Success stories

The accident had occurred several months earlier, and the consumer was unaware that he could challenge the adjuster's determination of fault. It was only when his policy came up for renewal and he saw the effect of the decision on his insurance premiums that he decided to inquire further. After spending several weeks attempting to reach the adjuster without success, he contacted our office for assistance.From the outset, it was apparent that the liability assessment deserved closer scrutiny. We raised the matter with the insurer, and less than 24 hours later, the insurer acknowledged that an error had been made and the determination of fault against the insured went from 100% to 0%. The claim was promptly corrected, and the consumer's insurance history was amended to reflect that he was not at fault for the accident.The consumer was astonished by how quickly the issue was resolved once the concerns were brought forward. What had been a source of frustration was corrected in a matter of hours, ensuring his insurance record accurately reflected the circumstances of the loss.

A homeowner contacted our office after receiving notice that their property insurance policy would be cancelled mid-term. The decision arose after discussions with the insurer regarding details of the home's electrical system. Although the insurer determined the property did not meet its underwriting appetite, the consumer had not withheld information and was unaware that the insurer's records differed from the actual characteristics of the home.After reviewing the circumstances, our office raised concerns about whether the cancellation complied with the rules governing mid-term policy cancellations. Following further discussions, the insurer reviewed the matter and agreed to reinstate the policy.Consumer takeaway: If your insurance policy is cancelled and you are unsure whether the cancellation was handled properly, ask for a clear explanation of the reason and seek clarification on the rules that support the decision. A review can sometimes lead to a different outcome.

A consumer contacted our office after her husband’s life insurance claim was denied. The insurer took the position that coverage would not have been issued had it known he had diabetes prior to applying for the policy.During our review, we noted that the medical information appeared less clear than initially presented. While one test result showed elevated blood sugar levels, there was no clear indication in the medical records that a diagnosis of diabetes had actually been made before the insurance application was completed. We also observed that a letter previously submitted by the physician did not directly address this distinction.We suggested that the consumer seek further clarification from the physician regarding whether a diagnosis of diabetes had ever been made. The physician subsequently provided a detailed explanation confirming that the single elevated reading did not result in a diagnosis and explaining why the insurer's assumption was not medically supported.After reviewing the additional information, the insurer reassessed its position, reversed its decision, and approved the life insurance claim.Consumer TakeawayMedical test results and medical diagnoses are not always the same thing. If a claim decision relies on medical information that appears unclear or incomplete, obtaining clarification from a treating physician can sometimes make a significant difference.Need Help Understanding an Insurance Decision?Our office helps consumers better understand insurance decisions and can assist in identifying information that may be relevant when requesting a review.

A consumer contacted our office after noticing that part of his rental vehicle expenses had been denied following a claim.Because the insurer’s preferred rental provider could not reasonably accommodate the consumer’s location and circumstances, the consumer obtained a rental vehicle from another provider closer to home. The daily cost was higher, and the insurer initially declined to reimburse the difference, taking the position that a less expensive option had been available elsewhere.After reviewing the policy wording, we raised concerns that the coverage referred to reasonable expenses incurred, rather than strictly the lowest-cost option available. Following further review, the insurer reconsidered its position and agreed to reimburse the additional rental costs.Consumer takeaway: Coverage decisions should be based on the wording of the policy and the specific circumstances involved. The least expensive option is not always the only reasonable one.

A consumer contacted our office after becoming increasingly frustrated with the handling of vehicle repairs following a claim. While the repairs had been completed, the consumer remained concerned that the paint colour did not match properly.The repair facility maintained that the work met industry standards, and the insurer relied on that assessment. Feeling that his concerns were not being heard, the consumer asked our office to review the matter.After discussing the issue with the insurer, a closer review was completed. Ultimately, the insurer agreed to revisit the concern with the repair facility, and arrangements were made for the paint work to be redone.Consumer takeaway: If you remain dissatisfied after a claim repair is completed, it is reasonable to ask questions and ensure your concerns are properly reviewed before the matter is considered resolved.

While on vacation, this consumer experienced a medical emergency and required urgent treatment. After receiving care, they contacted their insurer for direction and were advised to return home as soon as possible. They were reassured that their medical expenses and travel costs would be covered.The consumer promptly submitted all requested documentation upon their return. Then the hospital invoices started arriving.For more than six months, the consumer waited while being repeatedly told that everything was in order. With no resolution in sight and mounting frustration, they reached out to our office for assistance.After reviewing the file and contacting the insurer, the situation changed quickly. Within days, the consumer received confirmation that the claim would be paid.

