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December/January 2013
Official Journal of the Canadian Indeépendent Adjusters’ Association
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Adjusters Adapt to changing a Changing adapt to Claims environment. Environment claims
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Contents DECEMBER / JANUARY 2013 • VOLUME 6 • NUMBER
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Cover Feature 12 Fast Forward – Adjusters Adapt to a Changing Claims Environment Claims Canada asked five leading adjusters of top-ranked firms to sketch out what they think are the key trends that claims professional will be facing in the immediate and long-term future.
Spotlight 22 Being Boutique Quebec-based Demers Insurance Adjusters Inc. offers a recipe for adjusting on a specialized scale. BY CRAIG HARRIS
Education Forum 48 Crunching the Numbers Will “big data” have a big impact on claims adjusters?
News Features 24 Property Loss Trends Recent court decisions on key claims may influence adjuster behaviour. BY GLENN GIBSON
32 Regulating Health Care Clinics Ontario represents a key test ground for increased supervision of medicalrehabilitation facilities. BY WILLIE HANDLER
36 Big Brother 2013 Event data recorders, also known as vehicle “black boxes,” are a tipping point – what does this mean for claims handling? BY MARK FABBRONI
38 Minding the Millennials
42 Against Their Better Judgement
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Why insurers should love the Accounting Report Benefit. BY MICHAEL SIGSWORTH and DARRELL SHERMAN
44 Driver Test Ensuring drivers with medical conditions are able to drive competently is an important, but often misunderstood element of road safety. BY JOHN SHEARD and ELANA SCHNEID
Departments 4 First Notice 50 On The Scene
Columns
Some tips on understanding, motivating and retaining the new generation workforce. BY GINO FIORUCCI
10 President’s Message 48 Education Forum
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• first notice FN Anti-fraud task force calls for greater FSCO powers The Ontario Automobile Insurance Anti-Fraud Task Force has released its final report outlining nearly 40 recommendations, chief among them expanding the power of the province’s industry regulator, greater public disclosure on the part of insurers and licensing certain health clinics. Sixteen months after its inception, the task force steering committee has recommended the Ontario government amend the Insurance Act to allow the Financial Services Commission of Ontario (FSCO) greater power in investigating and enforcing fraud. Among other changes, the government could update the Insurance Act to allow FSCO to investigate and sanction “unfair or deceptive acts or practices” within organizations that might not currently be considered part of the insurance business under the Act, such as some health care providers, the report said. FSCO should also be given authority to oversee and audit the business and billing practices of health clinics or other individual practitioners who invoice auto insurers, according to the report. The Ontario government should consider changing FSCO’s mandate to reflect the new responsibilities, and commission an independent re-
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view of the updated regulator’s function within three years of changing its scope, the task force said. “FSCO will have to recognize that it will no longer be ‘business as usual,’” the report noted. The committee has also recommended implementing licensing for health clinics that treat patients injured in auto accidents. The ownership, costs of services and potential for conflicts from such clinics should also be reported through a licensing process, the task force noted. Other recommendations include improved consumer edu-
FRAUD cation, such as the creation of a new multi-lingual educational website and a fraud tip hotline run by FSCO. Greater information-sharing among organizations such as the Workplace Safety and Insurance Board (WSIB), and the Ontario Health Insurance Plan (OHIP) were also cited by the task force. l
Large-loss years from extreme weather no longer rarities: ICLR The Institute for Catastrophic Loss Reduction (ICLR) reports that large insured losses from extreme weather appear to be “the new normal” for the Canadian insurance industry, expecting that large-loss years will no longer be rarities. As insured losses from extreme weather continue to be tallied for 2012, this year looks to be shaping up to mark the fourth consecutive year for billion-dollar-plus weather-related losses in Canada, ICLR suggests in a statement. This represents an unprecedented run of losses and perhaps answers the question of whether the back-to-back billion dollar loss years in 2009 and 2010 were the start of a trend or a short-lived anomaly. Those losses were followed by the considerably more than $1 billion paid out in 2011 because of extreme weather and wildfires, notes the ICLR. “While we consider the trend toward more and larger weather-related losses as being the ‘new status quo,’ this does not mean that Canadian insurers will experience billion-dollar loss years every year,” cautions Glenn McGillivray, managing director of ICLR. “Rather, we are simply stating that while there will continue to be good years and bad years for such losses, large-loss years will no longer be the rarities they were just a few years ago.” ICLR attributes much of the trend to three sources: the increasing concentration of values, particularly in Canada’s largest cities; the poor state of Canada’s infrastructure; and climate change. l
www.claimscanada.ca
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• first notice FN Superstorm Sandy surges to insured hit of up to $22 billion Hurricane Sandy, which made landfall in New Jersey and New York in late October, has caused economic losses of over $70 billion in the two states, making it the second most expensive hurricane to hit the U.S., after Katrina. In terms of insured losses, AIR Worldwide updated its estimates from the storm in late November to $16–22 billion. Disaster modeling firm EQECAT also noted in early November that Sandy caused up to $20 billion in insured losses. The updated estimate from AIR is a result of the latest available information on surge height and extent from the U.S. Geological Survey, surface wind speed observation data, and findings from AIR’s postdisaster survey teams, notes a statement from the catastrophe modeler. AIR reports the estimates include wind and storm surge damage to onshore residential, commercial and industrial properties and their contents, automobiles, and time element coverage (additional living expenses for residential properties and business interruption for commercial properties).
