Claims

Claims

With over 70 years of experience you can trust you are in the right hands…

At the time of a loss, our professionally trained staff adjusters will be there to assist you with prompt and courteous service. They have over 70 years of combined experience in multi-lines claims adjusting.

How to Report a Claim

During regular business hours, please call your agent/broker representative. Click here for a full list of our agents/brokers.

If your claim occurs outside of our normal business hours, we offer an after hours Emergency Claims Service. Just call our dedicated toll-free line at 1-877-488-6642.

Peace of mind – 24 hours a day, 7 days a week, 365 days a year.

Do you know what to do if you’re involved in an accident?

Always make sure to take pictures and obtain the following information:

  1. The name and address of others involved in the accident, as well as their Insurance Company’s name and their policy number
  2. The names and contact information of any witnesses
  3. If the police are involved, the Officer’s name and the report number

When you insure with Lambton Mutual, you can expect that our Loss Prevention team will be there to assist you in identifying safety hazards that may exist on your property before you have a loss. This service is free of charge to policyholders and benefits everyone. By reducing losses, we can keep insurance premiums more affordable.

No one helps you prevent loss like Lambton Mutual. 

Our people are dedicated to improvement and undergo ongoing training as technology changes. Woodstove installations often pose potential fire risks, so we have two W.E.T.T (Wood Energy Technical Training) certified individuals on staff to assist you. In addition, our people are knowledgeable about construction, electrical wiring, plumbing and heating systems. If you have any questions, we’re always just a phone call away!

In order to provide coverage, your insurance company may require any of the following:

  • A written statement outlining the details of your loss
  • A police or fire department report
  • An inventory list of the damaged property with quantities, and value of the items being claimed
  • Evidence and documentation showing books of account, receipts, invoices, photos, or other vouchers verified by statutory declaration
  • Proof that you mitigated your loss and took steps to prevent further damage
  • Cooperation with reasonable requests from the insurance company

Did you know we offer ABC Fire Extinguishers below cost to our policyholders?

  • 2 1/2 lb $20
  • 5 lb $25
  • 10 lb $35
  • 20 lb $65

We also offer a fire extinguisher recharging service for policyholders. Simply drop your extinguisher off at your agent or broker’s office.

Due to severe weather events, an aging infrastructure incapable of accommodating excess water flow, and the use of more water-using appliances, water damage claims are on the rise.

Here’s how you can protect your property from water damage loss:

Basement:

  • Have a backwater valve installed professionally
  • Have downspouts extend 6 feet from foundation and away from your home
  • Install a battery backup source for your sump pump
  • Keep valuable items stored in plastic bins or off floor level

Pipes:

  • Replace aging and corroded pipes
  • Install a water alarm/shut off system
  • Avoid pouring fats and grease down the drain

 Domestic Water Containers and Appliances:

  • Never leave house with taps or appliances running
  • Replace plastic connection lines with steel braided hoses
  • Have hot water tank, softener, etc. serviced regularly

 Roof:

  • Replace worn and aging shingles
  • Use water barrier under shingles
  • Clean eavestroughs twice yearly, spring and fall

Managing Conflicts Of Interest

The Canadian Council of Insurance Regulators (CCIR) after public consultations agreed on three principles as best practices in managing actual or potential conflicts of interest. The principles promote consumer confidence in the insurance industry by outlining best practices for managing these situations when they arise.

The principles are:

  • The client’s interests come first: Distributors must put the interests of policyholders and purchasers ahead of their own;
  • Make clear any conflicts or potential conflicts of interest: Consumers must receive disclosure of any actual or potential conflict of interest that is associated with a transaction or recommendation; and
  • Ensure products are the right fit: Products recommended must meet the needs of the consumer.

Our Company supports these principles. If you feel that our representatives are not following them, please let us know. The Financial Services Regulatory Authority of Ontario regulates insurance companies and agents in Ontario.

Disclosure of Distributor Compensation & Financial Links

Lambton Mutual Insurance Company offers property and casualty insurance products through a combination of independent brokers and exclusive agents (agents who act only for Lambton Mutual). A fundamental requirement of the contract of insurance is that both parties (you and us) act in utmost good faith at all times. Further, our distributors must act with honesty, integrity and hold themselves to a high ethical standard in their dealings with both the customer and the insurer.

Our distributor agreements govern how and when they will be compensated for business placed with Lambton Mutual. We compensate our distributors in two ways: Firstly, we pay a fixed rate of commission expressed as a percentage and based on the annual policy premium. The rate of commission varies depending on the line of business as illustrated in the table below.