A consumer contacted our office after being found 100% at fault for a collision that they strongly believed they did not cause. The insurer’s decision was based on the understanding that the consumer was making a left turn at an intersection.After discussing the situation, we suggested that the consumer obtain the police report. In some cases, information recorded at the scene can help clarify facts that may not have been fully considered during the initial review.Once the report was obtained, it confirmed that the other driver had admitted to turning right on a red light. After this information was brought to the insurer’s attention, the claim was reviewed again and the fault determination was reversed.Consumer takeaway: If you believe important facts have been overlooked, ask questions and gather any available documentation. Sometimes a single piece of evidence can make all the difference in ensuring a fair outcome.

A consumer contacted our office after their automobile claim was denied and their insurance policy was subsequently cancelled mid-term. The consumer was concerned that the cancellation was related to the insurer's suspicion that inaccurate information may have been provided during a claim process.After reviewing the circumstances and discussing the matter with the insurer, it was determined that while the claim had been denied, the insurer did not have grounds under the applicable rules to cancel the policy mid-term on that basis. The insurer agreed to reinstate the policy and allow coverage to continue until the end of the policy term.This situation highlights an important point for consumers: a claim denial does not automatically give an insurer the right to cancel a policy mid-term. If you are uncertain whether a cancellation was handled properly, asking questions and seeking clarification can help ensure the correct process was followed.Consumer takeaway: If your policy is cancelled and you don't understand why, ask for a clear explanation of the reason and the authority under which the cancellation was made. Under New Brunswick law, an insurer has only limited grounds to cancel an insurance policy once it has been in force for more than 60 days. After this period, an insurer generally cannot terminate coverage except for specific reasons permitted by legislation.

A consumer contacted our office after reporting an automobile claim and waiting nearly two weeks without hearing from an adjuster.Although she had been able to speak with representatives through the insurer's general claims line, she still had important questions about arranging a rental vehicle, what would happen with her vehicle at the tow yard, and what to expect as her claim moved forward. After being advised that her concerns had been escalated, she remained without contact from an adjuster and became concerned that her claim was not receiving the attention it required.After our office reached out to the insurer, an adjuster promptly contacted the consumer, explained the claims process, answered her questions, and helped move the claim forward.Consumer Takeaway: If you are unable to obtain the information you need after making reasonable efforts to contact your insurer, don't hesitate to ask for help. Sometimes a simple follow-up can ensure your concerns are addressed and provide the clarity needed to navigate the claims process with confidence.

When a consumer's policy was cancelled for non-payment, the consequences were significant: higher insurance costs and difficulty obtaining coverage elsewhere.After reviewing the matter, it became clear that misinformation from the consumer's insurance representative had contributed to the missed payments. Once the insurer was made aware of the full circumstances, it agreed to issue a new policy at regular rates and remove the non-payment cancellation from the consumer's record.Sometimes, taking a closer look at a situation can make all the difference.

A consumer required assistance cancelling a life insurance policy but faced language barriers when dealing with an international insurer. We intervened, facilitated communication, clarified the required documentation, and guided the consumer through the process. As a result, the policy was successfully cancelled, and the consumer was very pleased with the outcome.

One consumer contacted our office after questioning whether their insurer was handling a claim fairly following a not-at-fault loss. The consumer was concerned about the limited rental coverage being offered and the conditions being applied to the reimbursement of personal property damaged in the vehicle.After reviewing the file, we identified that the claim was being handled under Direct Compensation for Property Damage (DCPD), where different considerations applied than those found in standard policy endorsements. We raised our concerns with the insurer, who reviewed the circumstances and recognized the challenges the consumer was facing. As a result, the insurer offered several additional days of rental coverage and worked with the consumer to provide flexible settlement options for the damaged contents. 

One consumer contacted our office after being required to pay a deductible on a claim where another party was clearly responsible for the damage. The insurer had taken the position that Direct Compensation for Property Damage (DCPD) did not apply because commercial equipment was involved. After reviewing the applicable legislation, we raised our concerns with the insurer and explained why the criteria for DCPD appeared to be met. The insurer promptly reviewed the matter, reversed its position, and refunded the consumer's deductible in full. This case highlights the importance of understanding your coverage and questioning decisions that may not be consistent with the facts of the loss.