While most of the damage was reported south of the border, the Insurance Bureau of Canada (IBC) noted preliminary estimates for insured losses in Canada from Sandy at about $100 million. Data suggests that thousands of claims have been filed for damage to homes, cars and businesses in the wake of the storm , which hit Ontario and parts of Quebec. The National Insurance Crime Bureau in the U.S. reports that the number of vehicles damaged from Sandy to be 230,000. The Ontario Motor Vehicle Industry Council (OMVIC) is reminding consumers to be vigilant as storm and flood-damaged vehicles from Hurricane Sandy’s aftermath may enter the province’s market. This is somewhat of a “historical pattern,” noted OMVIC. The 2012 Atlantic hurricane season officially ended Nov. 30, with 19 named storms, including Hurricane Sandy. Ten named storms became hurricanes last year, according to the U.S. National Oceanic and Atmospheric Administration (NOAA). The average number of named storms per year is 12, and for hurricanes is six, making 2012 an active year. l
Canadian cities want $2.5 billion annually for infrastructure The Federation of Canadian Municipalities is calling on the federal government to create a 20-year plan and to boost funding by $2.5 billion annually to address aging infrastructure across the country. The FCM is proposing the federal government increase its municipal infrastructure investments from $3.25 billion annually to $5.75 billion. That increase would bring spending more in line (as a percentage of GDP) with levels from the mid-1950s to the mid-1970s, which “allowed proper infrastructure maintenance and growth,” according to the FCM. Its proposed 20-year plan would also include five-year reviews. The Canadian government is currently working on a plan for infrastructure funding for when the current plan ends in 2014. “A long-term federal funding commitment that reflects the life-cycles of the infrastructure it is meant to fix is needed to allow municipalities to invest wisely and strategically in priority areas over decades, not just years,” FCM president Karen Leibovici said in a statement outlining its proposals. “It also means breaking away from budgets built on application forms and providing a predictable funding envelope for all municipalities.” Crumbling roads and bridges, over-crowded transit, poor resiliency and escalating repair costs are all contributing to Canada’s infrastructure problem, the FCM says. l
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• first notice FN Ontario appeal court upholds decision on FSCO mediations The Court of Appeal for Ontario has upheld a decision by a lower court to dismiss appeals by insurers in a case involving the wait time for mediation from the Financial Services Commission of Ontario (FSCO). The case, Hurst vs. Aviva Insurance Company, involved four individuals making separate but similar claims to their different insurers under the Statutory Accident Benefits Schedule (SABS) after they were in auto accidents. The claimants had gone forward with litigation against their insurers, citing failed mediation through FSCO, since their claims weren’t mediated within 60 days – a limit set out in FSCO’s Dispute Resolution Practice Code. A mediation attempt through FSCO is mandatory before a claimant can make a court action against an insurer. FSCO hadn’t provided reports to the claimants noting that mediation had failed, since it said the 60-day parameter only applied after the mediation application had been assessed by its staff and found to be “complete.” The insurers involved in the case then argued in court that mediation had not failed because the 60-day limitation didn’t apply in these situations, in
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A bi-monthly magazine (6x per year), Claims Canada is published by BIG Magazines LP, a div. of Glacier BIG Holdings Company Ltd. Business Information Group is located at: 80 Valleybrook Drive, Toronto, ON, M3B 2S9. Claims Canada magazine is the Official Publication of the Canadian Independent Adjusters’ Association [CIAA] and through its editorial content and circulation brings together the ‘entire property & casualty insurance claims market nationally’ with information and insight into the profession, business and people of insurance claims and loss adjusting. All key claims process stakeholders are reached as part of our readership community – including: both CIAA member and non-member independent claims adjusting firms; insurance and reinsurance company executive, claims management
