Complaint Protocol Transamerica Life Canada ... - · PDF fileTransamerica Life Canada...

1 Complaint Protocol –revised April 2012

Complaint Protocol Transamerica Life Canada (Transamerica) AEGON Fund Management Inc. (AFM)


Complaint Protocol - Risk Charter

Version Management

Version Date Author / Change by

Summary of change

1.0 1999 Jennifer Etwaroo Elaine Forma

Initial Version of Document

2.0 October 2003 Rose Leo Update of OHLI (CLHIO) contact Update change of CCO to Serge Cecchetto

3.0 April 2005 Rose Leo Update of Acknowledgment Letters

4.0 January 2007 Rose Leo Update of change of CCO to Gordon Murphy Updated with inclusion of separate Escalation Chart

5.0 August 2009 Rose Leo

6.0 May 2011 Rose Leo Updated change of CCO to Cindy Groat

7.0 April 2012 Rose Leo Updated change of CCO to John O’Hoski Updated content of document and escalation process chart(s)

Reviewer/Approver

Version Date Reviewer/Approver Summary of change

1.00 1999 Bob Bovaird Final Version

2.0 October 2003 Serge Cecchetto Final Revised Version

3.0 April 2005 Serge Cecchetto Final Revised Version

4.0 January 2007 Gordon Murphy Final Revised Version

5.0 August 2009 Gordon Murphy Final Revised Version

6.0 May 2011 Cindy Groat Final Revised Version

7.0 May 1, 2012 John O’Hoski Final Revised Version


Document Review Cycle

Version Last Review Next Review Comments

1.00 December 1999 As required Final Version

2.0 October 2003 As required Final Revised Version

3.0 April 2005 As required Final Revised Version

4.00 January 2007 As required Final Revised Version

5.00 August 2009 As required Final Revised Version

6.00 May 2011 As required Final Revised Version

7.00 April 2012 As required Final Revised Version

Period for which the documentation will be effective: This document will be ongoing, subject to any significant changes in the Compliance Manual at which time the document will need to be reviewed and updated. This document is owned and maintained by the Transamerica Life Canada Compliance Department.


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Contents Complaint Protocol - Risk Charter .................................................................................................. 2

Section I ........................................................................................................................................... 6

Complaint Protocol Transamerica Life Canada ............................................................................... 6

Purpose of the Protocol ........................................................................................................... 6

Central Complaint Registry ...................................................................................................... 6

Categorization of Complaints (Central Compliance Register) ................................................. 7

Filing/Receipt of the Complaint .............................................................................................. 8

Controlling the Complaints ...................................................................................................... 9

Quebec Clients Only – links for AMF Forms ............................................................................ 9

Definitions of Complaints .............................................................................................................. 10

Types of Complaints ...................................................................................................................... 11

Examples of Non-reportable Complaints .............................................................................. 11

Reportable Complaints .......................................................................................................... 12

Examples of Reportable Complaints ..................................................................................... 13

Market Conduct Complaints .................................................................................................. 14

Multiple Complaints .............................................................................................................. 15

Creation and Maintenance of a Register ....................................................................................... 16

Populating the Central Complaint Registry ........................................................................... 17

Complaint Examination ......................................................................................................... 17

Transfer of the File to the Autoritie des Marches Financiars (AMF) - Quebec only .............. 17

Conducting Investigations and Providing Resolutions .......................................................... 18

Other Points/Considerations for Complaint Handling .......................................................... 18

AEGON Fund Management (AFM) ........................................................................................ 20

National Accounts/Alliance Partner /Company Offices ........................................................ 20

Unresolved/Dispute Resolution – External Resources (All Provinces) .................................. 22

Section II ........................................................................................................................................ 23

Other Types of Complaints/Inquiries ............................................................................................. 23

Complaints Addressed to the President/CEO........................................................................ 23


Inquiries from Regulators ...................................................................................................... 23

Privacy Complaints ................................................................................................................ 24

Media Threats Complaints .................................................................................................... 24

Legal Threats Complaints ...................................................................................................... 24

Section III ....................................................................................................................................... 25

Other Related Information ............................................................................................................ 25

Reporting and Certification ................................................................................................... 25

Reporting to FSCO/AMF ........................................................................................................ 25

Other External Regulatory Contacts ...................................................................................... 26

Financial Consumer Agency of Canada (FCAC) ...................................................................... 26

Record Retention ................................................................................................................... 27

Compliance Team Contacts ........................................................................................................... 28

Life Market Conduct Compliance .......................................................................................... 28

Regulatory Compliance ......................................................................................................... 28

How to Access the Complaint Log/Compliance Files ............................................................ 28

Section IV ....................................................................................................................................... 29