One consumer contacted our office after learning their insurer would not renew their policy and discovering that their claims history was not properly reflected in industry records. Despite repeated efforts, the consumer was unable to obtain the necessary letter of experience, with the broker and insurer each referring them to the other. After our office intervened, the insurer provided the requested documentation directly to the consumer, allowing them to shop for insurance with other carriers and secure new coverage.

One consumer contacted our office after their vehicle repair claim had been stalled for months due to disagreements over the scope of repairs. The consumer and repair shop believed certain original parts were necessary to ensure safety systems and sensors functioned properly, while the insurer questioned some of the costs. We helped clarify the issues in dispute and pointed out concessions already made by the insurer that had been overlooked amid the frustration of a lengthy claims process. After discussions between the insurer and the repair facility, an agreement was reached on the required repairs and the claim was able to move forward.

Understanding the claims process can help consumers make informed decisions. One consumer contacted our office with concerns about a property contents claim and was unsure whether their insurer was handling the matter fairly. The consumer had submitted a detailed inventory of damaged property several weeks earlier but had not received an update. After our office reached out to the insurer, the contents claim was promptly reviewed and the consumer was contacted with a settlement offer. While we do not become involved in negotiating the value of claims, we were able to explain the claims process, help the consumer understand how actual cash value and depreciation may affect a settlement, and outline the options available if they disagreed with the offer. Sometimes, having a better understanding of the process can make all the difference.

Every day, our Office receives calls from consumers with questions about a wide range of insurance products and issues. Sometimes all a consumer needs is clear and reliable information. In those situations, we take the time to explain their rights, outline the claims or complaint process, and help them better understand how insurance works and what options may be available to them.For many consumers, this guidance is enough. Armed with the information we provide, they choose to address their concerns directly with their insurer, broker, or adjuster and are able to resolve the matter on their own.Others, however, require additional assistance and ask us to become more actively involved. In those cases, we can communicate with insurers, review claim files and policy documents, facilitate discussions, and advocate on the consumer's behalf to help ensure that their concerns are properly addressed.At the Consumer Advocate for Insurance Office, we believe there are no small inquiries. A simple question today can prevent a much larger problem tomorrow. Whether you are looking for information, guidance, or full advocacy services, our level of involvement is determined by your needs and your comfort level. From answering a single question to working directly on a complex insurance dispute, we are here to help consumers navigate the insurance system and understand their rights every step of the way.

One consumer contacted our office after an automobile fire resulted in a total loss, yet little progress had been made on the claim for more than two months. The consumer received conflicting information, with the adjuster indicating that key reports and documentation were still outstanding, while other parties maintained that the information had been provided weeks earlier. As the delay continued, the consumer faced additional rental, transportation, and vehicle ownership expenses beyond what was covered by the policy. After we became involved, the insurer took steps to move the claim toward resolution and agreed to reimburse the consumer for expenses that exceeded the policy limits..

Consumers sometimes accept premium increases without realizing there may be an error behind them. One consumer contacted our office after noticing a significant increase in their insurance premium following a claim involving a collision with a moose. The consumer believed the increase was unfair, but was unsure whether anything could be done. After reviewing the circumstances, we found that the loss had been recorded as an at-fault accident, even though wildlife collisions are generally treated as comprehensive claims and are not typically rated as at-fault losses. We contacted the insurer, who quickly investigated and recognized that the claim should have been recorded as 0% at fault. The insurer corrected the error and issued a refund for the additional premium the consumer had paid since renewal. This case highlights the importance of reviewing your insurance records and asking questions when something doesn't seem right.

Know your coverage. Claim what you're entitled to.After being seriously injured in a serious single-vehicle accident, this client assumed she had no options. She couldn't pursue a third party and didn't qualify for income loss benefits due to a prolonged period of unemployment.A review of her policy revealed a coverage that had not been fully explored. We stepped in, alerted the insurer, and the benefits owed were paid without delay.

Not every case involves a complex dispute. Sometimes, consumers simply need help getting a response.One consumer contacted us after repeated attempts to obtain a letter of experience from both the insurer and the insurance broker. Despite multiple requests, the document never arrived.A single email from our office was all it took.Within days, the insurer provided the letter of experience directly to us, bringing the matter to a swift resolution.

A consumer purchased a vehicle but had not yet obtained insurance. After being towed to a repair shop for roadworthiness repairs, the vehicle was struck while parked on the shop’s lot.When the consumer contacted the at-fault driver’s insurer, he was told they would not consider the claim unless he first took legal action against their insured. This approach was unreasonable, created unnecessary hardship for both the consumer and their own insured, and appeared inconsistent with normal industry practices.Following our intervention, the insurer agreed to deal directly with the consumer, avoiding costly and unnecessary legal proceedings and allowing the claim to be resolved fairly and efficiently.

