Insurance and Risk Management (IRM) has a complaint process available to the public.
A complaint is an expression of dissatisfaction related to a City of Toronto program, service, staff member or the City’s insurance adjusters, ClaimsPro; where a customer believes that the City or its staff has not provided a service experience to the customer’s satisfaction at the point of service delivery, and a response or resolution is explicitly or implicitly expected.
Note: The complaint process is not intended to deal with the outcome of your claim (e.g. a denial or settlement amount). The insurance claims process involves you (the claimant) and the ClaimsPro insurance adjuster assigned to act on behalf of the City’s liability insurance policy. If your claim has been denied, your remedy is to seek independent legal advice.
As noted under Insurance Claims above, the City’s insurance adjuster pays only when the City is legally liable which is determined by them considering your proof of claim.
The City’s insurance adjuster’s assessment of your claim is final and it can only be reviewed by them if you can provide additional relevant evidence to support your claim which was not considered by the adjuster originally.
A Complaint can be about one or more of the following:
A complaint process involves the steps below.
A complaint may be made in a number of ways:
Your complaint should include the following:
We will endeavour to resolve your complaint within 14 days of receipt.
Complaints will be resolved informally where possible.
If your complaint cannot be resolved informally, it will be recorded and tracked from initial receipt through the entire process until the complaint is resolved. You will be provided with a tracking number.
Staff will determine that the complaint is with the correct division, and:
Staff will outline the steps that will be taken to settle the matter and the estimated investigation duration.
Staff will determine what has happened and identify appropriate action to resolve the complaint (if possible) and summarize findings. If the complainant is not satisfied, staff will escalate the complaint to their immediate supervisor. If necessary, the complaint will be escalated to the Manager.
Internal review of complaints may not always result in resolution, and a complainant may seek external review. External review can take a number of forms:
If the resolution is accepted by the complainant, the complaint is closed.