Appendix A Complaint Definitions ....................................................................................... 29

Section V ........................................................................................................................................ 30

Appendix B Escalation Process .......................................................................................... 30

Sample External Recourse Text for Inclusion in Final Position Letter ........................................... 31


Section I

Complaint Protocol Transamerica Life Canada

Purpose of the Protocol

To set up an equitable and free examination procedure for all complaints received by Transamerica Life Canada (Transamerica), and AEGON Fund Management (AFM) (hereinafter referred to as “the Companies”). It is intended in particular to govern the receipt of complaints, acknowledgements of receipt and notices to the complainant. In addition, a process is in place for the creation of complaint files, and where applicable, the transfer of the complaint files to the regulator (i.e. Autorité des marchés financiers for Quebec residents). A Central Complaint Registry is maintained to ensure consistency in recording Reportable Complaints and to comply with regulatory tracking and reporting requirements. This Central Complaint Registry will be maintained in the Compliance Department who is responsible for filing a semi-annual on line declaration report with Financial Services Commission of Ontario

(FSCO) /Autorité des marchés financiers (AMF)/PARC (Participating Regulatory Authorities of Canada (PARC).

Central Complaint Registry

This Registry reflects the guidelines for the Complaint Protocol issued by the Financial Services Commission of Ontario (FSCO) and the Autorite de Marches Financiers (AMF), concerning the examination of complaints and the resolution of disputes. On July 1, 2009, the FSCO/ AMF Complaint Reporting Register System (CRS/SRP) became the National Complaint Reporting System. The system was adopted Canada wide with the exception of British Columbia, Northwest Territories and Nunavut.


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Categorization of Complaints (Central Complaint Registry)

Complaints are categorized by line of business and type of complaint as follows: (i) Lines of Business - Life/Disability/Health (Individual) - Investments (Annuities, Segregated Funds) (ii) Types of complaints Underwriting – Premium, Policy provisions, Refusal, Customer service (timeliness, knowledge, expertise), Change in risk category, alleged discrimination, Credit scoring, File confidentiality of insured, Information collection and needs analysis, Report to client, Performance of mandate Administration – Administrative procedures, Customer service (timeliness, knowledge, expertise), Statements, Fees/commissions, Pre-authorized Debit/Payment Plan, Transfers, Credit rating, Non-authorized transactions, Personal information protection, Collection Marketing and Sales (advisors and brokers) – Advertising (misuse of Company logo), Illustration of cost or return, Alleged misleading statement or misrepresentation (incomplete disclosure), Replacement disclosure form (incomplete), fraud, forgery, misappropriation of funds, rebating, undue influence/coercion/conflict of interest, delivery of policy, Tied selling, Discontinuation/Termination of service. Product – Policy Value, Availability/Accessibility, Renewal, Rate of Return (ROR), Policy provisions, Prospectus, Adequacy of product Claims/Settlement – Claim procedure, Delay in settlement, Refusal of claim, Customer service (timeliness, knowledge, expertise), Suspension of benefit, Reporting to client, Performance of mandate

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Filing/Receipt of the Complaint

A customer who wishes to file a complaint must do so in writing to the following address: Transamerica Life Canada Compliance Department 5000 Yonge Street Toronto, Ontario M2N 7J8 Fax # (416) 883-5174 E-mail address [email protected] Note: the e-mail address for Transamerica Compliance should be used as an initial contact ONLY. Written documentation with additional documents must be forwarded to the company. Any employee who receives a complaint and verifies that this is an escalated complaint shall immediately adhere to the complaint escalation process and document and escalate accordingly. Please see Appendix A & B. Home

mailto:compliance


Controlling the Complaints

The Compliance Department shall train company employees and give them the relevant information to ensure that this Protocol is properly administered. In addition to the responsibilities mentioned above, the Compliance Department must acknowledge receipt of the escalated complaint (those escalated to Compliance) within five business days (other complaints to be handled by each business unit responsible for them). The acknowledgement of receipt shall contain at least the following information:

Acknowledgment of client letter dated <<include date of client letter>>;

The reproach against the regulated company and the request for remedial action (i.e.

OHLI and/or AMF);

The time frame in which the complaint will be handled;

The name and contact information of the person responsible for examining the

complaint;

In the case of an incomplete complaint, a request for additional information that must

be sent to us within 10 days of the request, failing which, the complaint will be

considered to have been abandoned;

The contact details for third party remedial/alternative dispute resolution service

available to the client (i.e. OHLI and/AMF); and

For Quebec residents only, the complaint can be sent through the AMF by use of the on-

line forms available to the client. Please see link below.