After an accident, a consumer was told her vehicle was a total loss. The insurer made a written settlement offer, which the consumer accepted in writing. The claim appeared settled.Then, unexpectedly, the insurer withdrew its offer and announced it would repair the vehicle instead.Frustrated by the sudden reversal, the consumer challenged the decision. The insurer then changed course again, proposing a different settlement amount. Confused and concerned by the inconsistent claims handling, the consumer contacted our office.After reviewing the written correspondence and accepted settlement offer, we reached out to the insurer. Following our intervention, the insurer honored the original agreement and paid the settlement as promised.When something doesn't seem right, trust your instincts and contact our office. We're here to help.

When communication breaks down, consumers can be left in a difficult position. A consumer recently contacted our office after being told they might have to cover a repair invoice because payment from their insurer had not been received. Despite repeated inquiries from both the consumer and the repair shop, the insurer was unresponsive, making it difficult to determine the cause of the delay. After investigating the matter, we discovered that the insurer had mistakenly sent the payment to the wrong repair shop. Once notified of the error, the insurer promptly corrected the issue. 

The consumer attempted to cancel her policy both by telephone and in person; however, despite her requests, the policy remained in force. Subsequent efforts to resolve the issue were unsuccessful. After more than a month of attempting to have the policy cancelled, she contacted our office for assistance. We then reached out to the insurer, advised them of the circumstances, and they promptly processed the cancellation request.

Our office was contacted by an insured who had filed a claim for a stolen vehicle that was later recovered. The vehicle had been missing for an extended period and sustained damage while in the possession of the thief. Following a review of the reported damages, the insurer determined that there was insufficient evidence to establish that all the claimed damage resulted from the theft. As a result, only a portion of the repairs was approved for coverage.Dissatisfied with this outcome, the consumer contacted our office for assistance. We reached out to the insurer to explore whether the benefit of the doubt could be extended in this case, particularly since some of the denied damages were near other damaged body panels that had been accepted as part of the claim. Following a second review of the file, the insurer agreed, as a gesture of good faith, to expand the scope of repairs to include the previously denied damages.

A consumer was rear-ended while transporting an expensive bicycle on a vehicle-mounted bike rack. A claim was submitted, and the insurer promptly addressed the damage to the vehicle without issue. However, both the bicycle and the bike rack sustained significant damage in the collision.New Brunswick operates under a direct compensation program, whereby insurers are responsible for handling their own insured losses, regardless of fault, provided the appropriate coverages are in place. At fault losses are processed under the collision coverage and the not at fault claims are handled under Direct Compensation Property Damage (DCPD). As a result, insured individuals have no legal recourse against an at-fault third party for damage to their vehicle or to property being transported by that vehicle.In this case, the insurer declined coverage for the damaged bicycle and rack, advising the consumer to submit a claim under his homeowner’s insurance policy instead. The consumer considered this approach unfair, as it would require him to file claims under two separate insurance policies arising from the same incident.His concerns were justified. After the consumer contacted our office, we contacted the insurer and raised the issue. Upon review, the insurer promptly acknowledged the error, reversed its position, and agreed to indemnify the consumer for the damage to the bicycle and bike rack under the Direct Compensation Property Damage (DCPD) provisions of his automobile insurance policy.

A consumer contacted our office seeking assistance regarding issues with his car loan insurance claim. He explained that benefit payments were frequently issued late, often arriving after his loan payment due date, which caused him significant concern and financial stress. The consumer also advised that the payments had unexpectedly stopped approximately three months earlier without any explanation from the insurer.Despite making several attempts to have the payments reinstated, the consumer encountered ongoing delays. He reported that the insurer repeatedly requested the same information and supporting documentation, even though those documents had already been submitted on multiple occasions. As a result, the matter remained unresolved, and no payments were issued during that period.Our office contacted the insurer and requested a comprehensive review of the claim and payment status. Following our intervention, the insurer promptly reviewed the file and acknowledged that all required information had already been received and that no additional documentation was necessary. The insurer subsequently reinstated the claim benefits, issued the overdue payments, and offered to process the remaining benefit payments in advance to help prevent any further delays and ensure the consumer's loan obligations could be met on time.

