Complaint Process Flow

COMPLAINT PROCESS FLOWS FOR MULTIPLE

SECTORS

A. Insurance sector
1. STEP 1

1.1.1. Consumer login to account

1.1.1. Account (Basic Information)
1.1.1.1. System Generated Unique ID
1.1.1.2. First Name and Last Name
1.1.1.3. E-mail
1.1.1.4. Cell Phone (optional)
1.2. Consumers Launch URwitvoice Complaint Dashboard

2. STEP 2

2.1. System prompt – Please select your insurance company name (selection is required
to go to the next step)
2.1.1. Yes (access to next step)
2.1.1.1. Consumer selects insurance company (system makes note of
consumer selection and search for agents/connected with the insurance
company)
2.1.1.2. System prompt – Do you have agent or broker? (option of choosing
a broker or agent needs to be provided)
2.1.1.2.1. Yes
2.1.1.2.1.1. Please type the name of your agent or
broker
2.1.1.2.1.2. If system cannot confirm an active
“registration” for a broker or a “license” for an agent then
system displays “Hi “name of Consumer”, we are sorry
to inform you that the “name of the agent or broker”
you type does not appear to have an active license
with this regulator “name of regulator”. Please review
the name you type to make sure that it is correct.”

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 2.1.1.2.1.3. If consumer confirms name of agent or
broker type is correct, then system provides consumer
with following two options that required consumer to take
an action for each option:
2.1.1.2.1.3.1. System confirms with
consumer whether consumer has an
insurance policy with the insurance
company selected the in Step 2.1.1.2. If
confirmation is positive, then consumer can
go to the next step of the complaint
process. If not, consumer is not allowed to
proceed with the complaint and goes to
Step 2.1.1.2.1.3.2
2.1.1.2.1.3.2. System informs consumer
to contact regulator that licenses agents
to confirm license of agent if consumer
was dealing with an agent or to contact
regulator that registers broker. In each
situation, system, provide consumer with
the link to contact regulators. System
checks whether consumer has accessed
this link and keep a timestamp record of
this action. System will keep a timestamp
record if consumer does not access this
link.
2.1.1.2.2. No (Default submission to the selected insurance
company)
2.1.1.2.3. If name is found, system confirms that agent/broker’s license is
active, real time confirmation with the Regulator’s website)
2.1.1.2.3.1. If the system confirms an agent’s license
/broker’s registration is active, system keeps timestamp
record of the confirmation with the regulator website
2.1.1.2.3.2. System confirms with consumer if they have
policy with insurance selected company in 2.1.1.1. If
confirmation is positive, then consumer is allowed to the
next step of the complaint process. If not, consumer is not
allowed to proceed with the complaint.
2.1.1.2.3.3. System checks if we have an email for
agent/ broker

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 2.1.1.2.3.3.1. Yes, system defaults
submission of complaint to
broker/agent.
2.1.1.2.3.3.2. No, default option in
2.1.1.2.2

3. STEP 3

3.1. System prompt - What is your address? (auto complete location API i.e., such
Google Address API is integrated in System)
3.1.1. Country
3.1.2. Province or State
3.1.3. City/Town
3.1.4. Postal Code/Zip Code

4. STEP 4

4.1. System prompt - Please select a type of a product that you want to complain about (only
one selection is allowed for this step)
4.1.1. Life & Disability Insurance
4.1.2. Auto Insurance
4.1.3. Home Insurance
4.1.4. Travel Insurance
4.1.5. Other (describe)

5. STEP 5

5.1. System prompt - Is your complaint about? (only one selection is allowed for this step)
5.1.1. Cancellation
5.1.2. Renewal
5.1.3. Premium
5.1.4. Claim
5.1.5. Policy Changes
5.1.6. Customer Service
5.1.7. Other (please describe)
6. STEP 6

6.1. System prompt – Please provide detail about your complaint. (i.e., date that your
concern started, what are you unhappy about, etc.)