Quebec Clients Only – links for AMF Forms

http://www.lautorite.qc.ca/fr/formulaires-pour-consommateurs-conso.html (French)

http://www.lautorite.qc.ca/en/forms-for-consumers-conso.html (English)

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http://www.lautorite.qc.ca/fr/formulaires-pour-consommateurs-conso.html

http://www.lautorite.qc.ca/en/forms-for-consumers-conso.html


Definitions of Complaints Please click here to go to Complaint Definitions Chart Complaint: Is an expression of dissatisfaction from, or on behalf of, a consumer, about the business practice of the Company, its representatives or its selling intermediaries. For the purposes of this policy, a complaint is the expression of one of the following three elements:

A reproach against the regulated person (i.e. the Company, advisor).

The identification of real or potential harm that a customer has experienced or may

experience

A request for remedial action

Note: The expression may be verbal/written. The need for written documentation must

be emphasized as it provides a clear understanding of the complaint and is required for

appropriate record keeping.

A first-level intervention consisting of a communication from a customer which is an informal step aimed at having a particular problem corrected, is not a complaint, provided that the problem is dealt with as part of the regular activities and without the customer having to request escalation of the complaint. A complaint that remains unresolved at the front line level must be “escalated” to be reviewed and dealt with at a “higher” level. Alternately, a complaint may be “escalated” by a customer who has directed his or her complaint to a “higher” level in the Company (e.g. President/CEO, AVP/VP of Business Unit, Chief Compliance Officer). In this situation, the complaint is escalated to the Compliance Department and will be directed if necessary to the appropriate individual for handling. The complaint becomes reportable, when the customer is not satisfied with the information or explanation provided and “escalates” the complaint to a higher level in the company. The complaint itself is to be passed to a senior service representative, a supervisor or manager of the Business Unit. Where this happens, if the escalation is at the supervisor level, there is no need to report on any database or logs (i.e. Business Unit Monthly Escalation Log/Client Service Escalation). If the complaint is escalated to the manager, AVP or VP level in the business unit, it must be entered in the Business Unit Monthly Escalation Log and reported to Compliance so that it can be entered in the Central Complaint Registry. Home


Types of Complaints

Examples of Non-reportable Complaints

A customer contacts his/her advisor to complain about a lapse in his/her insurance

coverage. The client’s advisor contacts the Insurance Company, and subsequently

reports to the customer with an explanation for the lapse. The customer is satisfied with

the explanation.

A customer contacts the call centre to complain about a mistake in his/her mailing

address. The call centre takes all the information and informs the client that the

concerns have been referred to the appropriate front line operations level for handling.

The customer is satisfied and no further action is required.

A customer directs his/her concerns to the company in writing about a payment error

made with the monthly pre-authorized debit. The complaint is referred to the front line

staff for handling. The customer is satisfied and no further action is required.

Please click here to go to the Escalation Chart Home


Reportable Complaints

A complaint is considered reportable if it meets the AMF/FSCO’s definition of a complaint, which is; “A complaint is the expression of at least one of the following elements that persists after being considered and examined at the operational level capable of making a decision on the matter: a reproach against the organization, the identification of a real or potential harm that a consumer has experienced or may experience, a request for remedial action. Complaints are generally expressed in writing through correspondence, e-mail, fax, by phone, in person or other form that allows a complaint to be kept on file. Complaints handled via telephone must be documented so that they can be filed.” The definition characterizes the front line as “the level that routinely handles and makes operational decisions about the subject matter of the complaint.” The Company Call Centre does not routinely make operational decisions about the subject matter of complaints. Therefore, complaints referred from the Call Centre to another Company Business Unit would not be reportable unless they were referred to a “higher” level within that Business Unit, or to an employee of the department assigned with specific responsibility to deal with complaints (i.e. manager or above or Compliance). This definition automatically eliminates customer inquiries, concerns and the exchanging of information that is a part of everyday business handled by front line staff in each business unit. It specifically eliminates the following which do not have to be reported and will not be tracked in the Central Complaint Registry:

(i) matters that originate within the Call Center and are fully dealt with by the Call Center

staff or its management.

(ii) complaints referred from the Call Center to a member of front line staff, who routinely

makes operational decisions about the subject matter, and does so without referring it

to a “higher” level in the operational unit.

Complaints, other than those of a market conduct nature, will be investigated and resolved by operations area staff, including complaints that have been addressed to the President/CEO (the reply letter must be signed by the VP of the business unit and copy to the President/CEO and others including Compliance). Note: Presidential letters are an automatic escalation to Compliance for determination on how it should be handled. In addition when required, it will be requested that before the letter is mailed, it must be reviewed by Compliance. Please click here to go back to Escalation Chart Home


Examples of Reportable Complaints

A company denies a waiver of premium claim and advises the customer that if he has

any additional medical documentation, the denial will be reconsidered. The customer

writes to the company advising that he has already provided sufficient documentation.