Following significant water damage to their residence, a consumer was forced to temporarily relocate while repairs were completed. During the claims process, a miscommunication between the insurer and its preferred contractor regarding the scope of the restoration work resulted in the consumer being denied coverage for substitute accommodation expenses. The insurer took the position that the home remained sufficiently habitable and that additional living expenses were not warranted.The consumer subsequently raised concerns and provided documentation demonstrating that the affected area of the residence could not reasonably be occupied while repairs were underway. After reviewing the evidence submitted by the consumer and engaging with the insurer to clarify the circumstances surrounding the claim, it was determined that the information initially relied upon by the insurer was incomplete. As a result, the insurer acknowledged that the consumer should have been eligible for additional living expenses for the period during which the restoration work rendered that portion of the residence uninhabitable. The claim was reassessed, and the insurer agreed to provide coverage for the substitute accommodation expenses for the duration of the repairs.

While shopping for insurance, the consumer was advised that an insurance experience letter from their previous insurer was required. An insurance experience letter is a document issued by an insurance company that summarizes a client's insurance history, including coverage details and claims experience. This document is often used by prospective insurers when assessing risk and determining eligibility or premium rates.The consumer contacted their previous insurer to obtain the experience letter; however, the insurer repeatedly refused to provide the document. As a result, the consumer was unable to proceed with securing new insurance coverage.Following our intervention, we contacted the insurer and addressed the consumer's concerns. As a result of our efforts, the insurer provided the requested insurance experience letter, enabling the consumer to continue the insurance application process.

The consumer’s vehicle was deemed a total loss following an accident. She was understandably concerned about how her insurer would assess and settle the claim. Given the circumstances, we encouraged her to research comparable vehicles in her local market. This served two important purposes. First, it helped her develop a realistic understanding of her vehicle’s current market value, enabling her to confidently discuss and negotiate the settlement if necessary. Second, and most importantly in this case, it provided reassurance that the insurer’s offer was fair when it was presented.The consumer was pleased with the outcome. The settlement offer exceeded her expectations, providing a measure of satisfaction and peace of mind during what had otherwise been a challenging situation.

An insured was advised by a broker that automobile insurance coverage would cost approximately $100 per month. Relying on this quotation, he accepted the proposal and cancelled his existing insurance coverage.Shortly thereafter, he was informed that the insurer would not cover him.  The client had to look for coverage through the Facility Association at a premium nearly four times higher than the amount originally quoted by the broker.The insured subsequently contacted our office. We reached out to the insurer, which advised us that it had no record of the client ever having been insured with the company. As a result, no formal cancellation notice had been sent to the client, since the insurer's records did not reflect an active policy in his name.We then provided the insurer with a copy of the pink card that had been issued to the client, confirming one year of insurance coverage. Following its review of this information, the insurer acknowledged the coverage and agreed to honor the insurance arrangement initially offered to the client through the broker, thereby maintaining the coverage on the terms originally quoted.

An insured contacted our office to inquire why his insurance company had increased his premiums by a substantial 10% and 17% in two consecutive years, despite having no accidents or driving convictions during that period.We reviewed the rate increases approved by the Insurance Board and determined that the premium adjustments appeared to fall within the insurer's authorized rating parameters.Although the client was initially reluctant to switch insurance providers, we suggested that he compare rates in the marketplace. After shopping around, he found another insurer willing to provide equivalent coverage at a premium that was approximately $700 less per year. As a result, he ultimately decided to move his policy to the new insurer.

The insured's insurance claim's history indicated two at-fault accident-recorded one day apart, which resulted in a significant increase in premium rates when they sought auto insurance coverage. We assisted the consumer by contacting the insurer and requesting a review of the claim’s history to determine whether any errors had occurred. Following its investigation, the insurer confirmed that the second accident entry was a duplicate record of the same claim. The insurer subsequently corrected the error and issued the consumer an experience letter confirming that only one at-fault accident appears on their record.

An insured was initially deemed at fault by his insurer after being placed in an unavoidable emergency situation caused by an oncoming motorist. Although no physical contact occurred between the vehicles, he was forced to take evasive action to avoid a collision, resulting in his vehicle leaving the roadway and striking an electrical pole. We successfully challenged the insurer’s liability determination, leading to a reversal of fault and reimbursement of the consumer’s deductible.

