What are the steps to obtain a copy of your file from your insurance company? What to do in case of refusal?
Submit an access to information request to your insurer
First, a person who wishes to obtain documents in his or her file must apply for them under the Act :
Every person who carries on an enterprise and holds a file on another person must, at the request of the person concerned, confirm the existence of the business and give him or her access to his or her personal information.
It is important to specify in your application each document for which you wish to obtain a copy. As an example, here are some documents that may be the subject of a request for disclosure:
- Computer notes;
- Internal emails;
- Membership form;
- Recording of telephone conversations;
- Etc.
Refusal to communicate from your insurer
When a conflict arises with your insurer, it can be difficult to obtain a copy of your file.
The Act provides that an insurance company may refuse to disclose to an individual personal information concerning him or her where such disclosure may risk:
(1) to interfere with an investigation conducted by its internal security service for the purpose of preventing, detecting or suppressing crime or offences against the law or, on its behalf, by an external service having the same purpose or a holder of a security agency or investigation agency permit issued in accordance with the Private Security Act;
(2) to have an effect on legal proceedings in which either of those persons has an interest.
Now, what are your recourses in case your insurer refuses to provide you with the requested documents?
Challenging your insurance company’s decision
If refused, you can challenge the decision that was issued on the access to information request.
The Commission d’accès à l’information (hereinafter the “Commission”) will evaluate the following 4 criteria in order to determine whether or not you are entitled to have access to the requested documents. This test must be performed for each of the documents requested in your access to information request and not in an aggregate manner.
Is it personal information?
First, the Commission will consider whether it is personal information about the individual making the request for disclosure.
In the case of a joint insurance policy, we recommend that you make a joint access to information request to avoid a refusal on the grounds that certain information does not concern you. This right does not extend to personal information about other individuals or to information that is not personal.
Here are some examples of refusals on this ground:
- Emails exchanged between employees of the company;
- Computer notes relating certain actions taken by them: receiving mail or procedures, writing documents, conversations with people other than the applicants.
Is there legal proceedings?
Secondly, the Commission will examine whether the refusal is related to legal proceedings that are ongoing or that will be initiated.
We therefore invite you to avoid verbalizing your intention to contest or initiate legal proceedings against your insurer, as this gesture may justify its refusal to transmit documents. Among other things, the sending of a formal notice can be used to demonstrate the risk of legal proceedings.
What will be the impact on the legal process?
Third, the organization that refuses to provide the documents has the burden of proving that the disclosure could have an impact on the legal process.
As a general rule, if the requested document does not have a risk of influence in the judicial proceedings, the applicant should have access to it, in accordance with the other criteria.
Assessment of the application at the time of refusal
Finally, the risk of legal proceedings must be assessed on the basis of the material in the file at the time of the refusal in order to determine whether or not the refusal was well-founded at that particular time.
Please note that a decision by your insurance company refusing to provide you with the documents is not fatal. Indeed, the judge who will hear the action against your insurer, whether it is a judge of the Court of Québec or the Superior Court, may order the production of documents even if you have not had access to those documents under your access to information request.
Do not hesitate to contact our firm for any dispute against your insurance company.
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