The claims representative continues to correspond with the customer who remains

dissatisfied. Pursuant to the company’s Complaint Protocol, the complaint is escalated

to the next level.

A customer writes to Head Office complaining about the non-renewal of her insurance

policy. The Company corresponds with the customer several times to provide an

explanation of the company’s position from frontline staff at different levels. The

customer remains dissatisfied. Pursuant to the company’s Complaint Protocol, the

complaint is escalated to the next level.

A customer phones the Company Call Centre complaining about his billing notice. The

customer is provided with an explanation but is not satisfied and requests that he speak

to a supervisor. A supervisor speaks to the customer, reviews his complaint and

provides him with further clarification. The customer remains dissatisfied and the

supervisor escalates the complaint to the next level.

A customer calls her broker to complain about a negative option marketing campaign.

The broker contacts the company and subsequently provides an explanation to the

customer who remains unsatisfied. The customer contacts the OmbudService for Life &

Health Insurance (OLHI), who will direct the customer to the Company Chief Compliance

Officer/Compliance Department. The Compliance Department will review the client

concern, register it in the Central Complaint Registry and if necessary will refer to the

appropriate department for review and response.

For cases that a client approaches the regulator first (i.e. FSCO, AMF or OLHI), although

they have not gone through the normal process, these will be treated as

escalated/reportable complaints as the regulator is aware of the complaint. As such

these will be registered in the Central Complaint Registry. Compliance will review and

come to a decision and provide the response. In some cases input from other business

units may be required to help address the request.

Please click here to go back to Escalation Chart Home


Market Conduct Complaints

All Market Conduct complaints (those which involve a breach of insurance regulation or possible criminal activity) will be investigated and resolved by the Compliance Department. Such complaints may be filed against advisors personally (Sales Intermediaries) or the Companies. The reason for this is because the Company must adhere to the Canadian Life and Health Insurance Association (CLHIA) Guideline G8, Screening Agents for Suitability and Reporting Unsuitable Agents – and report any unsuitable activities to the appropriate regulator. Escalated or Market Conduct complaint require appropriate reporting to FSCO and/or AMF. In tracking complaints, Compliance will select the category into which a complaint most logically belongs. Examples Agents and Brokers(Sales Intermediaries) – Fraud, forgery, misappropriation of funds, rebating, undue influence/coercion, conflict of interest, non-disclosure of replacement to TLC, systematic replacement, fronting, suitability, misleading statement or misrepresentation Company – sales communications including general advertising, sales illustrations, misleading statement or misrepresentation, incomplete disclosure, incomplete comparison, clarity of communication, tied selling, inducements, churning and rebating etc. Home Please click here to go to the Escalation Chart


Multiple Complaints

Customer complaints sometimes fall into more than one complaint category. In these

cases, the complaint should not be counted more than once, and the category that most

fits the complaint should be chosen. Only one customer complaint should be recorded

for a customer if received within the same year of the initial complaint, and is related to

the same incident.

Where more than one type of complaint is made, judgment must be exercised to

determine the primary cause of the complaint, so that it can be recorded appropriately.

Where more than one line of business is the subject of a complaint, only one line of

business should be selected (usually the one that the client has the most concerns with).

Some complaints continue to “come back” after they are closed and a final position letter sent. These complaints should only be recorded once, provided the primary issue remains unchanged and they meet the definition of a reportable complaint and is within one year of the registered complaint. Examples A customer writes to complain about the continued obligation to make premium payments for his/her Universal Life Plan. The complaint is escalated to a manager, who verifies the details of the concerns with the customer, and explains the reason for the additional premiums. The complaint file is closed and final position given. The customer continues to call and complain about related issues, such as the company’s marketing material related to the product, then about the broker for not explaining the coverage properly. This should be recorded as one complaint. Home


Creation and Maintenance of the Central Complaint Registry A separate file shall be created for each complaint received and is determined to be a reportable complaint. These are handled and monitored by the Compliance Department. The Business Units are responsible for maintaining their own Monthly Escalation Log to track escalated complaints which are within the guidelines (i.e. have been handled within the frontline and have been escalated pursuant to the escalation process). This Escalation Log must be accessible by Compliance. Currently, there are two reports within the Business Units to track these types of complaints:

1. Business Unit Monthly Escalation Log (WIN) – used by the Client Service Escalation made up of cases reported by WFG Rocks (Operation and Client Service), Sales, Operations (Life and Investments) and Client Services

2. Excel Spreadsheet in a SharePoint site to which everyone has access within the business areas – and used by New Business Service (NBS), Policy Change, Underwriting, Distribution Compensation & Contracting (DC&C).

