Success stories

Following a single-vehicle accident, the insurer initially determined that the insured was at fault for the loss.However, the available evidence clearly demonstrated that the actions of another adult passenger were the direct cause of the accident.After we engaged with the insurer and reviewed the documented circumstances of the incident, the insurer reassessed its position and agreed not to record the loss as an at-fault accident against the insured.

A consumer contacted our office seeking clarification on whether their insurer could deny coverage for an accident on the basis that the driver did not hold a valid driver’s license at the time of the loss.Under the standard automobile policy wording in New Brunswick, operating a vehicle without a valid driver’s license and without being otherwise qualified to drive may indeed result in a denial of coverage.However, in this particular case, the information provided by the consumer suggested that, despite not holding a valid license at the time, the individual may nonetheless have been qualified to operate a motor vehicle.We advocated on the consumer’s behalf and were able to demonstrate that the driver met the criteria of being qualified to drive. As a result of our intervention, the insurer reassessed its position, and the claim was ultimately approved and paid.

A consumer contacted our Office seeking assistance following a recent policy cancellation for non-payment. It appears that the only correspondence he received from his insurer was a notice indicating that a payment had been missed and advising him to contact his agent.The consumer stated that he contacted his agent promptly upon receiving the letter, only to be informed that his policy had already been cancelled. He was subsequently offered a new policy at a significantly higher premium.He was advised that the increase was due to being treated as a new client, with no prior insurance history with the insurance company, despite having been insured with the company for nearly 30 years prior to the cancellation and he did not understand why he did not receive any prior cancellation notice or any follow-up communication, such as a phone call.We reached out to the insurance company and within a short period of time the situation was resolved in favor of the consumer.

The insured was traveling through a construction zone where traffic was separated by large cones dividing the median.An 18-wheeler inadvertently pushed one of these large cones into the insured’s lane, resulting in a collision with both the cone and the roadside barrier.The insurer initially opened the claim as a collision loss and rated the incident as at-fault on the insured’s record. This classification would have significantly increased the insured’s premium at the next renewal.Following our intervention, we successfully had the insurer reassess the claim. The loss was reclassified as a comprehensive claim, as the object struck was in motion and unexpectedly obstructed the insured’s path.

An insured individual contacted us after learning that his property had been uninsured for several weeks. A few weeks prior to his home insurance renewal date, he had compared several different offers in search of a better premium. Pleased with his findings, he secured a lower rate with another agency.He immediately accepted the new offer. Approximately three weeks before the coverage was set to take effect, his new agent informed him that everything was in order and that he should receive the invoices by mail. He then contacted his previous insurer to notify them not to renew his existing policy.Nearly six weeks after accepting the offer, he was informed by his agent that the insurer had declined his application. As a result, he found himself without insurance coverage for three weeks and had to seek coverage elsewhere.Unfortunately, no insurer was willing to insure him.After reviewing all the documentation, we contacted the insurer. In our view, the insurer had taken too long to assess the application, and the consequences of the refusal were significant for the insured.Ultimately, the insurer accepted our recommendations and agreed to provide retroactive coverage for a certain period, allowing the insured time to secure insurance elsewhere.

An insured individual contacted our Office after her insurance company refused to renew her policy.She had been insured with the same company for over 20 years. However, during the past year, she was involved in an at-fault accident, which was her second such accident within a five-year period. In addition, she had also been involved in a non-fault accident.Her broker made several efforts to assist her in securing continued coverage, but these attempts were unsuccessful, leaving her in a difficult situation.As a last resort, she reached out to our Office. We intervened on her behalf and engaged in discussions with the insurer. Ultimately, the insurance company agreed to renew her automobile insurance policy. The insured was very pleased with this outcome.

An insured individual contacted our Office after an insurance company incorrectly reported, in the DASH system (an internal industry database used to store information on insured individuals), that she had been involved in a motor vehicle accident.In reality, the insured had not been involved in any accident. The error resulted from another insurance company mistakenly entering her driver’s licence number into the system. Consequently, the DASH report indicated that she had an at-fault accident, which created significant difficulties when she attempted to renew her automobile insurance coverage.The insured had been trying to have the error corrected for nearly a year but was repeatedly redirected between insurers without resolution.After she contacted our Office, we initially worked with her current insurer to demonstrate that the information was inaccurate and resulted from an error made by a different insurer—one with whom she had no relationship. This intervention enabled her to proceed with obtaining insurance coverage.We then contacted all insurers involved, including the company responsible for the incorrect entry. After persistent follow-up, we were ultimately successful in having the record corrected. The insured expressed her gratitude to our Office and specifically thanked the staff member who handled her case, noting that she would not have been able to achieve this outcome without his assistance.

