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Appeal Procedures - Brokers/Agents
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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:
- Discuss the situation with the Underwriter at your
Servicing Carrier.
- 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:
- Speak to the Manager at your Servicing Carrier.
- 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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