Please refer to Appendix A & B

The file shall contain the following

The complainant's written complaint, including the three elements of the complaint (the

reproach against the Companies, the real or potential harm and the remedial action

requested);

The outcome of the complaint examination process (the analysis and the supporting

documents);

A copy of the regulated entity’s final response set forth in writing and containing

reasons for the response (if applicable)

Any complaint filed in writing/verbal, which has gone through all frontline levels of

intervention involved in the examination of the complaint; and

Any legal proceeding.

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Populating the Central Complaint Registry

The population of the Central Complaint Registry will occur through the referral of complaints to the Compliance Department. These referrals will occur in the following ways:

Directly through letters, telephone calls etc. sent to Compliance

Letters addressed to the President/CEO

Escalated from operations staff in accordance with the definition and examples

contained in this procedure and according to the escalation chart

By referral from senior management

Where complaints are referred by operations staff, it is required that previous steps in the Complaint Escalation Process have been taken, and it has been registered in the Business Unit Monthly Escalation Log.

Complaint Examination

Upon receipt of a reportable complaint, the Compliance Department shall carry out an

investigation.

The complaint shall be examined within a reasonable time period with a maximum of 30

business days following receipt of all the required information.

After the investigation, the Compliance Department shall send a response in writing,

providing the rationale for the Company’s position.

Transfer of the File to the Autorite des marches financiers (AMF) - Quebec only

If the complainant is not satisfied with the examination of his complaint by the

Compliance Department or the outcome of the examination, they may request that

their complaint file be transferred to the AMF. This can be at the end of the

investigation or at the beginning.

The transferred file shall include all the documents regarding the complaint file,

excluding any medical documents.

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Conducting Investigations and Providing Resolutions

In carrying out complaint investigations it is expected that these will be conducted with the following objectives in mind:

The investigation be done quickly with a target of 30 business days to resolve all

complaints

The investigation is to be carried out objectively and the resolution based solely on the

facts revealed, i.e. the weight of the findings show that the conclusion and resolution is

the most reasonable.

The recommendations and resolutions reached should be consistent with those of a

similar nature that have occurred previously. Consistency is of paramount importance.

In cases where a final position will be stated, the final position letter must reference to OHLI, the third party complaint resolution service. Please see content on the attached link of details to be included in the letter. If the final position is coming from the business unit, the letters must be reviewed by the Compliance Department prior to mailing and evidence of review must be maintained for both reportable and non-reportable complaints. SampleExternalRecourseText Home


Other Points/Considerations for Complaint Handling

Complaints that originate in the business unit or associated company(s) initially, and are

assessed as reportable, are to be sent to Compliance.

Complaints initially deemed as non-reportable, but later change to reportable through

“escalation”, are to be sent by the business unit to the Compliance Department.

Compliance will enter all reportable complaints in the Central Complaint Registry.

The initial acknowledgement will be sent to the customer by the Compliance

Department. Using e-mail or Canada Post mail, Compliance will forward copies of the

documents to the appropriate Business Unit for handling (unless the complaint is about

the market conduct of the advisor).

If Reportable Complaints are referred to the Compliance Department by field offices,

other companies or advisors, in order to initiate the investigation, the details as they

relate to the customer’s concerns must be forwarded in writing by the policy owner. In

cases where the received complaint is not signed by the policy owner, a release signed

by the policy owner must be received. This will allow TLC to reply directly to the person

writing in on behalf of the policy owner.

For cases that have been registered in the Central Complaint Registry and referred to

the Business Unit for handling, once the Business Unit has addressed the client concerns

and a reply is sent, a copy of the signed reply, including all relevant attachments, must

be forwarded to the Compliance Department using e-mail.

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AEGON Fund Management (AFM)

The business unit for AFM is responsible for maintaining a separate register to track all the complaints (please refer to page 16, “Creation and Maintenance of a Register” of the Complaint Protocol). The Compliance Department is responsible for tracking and registering any Escalated Complaints for AFM (pursuant to the escalation process (see attached appendix A & B). Dealer/advisor service complaints received by AFM should be acknowledged by the business unit. Market conduct complaints will be acknowledged by the Compliance Department, and forwarded to the registered dealer for handling and resolution (as required under Policy 3 of MFDA Rules). Please see link attached. http://www.mfda.ca/regulation/policies/policy03.pdf http://www.mfda.ca/regulation/notices/MR-0073.pdf If the client is not satisfied, they can contact the Ombudsman for Banking Services and Investments (OBSI): By telephone in Toronto at (416) 287-2877 or toll free at 1-888-451-4519 By e-mail at [email protected] Home