The automobile insurance policy issued in New Brunswick contains, among other prohibitions, a condition that an insured must not drive or operate an automobile unless they are authorized by law or qualified to drive or operate the automobile. In this matter, an unlicensed driver was involved in a motor vehicle accident. The insurer initially took the position that the absence of a valid driver’s license constituted a breach of the policy, as the driver was not “authorized by law” to operate the vehicle. We obtained from the insured all relevant facts necessary to assess whether the driver nevertheless met the alternative requirement of being “qualified to drive or operate the automobile.” This determination is fact specific. Based on the information gathered, we were able to demonstrate that, despite lacking a valid licence, the driver possessed sufficient training, experience, and knowledge to safely operate the vehicle and was therefore qualified within the meaning of the policy. After reviewing the evidence presented, the insurer accepted that the driver was qualified to operate the automobile for the purposes of the insurance contract and withdrew its allegation of breach.

Customer accident — A customer contacted our office after an accident and reported that his insurer claimed his automobile policy had been cancelled before the loss. Request for notices — We asked the insured to provide any cancellation notices, especially a registered letter, which is legally required in New Brunswick for certain types of policy cancellations. No registered letter received — The customer stated that he had never received such a letter. Inquiry to insurer — We contacted the insurer and requested: A copy of the registered cancellation letter Canada Post tracking information proving it was sent Insurer unable to provide proof — The insurer could not produce: The letter allegedly sent Any tracking or mailing evidenceCancellation deemed invalid — Because the insurer could not demonstrate compliance with statutory cancellation requirements, it acknowledged that the cancellation was not legally effective.Coverage reinstated — The insurer accepted responsibility for the claim and agreed to provide coverage.

An insured called on our services when he made a claim after a fire. After listing all of the items lost, the insured realized that the total loss exceeded the $63,000 policy limit. He also learned at that time that the $27,000 bill from the contractor would be deducted from the limit. Nobody had taken the time to explain to him that these costs would come out of the $63,000 limit. He also was not given the chance to inspect and inventory his belongings before they were moved. After listening to the insured, we contacted the insurer to explain that its client had not been properly informed and had not had the chance to inspect his property. After several discussions, the insurer accepted our recommendations and agreed to grant the insured the full limit with no deductions. The insurer acknowledged that there had been a lack of communication.

An accident occurred while Mr. B was operating a vehicle owned by Corporation C. At the time of the loss, the only individual listed as a driver on the insurance policy had been deceased for several years. Upon receiving the claim, the insurer denied coverage on the grounds that Mr. B was not an authorized or listed driver. Our office conducted a detailed review of the circumstances and confirmed that the broker had previously been notified of the death of the sole listed driver. We submitted this information to the insurer and advocated on behalf of the insured, asserting that the claim ought to be honoured in light of the facts. Following its reassessment of the file and the information provided, the insurer reversed its initial position and proceeded to pay the claim.

An insured contacted the Office of the Consumer Advocate for Insurance to dispute her insurer’s determination that she was entirely at fault for an accident. We collected the necessary information regarding the circumstances of the collision and assessed whether the decision aligned with the governing regulation. Our review showed that the insurer had applied an incorrect section of the regulation. We subsequently advocated on the consumer’s behalf, outlining our concerns. Upon reconsideration, the insurer concurred with our interpretation and withdrew its assignment of liability to the insured.

An insured individual purchased a life insurance policy to ensure his family would be financially protected in the event of his death. Sadly, he passed away nearly two years after the policy took effect. When the beneficiary submitted a claim, the insurer denied it, alleging that the insured had misrepresented his health by failing to disclose a medical condition on the application. Our Office conducted a thorough review of the policy and the medical records. Based on the information available, we determined that the insurer’s decision to deny the claim was not justified. We engaged in extensive correspondence with the insurer, advocating on behalf of the beneficiary and providing relevant case law supporting the validity of the claim. After several months of discussions, the insurer reversed its decision and paid the full life insurance benefit, including interest from the date of death until the date of payment.