, consumer liaison officers and representatives from the Financial Consumer Agency of Canada. More, they examine a statistically valid sample of case files, including all files sent to mediation, statistical reports, all minutes from board and committee meetings published since the last report, policies, procedures, budgets and business plans, other ombudservice websites and all published reports issued by third party evaluators.
“An assessment of complaint is given when all criteria are met without any significant deficiencies, including instances where the requirements of the guideline have been achieved by other means,” they write. “Based on the scope of the work performed and the evaluation methodology used, we have determined that the GIO has achieved its public interest purpose,” they conclude.
In response to suggestions from the evaluators, the GIO says it will enhance its enterprise risk management framework, with particular attention paid to adopting a risk appetite statement and appropriate risk tolerance targets. It will enhance its board of directors’ skills matrix and plans to enhance its accessibility support for consumers with special needs or language comprehension challenges.
“The results of our independent evaluation demonstrate that the GIC is successful in implementing its mandate to independently assist consumers from across Canada with their insurance disputes,” says the GIO’s executive director, April Schulze. “We are always open to feedback to ensure we are providing accessible and timely services.”
