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 Appeal Procedures - Brokers/Agents

At Facility Association, decisions are made in accordance with the rules set out in the
Facility Association Rules and Rates Manual or the Plan of Operation. On occasion,
brokers may request that a decision be arrived at or revisited based on individual
circumstances.

In such instances, these are the steps to be taken:

For appeals involving individual insurance policies:

  1. Discuss the situation with the Underwriter at your Servicing Carrier.
     
  2. If the situation is not resolved, speak to the Manager at your Servicing Carrier. It
    may be there is a misunderstanding that can be cleared up at this point.

    If the decision remains unchanged, document the request including any additional information or exhibits to substantiate the appeal and send a copy of the documentation to your servicing carrier who will forward it to the Operating
    Committee Chairperson in your jurisdiction for discussion and resolution.

    The Provincial Operating committees consist of two Servicing Carrier
    Members, two broker members, and two non servicing carrier members.

    You will be advised of the decision. NOTE: A copy of your documentation
    will be provided to the Servicing Carrier.
     

For appeals not involving individual insurance policies, but a rule in general:

  1. Speak to the Manager at your Servicing Carrier.
     
  2. If the issue remains unresolved, document your request and send a copy of the
    documentation to the Facility Association who will refer the case to the Rates and
    Rules Committee for discussion and resolution. You will be advised of the
    decision.

NOTE: All appeals must adhere to these steps in the order outlined. 

 

 

 


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