Secondly, we offer a contingent profit commission program that rewards the efforts of those distributors who write a profitable book of business. Lambton Mutual’s contingent profit commission is potentially payable after the end of a year and it is based on specific criteria that recognize the profitability of a distributor over a three-year period. Profitability is measured by comparing premium revenue against expenses (e.g. Claim costs, commission expense, reinsurance costs, etc.). For the year 2021, we paid profit commissions equal to 0.63136% of our total written premium. Lambton Mutual Insurance Company does not have financing arrangements with any of its distributors.

As a mutual insurance company, we are owned by our policyholders and do not have shareholders. As such, any profit is either reinvested back into the company, or, from time to time, may be returned to our policyholders. Lambton Mutual is dedicated to providing high quality insurance products at cost to our policyholders through prudent management practices, effective underwriting and loss prevention measures.

Commission rates by Line of Business:

  • Automobile 12.5%
  • Property 17%-20%
  • Liability 17%-20%

Percentage of Gross Written Premiums by Line of Business for 2021:

  • Automobile 44.1%
  • Liability 7.8%
  • Property 48.2%

Background

In 1996, the Financial Services Commission of Ontario (FSCO) created the Office of the Insurance Ombudsman (OIO) and a system for the informal resolution of consumer complaints about the business practices of insurance companies. The system places primary responsibility on insurance companies to handle and resolve consumer complaints about their products and services. The OIO deals only with complaints that are not resolved by companies within a reasonable time. Lambton Mutual developed a “Consumer Complaint Handling Protocol”. Debbie Van Eyk is appointed as the Company’s Ombudsman/Liaison Representative.  Effective June 8, 2019, FSCO transitioned to the “Financial Services Regulatory Authority” (FSRA).

FSRA requires insurance companies to collect and submit consumer complaint data to the OIO on a regular basis. Individual company data is submitted in confidence and is not published or released upon request. Complaint data is published by the OIO on an aggregate basis by line of business. The collected information provides the OIO with an indication of the proportion of complaints addressed by the industry allows them to track complaint trends and assists in the identification of marketplace issues.

FSRA also requires companies to amend their protocol to ensure that complainants who have unresolved complaints are aware of his or her right to have a complaint reviewed by the OIO if it has not been resolved within a reasonable period of time through the Company’s Complaint Handling Protocol.

Definition of a Reportable Complaint

A complaint is the expression of at least one of the following elements that persists after being considered and examined at the operational level capable of making a decision on the matter:

  1. a reproach against an organization;
  2. the identification of a real or potential harm that a consumer has experienced or may experience; or
  3. a request for a remedial action.

Complaints are generally expressed in writing through correspondence, email, fax or other form that allows a complaint to be kept on file. Where a consumer complains by phone or in person and the complaint is handled and examined by the person responsible for the examination of complaints and delegated as such in the organization’s policy, the complaint must be documented so that it can be kept on file.

The initial expression of dissatisfaction by a consumer, whether in writing or otherwise, will not be considered a complaint where the issue is settled in the ordinary course of business. However, in the event the consumer remains dissatisfied and such dissatisfaction is referred to the person who is responsible for the examination of complaints and designated as such in the organization’s policy, then it will be considered as a complaint.

However, organizations must refrain from any undue delay in referring a matter to a higher level solely for the purpose of avoiding reporting requirements.

Where a consumer remains dissatisfied after a reasonable attempt has been made to settle the issue, organizations without a multilevel complaint examination structure are then considered to have received a complaint.

Lambton Mutual Insurance Company Complaint Handling Protocol

  1. The “Company Ombudsman/Liaison Representative” (as filed with OIO) is Deborah A. Van Eyk, CIP, President & CEO.
  2. To activate the Company’s complaint handling process, a policyholder(s) must provide a description of his/her complaint to the Company in writing.
  3. Letters of complaint will be reviewed by the “Company Ombudsman/Liaison Representative” or his/her alternate within five (5) business days of being received at the Company.
  4. The “Company Ombudsman/Liaison Representative” will consult with appropriate staff representatives and send to the policyholder a letter outlining the Company’s final position within sixty (60) days of the “Company Ombudsman/Liaison Representative’s” review of the letter of complaint.
  5. Our goal as a policyholder-owned, purely mutual company is to treat policyholders in a fair, courteous and timely manner. Time lines mentioned above are minimum standards.
  6. This Complaint Handling Protocol does not apply to any situation involving litigation by the insured against the Company or where the insured has retained legal assistance in that regard.
  7. Complainants who have unresolved complaints will be advised how to contact the Office of the Insurance Ombudsman.

Financial Services Regulatory Authority of Ontario:

25 Sheppard Ave W., Suite 100
Toronto, Ontario
M2N 6S6

Telephone: 416-250-7250
Toll free: 1-800-668-0128

Online Complaint submission link:  https://www.fsrao.ca/industry/home-life-and-health-insurance-sector/general-insurance-forms-and-documents/if-018

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