The client was initially advised by the insurer that he was not at fault for the accident. However, the insurer subsequently reversed its decision and determined that the insured was at fault. As a result of this change in position, the insurer refused to cover the costs associated with the rental vehicle invoice.The client then contacted our office seeking assistance. We intervened by contacting the insurer and requesting that the file be reviewed once again. Following a reassessment of the circumstances surrounding the claim, the insurer concluded that its original determination had been correct and that the client was, in fact, not at fault for the accident.Based on this revised review, the insurer reinstated its initial position, accepted liability for the rental vehicle expenses, and agreed to cover the outstanding rental invoice.

The client contacted our office seeking assistance with an insurance claim involving her vehicle. She wished to retain her car despite the fact that the estimated repair costs exceeded the vehicle's value, which led the insurer to classify it as a total loss. We contacted the insurance company on the client's behalf to discuss her concerns and explore possible options. Following our intervention, the insurer agreed, as a gesture of goodwill, to allow the client to keep her vehicle rather than proceed with the total loss settlement in the usual manner. The client was pleased with the outcome and appreciative of the assistance provided.

A client’s insurance policy was cancelled for non-payment, a situation that can have serious and long-lasting consequences on an individual’s insurance record and future ability to obtain coverage at reasonable rates. Upon becoming aware of the cancellation, the client immediately contacted his insurance broker and made every effort to rectify the situation. Unfortunately, despite his prompt actions, the matter was not resolved. The client advised that he had not received any notice of the missed payment, nor had he received a registered letter notifying him of the impending cancellation.Following our intervention, we engaged with the insurer to review the circumstances surrounding the cancellation. After considering the facts, the insurance company agreed that the matter resulted from a misunderstanding and acknowledged the client’s efforts to address the issue as soon as he became aware of it. As a result, the insurer reinstated the policy without interruption and removed the missed payment and cancellation from the client’s record. This outcome prevented the client from experiencing the significant negative consequences that can arise from a cancellation for non-payment and restored his insurance standing.

The insurer initially determined that the consumer was 50% responsible for a collision at a four-way stop. In support of its position, the insurer indicated that there were two conflicting versions of the accident and no available camera footage or independent evidence to establish fault conclusively.After reviewing the circumstances of the loss, including the RCMP report containing both drivers’ statements and the location and nature of the damage sustained by each vehicle, we identified concerns regarding the insurer’s liability assessment. In particular, the physical damage appeared to be more consistent with the insured’s version of events than with the version relied upon by the insurer.We subsequently contacted the insurer and requested a further review of the file, highlighting the available evidence and the apparent inconsistency between the damage patterns and the insurer’s fault determination. Following a reassessment of the claim, the insurer agreed that there was sufficient evidence to support its insured’s account of the accident and concluded that its original liability assessment should be revised.As a result, the insurer overturned its previous decision, found its insured to be 0% at fault for the accident, and amended the claim file accordingly.

An insurer was applying a deductible to damages arising from a motor vehicle accident for which the insured was not at fault and which should have been covered under Direct Compensation Property Damage (DCPD) provisions. Despite numerous attempts by both the client and the repair facility to resolve the issue directly with the adjuster, the matter remained unresolved.Within 24 hours of the client contacting our office, we intervened and communicated directly with the insurer. Following our involvement, the insurer promptly confirmed to the repair facility that the deductible would be waived, as required under the circumstances, and authorized the commencement of repairs. Our timely intervention eliminated an unnecessary financial burden on the client and prevented further delays in returning their vehicle to service.

The consumer did not agree with the total loss automobile valuation, arguing that it failed to adequately account for the vehicle's exceptionally low mileage. Upon reviewing the evaluation, we confirmed that no adjustment had been made to reflect the vehicle's low kilometres. We subsequently contacted the insurer to raise this concern. After further review, the insurer acknowledged the oversight and agreed to reassess the valuation and make an appropriate adjustment to reflect the vehicle's low mileage, resulting in an increased settlement value.

A policyholder submitted a claim for water damage, which was initially reviewed and accepted by the insurer. Following the insurer’s approval, the parties reached an agreement regarding the scope of the loss and the amount to be paid under the policy.However, after the claim had been approved and partial payments had already been issued, the insurer reversed its position. The insurer advised that it had incorrectly interpreted the policy coverage and asserted that the claim should not have been approved in the first place. As a result, the insurer refused to issue the remaining payments that had formed part of the agreed settlement, leaving the policyholder facing significant uncertainty and financial hardship.Upon being retained, we reviewed the file, including the policy wording, the insurer’s communications, and the circumstances surrounding the original approval of the claim. We then engaged directly with the insurer and raised concerns regarding the fairness of withdrawing coverage after the claim had already been accepted and settlement terms agreed upon.Following our intervention, the matter was escalated to the insurer’s senior leadership team for further review. After reassessing the file, the insurer acknowledged the circumstances surrounding its original approval and agreed to honor the claim on the terms that had initially been accepted. As a result, the outstanding payments were issued and the claim was settled in accordance with the original agreement, bringing the matter to a satisfactory resolution for the policyholder.