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line with FSCO’s view. A lower court judge dismissed those motions by the insurers, who then appealed to the Court of Appeal for Ontario. In a decision released Nov. 28, the appeal court upheld the previous decision. The decision hinged on wording in various sections of SABS, which the appellant insurers had argued did not set out a 60-day limitation on the mediation wait time. “I do not accept that the 60-day clock does not begin to run until FSCO has assessed an application as complete,” Justice Russell Juriansz wrote in the decision. “The purpose of the legislation is to make mandatory a mediation process that is timely and effective,” the decision notes. “This has serious repercussions for the tens of thousands of Applications for Mediations stuck in backlog at FSCO,” wrote Miller Thomson lawyer Talaal Bond in a blog on the case. “Essentially, all the Applications that were filed in excess of 60 days may proceed directly to litigation should the insured so choose. This, in turn, will likely overwhelm the arbitrations unit and devour already limited court resources.” l
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Gary White Production Manager (416) 510-6760
and claims adjusting personnel; corporate risk managers and loss control professionals; insurance brokers; insurance law firms; forensic engineers and accountants; appraisal, restoration, rehabilitation and collision repair professionals; Insurance Institute chapters; insurance associations, regulators and related claims market recipients. The contents of this publication may not be reproduced or transmitted in any form, either in part or in full, without the written consent of the copyright owner. Nor may any part of this publication be stored in a retrieval system of any nature without prior written consent.
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Message from the President La Plume du Président JOHN D. SEYLER
The New Year is upon us. On behalf of your national executive, I hope 2013 brings you all success and happiness with business and family. With a new year comes renewed hope and optimism. The members of the CIAA national executive and your regional chapters have worked extremely hard to advance the cause of Independent Adjusters across the country. They will continue to strive to represent our association and our industry as a whole. The work of an association like ours is not flashy or glamorous. We have at times been criticized for being too slow to accomplish some of our goals. Changing the paths of a government or regulatory authorities is always a work in progress. I have learned that we can’t always accomplish our goals alone. Recently, I met with the leaders of the Risk and Insurance Management Society (RIMS) in a summit of insurance association heads. The discussion was not unlike one that takes place at our National Advisory Panel where we seek direction from Insurers and Industry groups. I realized we all have similar challenges. One of the discussions was the readiness of our industry to respond to a widespread disaster. It is not a case of if an earthquake or some other widespread damage strikes a densely populated area of Canada, but simply when – and where? I don’t believe the public is ready to respond to a disaster. Do You? Our emergency services would be stretched to breaking. Are you ready? I think adjusters should review their businesses to ensure they are prepared to function in the aftermath of such an event. What would you do without electricity, the cell network or the internet? Could you and your adjusters relocate if your office space was inaccessible? Over the course of the coming year I want to try and learn, plan and prepare for such a disaster. I would urge our members who have gone through such an exercise share their knowledge so we are all prepared to serve our clients and the insuring public. I am hoping to develop a resource for our members to draw from on our website. Keeping with the theme of working with other associations, I recently met with our Ontario Regional President Teri Mitchell and Ontario Insurance Adjusters Association President Steve DelGreco to discuss synergies we share within our organizations. The OIAA has been 10 Claims Canada
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La nouvelle année approche à grands pas. De la part de votre comité exécutif national, j’espère que 2013 vous apportera succès et bonheur dans vos vies professionnelles et familiales. Avec la nouvelle année arrivent un espoir et un optimisme renouvelés. Les membres du comité exécutif national de l’ACEI et de vos chapitres régionaux ont travaillé très fort pour faire avancer la cause des experts indépendants à l’échelle du pays. Ils continueront de faire en sorte de bien représenter notre association et notre industrie dans son ensemble. Le travail d’une association comme la nôtre n’attire pas le regard ni l’attention. Nous avons parfois été critiqués pour notre lenteur à atteindre certains de nos objectifs. Modifier la trajectoire d’un gouvernement ou des instances réglementaires est un travail continu et de longue haleine. J’ai appris que nous ne pouvons pas toujours atteindre nos objectifs seuls. Récemment, j’ai