National Accounts/Alliance Partner /Company Offices

http://www.mfda.ca/regulation/policies/policy03.pdf

http://www.mfda.ca/regulation/notices/MR-0073.pdf


If the customer goes directly to the distributor/associated company, the same process is to be followed as outlined under page 16 “Creation and Maintenance of a Register” of the Complaint Protocol. For any customer reportable complaints about the advisor received by them and handled at their level, the insurance companies’ Compliance Department must be copied in their reply. If they determine that the complaint cannot be handled at their level, it should be escalated to the insurance company’s Compliance Department for review/handling. If the customer contacts the insurer directly, the insurer will communicate with the customer to get the complaint in writing and get an understanding of the situation but the insurer will always involve the National Accounts, Alliance Partner or Company Offices for those complaints against their advisors. Once the complaint has been escalated to TLC’s Compliance Department, the following will occur:

TLC will acknowledge receipt to the client as necessary and copy the servicing agency

applicable

TLC Compliance Department will contact the Compliance Department of the distributor

/associated company involved to obtain further details or where necessary to outline

options for settlement.

The distributor/associated company will receive a copy of the insurer decision for

discussion before it is sent to the customer

The timeline to respond to the customer is outlined under the Transamerica Complaint

Protocol and should be taken into consideration when a request for comments is

requested.

Once a decision or reply is made to the client, the Distributor/Managed General

Agent/Company Office will be copied in our reply.

Note: the above is also applicable to any complaints received that are related to CI policies. Home


Unresolved/Dispute Resolution – External Resources (All Provinces)

The objective is to resolve all complaints received to the satisfaction of the complainant. Where unresolved, the letter to the complainant should state that this is the Company’s final position and should also contain the following: For complaints, other than Market Conduct complaints against an advisor or the Company, a statement that the complainant is entitled to a review of their complaint by a third party dispute resolution organization and that the designated organization for this purpose for the life insurance industry is the: Toronto Office OmbudService for Life & Health Insurance (OLHI) 401 Bay Street, Suite 1507 P.O. Box 7 Toronto, Ontario M5H 2Y4 Tel: 1-888-295-8112 or (416) 777-9002 Fax: (416) 777-9750 Website: www.olhi.ca or Montreal Office Ombudsman des assurances de personnes (OAP) 1001 De Maisonneuve Blvd.West, Suite 640 Montreal, Quebec H3A 3C8 Tel. 1-866-582-2088 or 514 282-2088 Fax: 514 845-6182 Website: www.oapcanada.ca This requirement is mandatory. This is done when our final position is stated in the letter, and is true for both Business Units and the Compliance Department. In addition, as part of the acknowledgment process, the appropriate regulatory contact information is included with all acknowledgment letters regardless of province. This is to provide the complainant with the regulator’s contact information should the complaint relate to advisor conduct. For Market Conduct complaints, where the investigation reveals a reportable incident against the agent, the Compliance Department will take the necessary disciplinary action and report to the appropriate provincial regulator. This requirement is mandatory. Home

http://www.olhi.ca/

http://www.oapcanada.ca/


Section II

Other Types of Complaints/Inquiries

Complaints Addressed to the President/CEO

In cases where the complaints are received directly by the president’s office, the

process is that the administrative assistant will follow the Complaint Protocol

Escalation Process and escalate to Compliance to be registered and for review

to determine who should handle.

If presidential complaints are received through the business units, the process is

to follow the Complaint Protocol Escalation Process and escalate to Compliance

to be registered and for review and determination of who should handle.

Please click here to go to Escalation Chart

Inquiries from Regulators

Such inquiries must be directed to the Compliance Department for handling.

Inquiries are frequently received from regulators (i.e. copies of applications and

account documentation etc). While such inquiries may have been prompted by

a complaint, regulators are often reluctant to give any information. Such

occurrences will be tracked in a separate database and only added to the

complaint database once we are advised of the complaint or of disciplinary

action. Compliance will respond to the inquiry and request assistance from the

operations unit to obtain information.

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Privacy Complaints

Complaints received where a policyholder is expressing dissatisfaction about the

manner in which their personal information is being maintained or used must be referred to the Privacy Office for handling.

The Privacy Office will register the complaint in the Privacy Log and correspond

with all appropriate individuals accordingly. This includes an acknowledgment

letter to the individual who has launched the complaint/concern. This process

also applies when a policyholder requests access to the content of their file.

Any distributor, representative, advisor or client questions regarding Transamerica Life Canada’s Privacy Policy can be directed to: Transamerica Life Canada Privacy Office 5000 Yonge Street Toronto, Ontario M2N 7J8 Phone# (866) 447-7390 (English) (866) 880-6075 (French) The policy is available online at www.transamerica.ca or at www.imaxxwealth.com and through the Transamerica website. Link to the Privacy Office Privacy Office

Media Threats Complaints

If the complainant states that he/she will take their complaint to the media, immediately refer this type of information to the Compliance Department. Information is reviewed against the Central Complaint Registry and if necessary will be escalated to the Communications Department.

