Transcript for:
12. Policyholder Protection

now assuris is a not for-profit organization that is funded by the insurance industry and so the purpose of assuras is to protect Canadian policy holders in the event their insurance company becomes insolvent or bankrupt and so this type of policyholder protection is made available by an independent company known as aurus and as indicated before all of the insurance companies that participate in the insurance industry in Canada uh contribute funds to support the ongoing benefits and the operation of this organization known as aurus now there are certain levels of benefits available to policy holders in the event of the insolvency of their insurance company now uh most times if an insurance company becomes insolvent uh what the regulator does is first of all tries to find another insurance company to acquire that insurance Insurance uh the troubled insurance company uh to maybe transfer the policies over to that other company and so they would buy out the obligations of the troubled company if they cannot find another organization another insurance company to take over the struggling company then uh that company has to be liquidated and in the event of a liquidation then benefits available under assuris would apply to the policyholders of that liquidated company so what are the benefits available under assurance and you'll see that these benefits will vary by the type of policy that is has been issued by the insurance company and so let's start with the death B benefits under insurus policy holders are guaranteed that if their insurance company becomes insolvent they are going to be guaranteed uh $200,000 of their death benefit uh or 85% of the promised benefit whichever is higher and so if we have policies that are uh under $200,000 that then basically uh the first $200,000 or the entire policy would be guaranteed by aurus for policies exceeding $200,000 of death benefit then the guarantee under assuris is 85% of that benefit so death benefits 200,000 or 85% of the promised benefit whichever is higher uh with respect well to with respect to health expenses uh Health expenses uh these will be covered $60,000 or 85% of the promise benefit whichever is higher monthly income types of plans and so this can be uh things like uh disability income plans uh it would also be plans like immediate annuities where you're annuity payments have started and so any any type of plan that's generating a monthly income uh the coverage Level under Assurance is $2,000 per month or 85% of the promised benefit whichever is higher uh cash value in your policy if you it's limited to again $60,000 or 85% of the value whichever is higher so these numbers that you see in bold these are the minimum amounts that are you know any coverages up to that level you're basically going to get 100% of this uh these level of benefits covered under assuras if you your benefits are in excess of these items I have here in bold you're going to get at least 85% of the additional amount so you know if we had a policy for example of uh $500,000 uh and your polic and your the company becomes insolvent in the event of a death uh that policy would get from assurers a minimum guarantee payment of 85% of $500,000 and so uh you can do the same types of calculations for these other ones I have just covered now one that's a little different is an accumulated or basically a deferred annuity uh and so deferred annuities as you know can be accumulation annuities uh and so for an accumulation annuity uh what's covered is 100% of the uh deposit that you put into that into that accumulation annuity up to a maximum of $100,000 and so this is uh similar to numbers that you would have in uh similar consumer protection plans that are available from banking Industries or from the Securities industry so uh all of these have a a minimum limit and then 85% applied to the excess uh and the exception here is obviously the annuity the payout annuities uh sorry the accumulation annuities pardon me uh they are limited to 100% of the Val value the accumulation up to $100,000 so these are the basic benefits that are available under Assurance uh which as I said again not for-profit organization funded by the insurance industry designed to protect the policy holder now the one other point I want to cover is with respect to policy holder protection is the edsman service that's available to The Life and Health Service Insurance sector and so the edsman service is a national independent complaint resolution organization that if a client has got a complaint uh against any specific insurer uh they obviously will start with complaining to the agent or the company and if they get into a situation where uh their complaint is not being resolved uh based on their uh expectations they can then take their complaint to the Ombudsman and the Ombudsman will try to resolve the complaint try to get the parties to work together the parties being the client and the insurance company uh what's important here is the edsman does not have the power to uh say this is what to resolve it and tell the parties what's going to happen the role of the edsman is really to facilitate a discussion and to facilitate the resolution of the issue that the client would have with the insurer and so they're going to assist in trying to get the insurance company to resolve the issue with the client and many insurance companies don't want the bad image of uh you know the client complaining uh and assuming that the complaint is reasonable uh they will work with the Ombudsman service to try and resolve this now obviously if the Ombudsman and the client and the insurance company cannot come to a resolution then the client always has the option to uh go forward with legal proceedings against the insurance company but this edsman service is there as a go between to try and uh resolve any issues that the client or the policy owner would have with the insurance company so those are the two key areas on policyholder protection that uh we are going to cover in this session