A client contacted our office after being involved in a motor vehicle accident. The insurer disputed whether certain damages to the client’s vehicle were caused by the accident. After reviewing the photographs and considering the circumstances surrounding the collision, we concluded that the disputed damages appeared consistent with the accident as described by the client.We contacted the insurer and requested that an independent appraiser inspect the vehicle. Following the inspection, the appraiser reached a similar conclusion and confirmed that the damages were attributable to the accident. As a result, the insurer accepted responsibility for the full extent of the damages and agreed to provide coverage for all repairs.

A policyholder contacted our office after being involved in a motor vehicle accident. She was experiencing significant difficulty communicating with her adjuster and had been unable to obtain updates regarding the status of her claim. As a result, she was concerned that her vehicle might be deemed a total loss and felt overwhelmed and confused by the claims process.We took the time to explain the claims process in detail, including the typical steps involved in assessing vehicle damage, determining repairability, and resolving the claim. By providing clear information and answering her questions, we were able to alleviate many of her concerns and give her a better understanding of what to expect moving forward.In addition, we contacted the insurer on the policyholder’s behalf and requested that they follow up directly with their client to provide an update on the status of her claim and address her outstanding concerns. Following our intervention, communication between the insurer and the policyholder improved, and the claim was able to progress more efficiently.Our involvement made a meaningful difference by helping the policyholder better understand the process, providing reassurance during a stressful time, and facilitating communication with the insurer so that her claim could continue moving toward resolution.

An insured contacted our office regarding the disclosure of personal information by his insurer. Following a motor vehicle accident, the insurer provided the at-fault party’s insurer not only with the insured’s name, but also his home address, telephone number, and other personal details.The other party subsequently used this information to harass the policyholder, to the point that police intervention became necessary.The client questioned the extent of the information disclosed during the claims process, and we agreed that it did not appear necessary to share such a broad range of personal information for the purpose of handling the claim. Ultimately, the insurer reached a settlement with the client that was satisfactory to him.It is worth noting that if you believe your insurer has disclosed your personal information without proper authorization, beyond what is permitted by applicable privacy laws or by any consent you may have provided, you have the right to file a formal complaint with the Office of the Privacy Commissioner of Canada.

An insurer had determined that its insured was responsible for a motor vehicle accident without notifying her of that decision.Several years later, when she decided to switch insurance providers, she was informed that the accident appeared on her driving record and that, as a result, her insurance premiums would be higher.She immediately took steps to have her record corrected, but her efforts were unsuccessful. She then turned to our office for assistance.After hearing her account and reviewing the legislation and regulations applicable to her situation, we contacted her former insurer to point out the error. Based on the Fault Determination Rules, we were convinced that she should not have been held responsible for the accident.Following several discussions and exchanges with the insurer, the company ultimately accepted our recommendation and overturned its original decision. Her record was accordingly corrected.

After his vehicle was damaged in a motor vehicle accident and sent for repairs, the insured was provided with a rental vehicle under the loss-of-use coverage he had purchased.As the repairs took longer than anticipated, and knowing that his rental coverage was subject to a limit on the number of rental days, the insured contacted the insurance adjuster to inquire whether the insurer would continue covering the cost of the rental vehicle. He was assured not to worry and was led to believe that the rental remained fully covered.When he returned the rental vehicle, however, he was informed that he owed approximately $1,000 in rental charges.Following our intervention, the insurance company acknowledged that an error had been made on its part and agreed to pay the outstanding invoice in full.

A consumer contacted our Office regarding delays in the repair of her motor vehicle and the insurer’s refusal to continue covering the cost of a replacement vehicle while the repairs were ongoing.The consumer’s vehicle had been stolen and used by thieves, who had also consumed drugs inside it. As a result, the vehicle required a remediation process to ensure it was free of drug contamination. Although the vehicle underwent cleaning on two occasions, it was evident that the cleaning had been inadequate. This delay ultimately caused the 30-day coverage period for a replacement vehicle, as stipulated in her policy, to expire.The insurer declined the consumer’s request to extend this coverage period.After reviewing the facts of the case, including photographs clearly demonstrating the inadequate cleaning of the vehicle, we contacted the insurer. Following a reassessment of the documentation, the insurer agreed to extend the consumer’s access to a replacement vehicle beyond the 30-day period outlined in her policy and to arrange for further cleaning of the vehicle.