Legal Threats Complaints

If complaint is received or a complaint that is already in the review process becomes the subject of a legal action, immediately escalate to the Compliance Department. A check will be done against the Central Complaint Registry and if necessary escalated to the Legal Department.

http://intranet.ds.global/transamerica/l-and-p-canada/business-centre/about-transamerica-life-canada/Pages/privacy-office-page.aspx


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Section III

Other Related Information

Reporting and Certification

(i) Monthly Monitoring and Reporting of Complaint Logs

The Compliance Department will review Business Units complaint logs on a

monthly basis to ensure accuracy, completeness and compliance with the

Complaint Protocol.

In addition, Compliance will also prepare and distribute to senior management a

quarterly analysis of complaints.

(ii) Audit Committee Quarterly Complaint Protocol Certification

The Chief Compliance Officer will provide the Audit and Conduct Review

Committee of the Board of Directors quarterly updates concerning the

adherence to the procedures outlined in the complaint Protocol by all business

unit participants.

Reporting to FSCO/AMF

Effective January 15, 2006, a reporting data base as set out by the Financial Service Commission of Ontario (FSCO) and the Autorite de marche financier (AMF) was implemented and began to be used to monitor escalated complaints as per the Complaint Protocol. The proposed reporting time frame has been set to a semi-annual reporting schedule. Home


Other External Regulatory Contacts

Financial Consumer Agency of Canada (FCAC)

The Financial Consumer Agency of Canada supervises all federally regulated financial institutions to ensure that they comply with federal consumer protection provisions. It also educates consumers and monitors industry codes of conduct and public commitment designed to protect consumer interest. These consumer protection provisions cover a variety of operating practices that directly affect our clients. For example, financial institutions are required by law to provide consumers with information about their fees, interest rates and complaint-handling procedures. Regulatory complaints should be addressed in writing to: Financial Consumer Agency of Canada (FCAC) 6th Floor, Enterprise Building 427 Laurier Avenue West Ottawa, Ontario K1R 1B9 Toll-free: 1-866-461-3222 Website: www.fcac-acfc.gc.ca Quarterly reporting to FCAC is required as per their guidelines for reportable complaints. Reporting to FCAC must be done regardless if we have complaints that fall within the guidelines or not. A NIL report must always be submitted for Consumer Provision Complaints and NIL Reports Quarterly. The following are links and reporting chart dates. reportable complaints reportable complaints nil report new online interactive framework model Home

http://www.fcac-acfc.gc.ca/eng/industry/compliancef/definition/index-eng.asp#ReportableC

http://www.fcac-acfc.gc.ca/eng/industry/compliaResourc/forms/index-eng.asp

http://www.fcac-acfc.gc.ca/eng/industry/complianceF/index-eng.asp


FCAC Quarterly Reporting Chart

Record Retention

All records must be retained for a period of seven years from the date the complaint was received. Home

FCAC

Quarter

Inclusive

Dates

Quarterly

Reporting

Deadline

1 April - June August 31

2 July – September November 30

3 October - December March 2

4 January - March May 31


Compliance Team Contacts

Life Market Conduct Compliance

John O’Hoski, AVP, Chief Compliance Officer (416) 883-5173 Rose Leo, Mgr. Compliance, Investigation and Analysis Unit (416) 883-5170 Eileen Hems, Specialist Compliance, Investigation and Analysis Unit (416) 883-5167 Sue AuCoin, Specialist Compliance, Investigation and Analysis Unit (416) 883-5185 Monica Ly, Sr. Mgr. Compliance, Special Investigations (416) 883-5860 Fax (416) 883-5174 e-mail address [email protected]

Regulatory Compliance

John O’Hoski, AVP, Chief Compliance Officer (416) 883-5173 Nafees Khurshid, Sr. Mgr. Regulatory Compliance (416) 883-5172 Effie Bekas, Mgr, Regulatory Compliance (416) 883-5526 Barry Zhang, Compliance Associate (416) 883-5561 Fax (416) 883-5174 e-mail address [email protected]

How to Access the Complaint Log/Compliance Files When the business unit requires copies of correspondence within the Compliance file, you must contact the Compliance Department requesting the applicable correspondence. The Compliance Department will determine if the requested information can be released, and e-mail the information accordingly. While the investigation is ongoing in Compliance, a Special Handling indicator is placed on WIN so that individuals know to contact Compliance before releasing any information. Once the Compliance investigation is completed, the Special Handling indicator on WIN will be removed and notes put on WIN to indicate that this was a Compliance case and is now closed. Home

mailto:[email protected]

mailto:[email protected]


Section IV

Appendix A Complaint Definitions

Please click here for Complaint Definition Listed below are categories of complaints and escalation process. Complaints can be expressed verbally or in writing.