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 i. In this step consumer needs to have these options to provide detail:

• Write

• Voice

• Video
6.2. System prompt – Do you have documents you want to upload with
complaint.
6.2.1. Yes (maximum size of document(s): xxx)
6.2.1.1. System checks for size of upload and determine if upload is
compliant)
6.2.1.2. No (System messages user to change the file size)

7. STEP 7

7.1. System prompt – Do you have a specific resolution in mind? (i.e., date your
concern started, what are you unhappy about, etc.)
7.1.1. Yes (please detail below)
7.1.2. No, not the moment

8. STEP 8

8.1. System prompt – Based on Step 2

8.1.1. System prompt – Have you tried to resolve this complaint with name of:
Agent or Broker?
8.1.1.1. Yes (escalation procedure to follow if consumer chooses to escalate )
8.1.1.2. No (System default submission to agent/broker for resolution first)
8.2. System prompt – Submission
8.2.1. Disclaimer (to be done)
8.2.2. Consumer needs to write his or her name to Acknowledge Disclaimer (System
keeps timestamp of consumer’s acknowledgment)

9. STEP 9

9.1. System prompt –Consumer pays the submission fee

9.1.1. Submission
9.1.2. System show submission with expected date of reply.
9.1.2.1. System check if replies is received (system keep note of date
of reply)

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9.1.2.2. System prompt – Please confirm your satisfaction with reply.
9.1.2.2.1. Yes
9.1.2.2.1.1. System prompt – Rate the reply you
receive? (Rating scale from 1 to 5 in stars)
9.1.2.2.1.1.1. System prompt – Please
provide comment to rating.
9.1.2.2.1.1.2. Rating/comments is
shared with insurance company and
Agency/broker/agent
9.1.2.2.1.1.3. Consumer will have 5 days
after rating/comments their
rating/comments assigned to broker
insurance company and broker/agent to
change it
9.1.2.2.1.1.4. After 5 days
rating/comments posted on the public
section site and insurance company and
broker/agent can comment on consumer
rating/comment if they have an account
with URwitvoice
9.1.2.3. No
9.1.2.3.1. System prompt – Please detail your satisfaction with the
reply.
9.1.2.3.2. Repeat 9.1.2.2.1.1
9.1.2.3.3. If complaint had not been submitted yet to the insurance
company’s the designated complaint officer
9.1.2.3.3.1. System prompt – Do you wish to submit
your complaint to your insurance company’s the
designated complaint officer for further review?
9.1.2.3.3.1.1. Yes
9.1.2.3.3.1.2. System provide
consumer with the option to submit
complaint (consumer is not required to
pay fee submit at this stage )
9.1.2.3.3.1.3. Repeat of Step 9.1.2 to
9.1.2.3.2

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9.1.2.3.3.2. If No, which means complaint had already
been submitted to the insurance company’s designated
officer responsible to handle complaint and
consumer is not happy with the results
9.1.2.3.3.3. System prompt – Request consumer to
confirm whether the consumer wish to submit complaint to
the insurance ombudsman?
9.1.2.3.3.3.1. Yes
9.1.2.3.3.3.2. System request consumer
to confirm whether insurance company has
provided its final position
9.1.2.3.3.3.2.1. No (system auto
generates an email that the consumer will
have the option to send to the insurance
company’s complaint officer to request the
insurance company final position
9.1.2.3.3.3.2.1.1. If email is sent
system tracks for reply, if not auto
reminder is sent to the insurance
company to request for reply)
9.1.2.3.3.3.2.1.2. If consumer does
not send the email no further
escalation procedure can be done
and inform the insurance company
final position is required and remind
consumer that complaint file will be
closed after 5 days and can’t to
reopen. Then consumer is provided
with these two following options to:
9.1.2.3.3.3.2.1.3. either download
their file and eliminated all
information from the system
9.1.2.3.3.3.2.1.4. Or keep this
information in a secured dedicated
cloud type connected to their
account for fee
9.1.2.3.3.3.2.1.5. If consumer
chooses this option fees needs to
be paid otherwise inform consumer
to download their and that all of

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 their of their personal information,
including document uploaded will
be wiped from their account
9.1.2.3.3.3.3. Yes system ask
consumer to confirm the ombudsman to
escalate the complaint to:
9.1.2.3.3.3.4. General Insurance
OmbudService ( Consumer will find this
information in the Insurance Company
Final Position)
9.1.2.3.3.3.5. OmbudService for Life &
Health Insurance ( Consumer will find
this information in the Insurance
Company Final Position)

10. STEP 10

10.1. For 9.1.2.3.3.3. 4 – System Takes consumer to this Complaint Form found on this
https://www.giocanada.org/complaint-form/ and prepopulated this form the information that the
consumer has already provided in system
10.1.1. On this complaint the default email will be the email that they have with
URwitvoice
10.1.2. Repeat of Step 9.1.2.
1.. For 9.1.2.3.3.3. 4 – System Takes consumer to this Complaint Form found on this
https://olhi.ca/complaints/submit-a-complaint/ and prepopulated this form the information that the
consumer has already provided in system
10.1.3. On this complaint the default email will be the email that they have with
URwitvoice
2.. Repeat of Step 9.1.2.