The consumer’s policy was cancelled for non-payment, despite their proactive effort to arrange a payment plan with their agent a month in advance. At the time, no options or alternatives were presented to help the consumer manage or defer the upcoming payment, ultimately resulting in the cancellation of the policy.Upon review, the insurer acknowledged that accommodations could have been made to support the consumer and potentially avoid the cancellation. As a result, they agreed to remove the non-payment cancellation from the consumer’s record, allowing her to secure coverage in the standard insurance market without penalty.A cancellation for non-payment can have serious and lasting consequences for an insured individual, often leading to significantly higher premiums and reduced access to affordable coverage. In this case, correcting the record helped prevent those negative impacts and restored the consumer’s ability to obtain insurance under normal conditions.

A consumer contacted our office after their insurer assigned them 50% responsibility for an accident, despite their belief that they were not at fault. The third party involved provided a conflicting account, placing full responsibility on the consumer, which led the insurer to initially determine shared fault.After the consumer submitted photographs and additional evidence to our office, we contacted the insurer and requested a further review of the claim. Based on the information provided, we were of the opinion that the consumer was likely not at fault.Following a reassessment, the insurer agreed with this conclusion and revised their decision, ultimately assigning 0% liability to their insured. Avoiding an at-fault designation was significant, as such a finding could have led to an increase in the consumer’s insurance premiums.

An insured contacted our office regarding a motor vehicle accident involving her live-in son. While the insured was hospitalized, her son took her vehicle without her consent. While operating the vehicle under the influence of alcohol, he struck a telephone pole, causing damage to both the insured’s vehicle and the utility company’s equipment.The insurer denied coverage for the damage to the insured’s vehicle on the basis that the son was operating the vehicle while impaired. In addition, the insurer incorrectly applied a Section C – Collision exclusion (theft of a vehicle by a person residing in the same household) to deny coverage under Section A – Third Party Liability. As a result, the insurer took the position that the damage to the utility company’s property—estimated at approximately $6,000 to $7,000—was not covered, leaving the insured personally responsible for these costs.Given that the damage to the utility equipment clearly fell within the scope of third-party liability coverage, we disagreed with the insurer’s position. We advocated on behalf of the insured, and following a further review, the insurer ultimately reversed its position and agreed to cover the third-party damages.

A consumer contacted our Office regarding an insurer’s change of position.The client had been negotiating with the insurer concerning the compensation to which he was entitled following a motor vehicle accident. He ultimately accepted the offer made by the insurer.Subsequently, the insurer reversed its position, claiming that an error had been made and that the offer should have been for a lower amount. The client attempted to persuade the insurer to honour the original agreement, but these efforts were unsuccessful.Our Office intervened and took the position that a binding agreement had been reached between the parties and that the insurer could not unilaterally alter its terms.The insurer ultimately agreed to reinstate the originally agreed-upon amount.

A consumer contacted our Office following a disagreement with his insurer regarding the extent of the damage to his motor vehicle after an accident.Without conducting a proper appraisal, the insurer asserted that some of the damages were unrelated to the collision. It advised the client that, if he was dissatisfied with this determination, he could resort to the appraisal process available under the Insurance Act (which we have previously noted in our annual report is often used as a lever to pressure clients into abandoning legitimate claims).We reviewed photographs of the damage, and, at first glance, it appeared likely that the damages were indeed caused by the collision.We therefore contacted the insurer and advocated on behalf of the insured to ensure that a proper appraisal of the damages would be conducted before requiring the client to resort to the legislated appraisal process.The insurer agreed to proceed as we had suggested.

An insured individual received a renewal notice indicating that their insurance premium would increase by 23%.They contacted our Office to inform us of the situation.Our Office reviewed recent decisions issued by the New Brunswick Insurance Board to determine the rate increases that had been approved. We observed that the approved increases were significantly lower than the increase proposed for this client.We then contacted the insurance company to clarify the reasons behind such a substantial increase. The insurer agreed to review the matter.Following their review, the insurer confirmed that an error had occurred and that the insured was, in fact, entitled to a reduction rather than an increase in their annual premium.

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.

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 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.

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.

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 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.