Guidelines for claims
appeals and resolution 

Claims outcome not to your satisfaction? Here's how you can escalate your concern.

We know any medical emergency can be taxing, but we want this process to be as smooth as possible.

We make all claims decisions based on the information we receive. We will review any new information we might receive after having made our decision. If you believe our decision is incorrect based on the evidence we find, you may appeal.

To appeal a claim decision, or make a general inquiry about the decision, please follow the appeal process below:

• If you believe the evidence on which we have based our decision is incorrect, or if there is other evidence in relation to your claim that is not known to us, you may appeal your claim. If you decide to do so, please submit your appeal in writing. Please clearly outline why you feel the decision is incorrect along with your supporting documentation. Your appeal will then be reviewed and a response will be provided in writing.
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• If you intend to appeal this decision, we ask that you submit your written appeal to Allianz within 180 days of receiving notice that your claim was denied.
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• An appeal can be sent to our office via email at appeals@allianz-assistance.ca or by mail to:
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•         Allianz Global Assistance
          Appeals Department
          P.O. Box 277
          Waterloo, ON N2J 4A4
  
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• If you are a US customer seeking to appeal your claim, please email claimappeals@allianzassistance.com.
  
  Please note that we reserve the right to invoke other terms, limitations, and exclusions upon further review of your file.

• Should your complaint or claim still remain unresolved following the internal appeals process with Allianz Global Assistance, you may send a request for additional consideration of your complaint or claim in writing to the relevant Ombuds Office. 
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• Please note that the Ombuds Office will only review concerns that have gone through the appropriate steps above so you will want to indicate who you have spoken with at Allianz Global Assistance and provide a copy of our final position letter to the relevant Ombuds Office:
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• For products underwritten or insured by CUMIS General Insurance Company or Co-operators Life Insurance Company: 
  
  By mail:   
  Ombudsperson 
  c/o The Co-operators Group Limited 
  130 Macdonell Street 
  Guelph ON, N1H 6P8 
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• Email: 
  Ombuds@cooperators.ca
   
  
  
• Phone: 
  1-877-720-6733
  
  
• Fax: 
  519-823-9944
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• For products underwritten or insured by Allianz Global Risks US Insurance Company (Canadian Branch):  
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• By mail:     
  Ombudsperson
  Allianz Global Risk US Insurance Company (Canadian Branch)
  1600-130 Adelaide Street West
  Toronto ON,  M5H 3P5
  Canada
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  Email:       
  ombudscanada@agcs.allianz.com
  
  Phone:     
  416-915-1956
  
  Fax:         
  416-849-4555
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  For products underwritten by all other insurers, please refer to your policy document for more details. 
  
  After the Ombuds Office’s review, you will receive a written response, except in the case where a simple concern can be cleared up over the phone. Most investigations are completed within 30 business days of receiving your complaint and all supporting documentation. If this deadline cannot be met, you will be contacted as to why extra time is required and when you can expect a response. 
  
  The written response from the Ombuds Office is considered the insurance company’s final position. Unless you subsequently present any new and relevant information that was not already previously reviewed, your case will not be reopened.

• If we have not been able to resolve your concerns to your satisfaction and you wish to pursue the matter further, you may contact the General Insurance OmbudService (GIO). GIO is an independent service that offers recourse to consumers who have not been able to resolve their complaint by dealing with their insurance company. The OmbudService can be reached at 1-877-225-0446 or through the General Insurance OmbudService website.
  
  
• Note: You must follow the Company’s Complaint Resolution Process described above, before the GIO will become involved.
  
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• For Quebec clients; if you are not satisfied with how your concern was handled, or the results of our investigation, the law gives you the right to request, in writing, that a copy of your file be transferred to the Authorité des marches financiers (AMF). You can reach the AMF by calling 1-877-525-0337 or by email at: renseignement-consommateur@lautorite.qc.ca.

The Financial Consumer Agency of Canada (FCAC) provides consumers with accurate and objective information about financial products and services, and informs Canadians of their rights and responsibilities when dealing with financial institutions. FCAC also ensures compliance with the federal consumer protection laws that apply to banks and federally incorporated trust, loan and insurance companies.