ExamplesofNonReportableComplaints Examples of Reportable Complaints Examples of other Types of Complaints Link for Market Conduct Definition Home

•client complaint/concerns expressed verbally/in writing - no need to escalate to next level

•client complaint/concerns received via distributor office/advisor situation has been resolved - no need to esclate to next level

•no need to register in the Client Service Escalation Log (CSE)

Non Reportable Complaints

•client complaint/concerns are expressed verbally/in writing and has been dealt with by frontline staff

•request to have concerns reviewed by next level of management

•client alleges market conduct concerns (escalate to Compliance)

•register in the Client Service Escalation Log (CSE)

Reportable Complaints

•Complaints to the President/CEO

•Complaints addressed to Chief Compliance Officer/Ombudman

•Regulator Request

•Privacy Complaints/Requests

•Media Threats Complaints

•Legal Threats Complaints

•NOTE: all of the above scenerios are considered Reportable and are automatically escalated to Compliance.

Other Complaints


Section V Appendix B Escalation Process

Click here for Types of Complaints

Home

Level I

•review/handling took place at frontline (i.e. call centre, call centre supervisor, - case handled no further escalation

•no Client Service Escalation (CSE) update

•notes in WIN and other normal handling process

•client concerns/inquiry handled at the advisor/distributor level - no further escalation

Level II

•escalation to manager in the business unit from Level I

•manager must update the Client Service Escalation (CSE)

•case is handled by the manager and reply sent out

•update WIN as necessary

Level III

•Scenario (A)

•escalation to AVP/VP from Level II

•AVP/VP address the client concerns accordingly (correspondence to the client will be addressed by this level either written or verbal)

•SR Log must be updated and case escalated to Compliance for purpose of recording and monitoring

•Scenario (B)

•Compliance is dealing with case - may be market conduct or escalated case - case will be logged in the Central Complaint Registry and handled accordingly.


Sample External Recourse Text for Inclusion in Final Position Letter Referral to OLHI I hope that this letter has addressed your concerns, and has fully clarified this matter for you. Should you remain dissatisfied, however, and wish to pursue the matter further, external recourse is available to you, as follows. NOTE: the first paragraph may need to be modified in line with each case The OmbudService for Life & Health Insurance (OLHI) is an independent service, which deals with concerns about life and health insurance products and services that have not been resolved through the company’s dispute resolution system. The OLHI is a member of the Financial Services Ombuds Network (FSON), a national dispute-resolution system. You may contact a representative of the OLHI by calling its toll-free number at 1-888-295-8112, or (416) 777-9002 if calling in Toronto, or through its website at www.olhi.ca. Be aware that OLHI’s mandate is restricted to insurance company products and services. If OLHI determines that your case is outside of its mandate, for example a market conduct issue involving an independent agent, OLHI may refer you to the appropriate provincial or territorial regulatory authority. For your information, the contact information for the regulator responsible for insurance agent licensing and market conduct issues in your province/territory is: (add regulator contact information) Home

http://www.olhi.ca/


Referral to OLHI and AMF

I hope that this letter has addressed your concerns, and has fully clarified this matter for you. Should you remain dissatisfied, however, and wish to pursue the matter further, external recourse is available to you, as follows: The OmbudService for Life & Health Insurance (OLHI) is an independent service, which deals with concerns about life and health insurance products and services that have not been resolved through the company’s dispute resolution system. The OLHI is a member of the Financial Services Ombuds Network (FSON), a national dispute-resolution system. You may contact a representative of the OLHI by calling its toll-free number at 1-888-295-8112, or (416) 777-9002 if calling in Toronto, or through its website at www.olhi.ca. The regulation of life insurance companies in Quebec is administered by the Autorité des marchés financiers. If after dealing with the OLHI, you remain dissatisfied with the way in which your complaint has been handled or with the results of the process, you may ask that your file be transferred to the Autorité. You can reach the Autorité by calling toll-free at 1-877-525-0337 or, in Quebec City, at 418-525-0337, in Montreal at 514-395-0337, or by e-mail at [email protected]. Be aware that OLHI’s mandate is restricted to insurance company products and services. If OLHI determines that your case is outside of its mandate, for example a market conduct issue involving an independent agent, OLHI may refer you to the appropriate provincial or territorial regulatory authority. For your information, the contact information for the regulator responsible for insurance agent licensing and market conduct issues in your province/territory is: (add regulator contact information) Home

http://www.olhi.ca/

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