rencontré les dirigeants de la RIMS dans le cadre d’un sommet rassemblant des directeurs d’associations d’assurance. La discussion ressemblait à celles tenues à l’occasion des rencontres de notre groupe consultatif national, où nous échangeons nos points de vue avec des assureurs et des groupes de l’industrie. Je me suis aperçu que nous sommes tous confrontés à des défis similaires. L’une des discussions a porté sur le niveau de préparation de notre industrie pour répondre à une catastrophe majeure. La question n’est pas l’éventualité d’un tremblement de terre ou d’une autre catastrophe majeure dans une région densément peuplée du Canada, mais plutôt de quand et où elle aura lieu. Je ne crois pas que le grand public est prêt à réagir à une catastrophe. Et vous? Nos services d’urgence seraient exploités à leur extrême limite. Êtes-vous prêt? Je crois que les experts devraient évaluer leurs processus opérationnels afin de s’assurer qu’ils pourront fonctionner à la suite d’un pareil évènement, où ils n’auraient ni électricité, ni réseau de téléphonie mobile ni Internet. Est-ce que vos experts et vous seriez en mesure de vous réinstaller, si vos bureaux étaient inaccessibles? Au cours de la prochaine année, je veux essayer d’apprendre, de planifier et de me préparer pour une telle éventualité. Je demande à nos membres qui ont fait l’expérience de ce type d’exercice de partager leurs connaissances, afin que nous soyons tous prêts à servir nos clients et assurés. J’espère mettre au point une ressource pour nos membres, accessible depuis notre site Web. Dans le même ordre d’idées, soit de collaborer avec d’autres associations, j’ai récemment rencontré notre président régional pour l’Ontario, Teri Mitchell, ainsi que le président de l’Ontario Insurance Adjusters Association (OIAA), Steve DelGreco, pour discuter des synergies communes au sein de nos organismes. www.claimscanada.ca
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very successful in organizing industry events such as their OIAA Tradeshow and Conference. They have been advocates of adjuster education across Ontario with their educational programs and have a leadership structure that deserves to be emulated. Steve has proven to be a true friend of CIAA and we are moving towards having a closer ,more cooperative relationship with the OIAA to the benefit of all our members. I hope we can expand this type of relationship building across the country. In my years in insurance, I have seen time and time again the industry rally to support charitable causes. I wanted to thank those that supported my Movember cause. My wife was never so happy as when she saw the first of December. I am also proud to work on the WICC Gala committee. This event is scheduled for April 11, 2013 in Toronto. It is sure to be an event that you won’t want to miss if you are in the Toronto area. This year’s entertainment is a great Canadian artist, Chantal Kreviazuk. You can always donate to WICC all across Canada, so let’s show them what Independent adjusters really stand for! In closing, make sure you visit the CIAA website. It is a real benefit of membership. You will find forms, updates and links to invaluable resources for adjusters and clients alike. We are working to improve the website in conjunction with Claims Canada, so keep checking back regularly for more features and improvements. n
L’OIAA a organisé avec beaucoup de succès des évènements liés à l’industrie tels que la Conférence et foire commerciale de l’OIAA; elle promeut la formation des experts à l’échelle de l’Ontario au moyen de ses programmes pédagogiques; et elle a une structure de leadership qui mérite d’être imitée. Steve a prouvé son engagement auprès de l’ACEI et nous développons une relation de coopération plus étroite avec l’OIAA qui bénéficiera à tous nos membres. J’espère que nous pourrons nouer ce type de relation dans l’ensemble du pays. Au cours de mes années dans le secteur de l’assurance, j’ai vu à maintes reprises notre industrie appuyer des causes charitables. Je tiens à remercier ceux et celles qui m’ont appuyé dans le cadre du Movember. Ma femme n’a jamais été plus heureuse que lorsqu’elle m’a aperçu le 1er décembre. Je suis également fier de travailler au sein du comité du gala au profit de la WICC. L’évènement se déroulera le 11 avril 2013 à Toronto. Si vous êtes dans les environs de Toronto, c’est un évènement que vous ne voudrez pas manquer. Cette année, l’artiste canadienne Chantal Kreviazuk chantera pour nous. Vous pouvez également offrir un don à la WICC de n’importe où au Canada; montrons à tous que les experts indépendants ont du cœur! Pour terminer, assurez-vous de visiter le site Web de l’ACEI. Il s’agit d’un véritable avantage du fait d’être membre. Vous y trouverez des formulaires, des mises à jour et des liens vers des ressources inestimables pour les experts en assurances et pour les clients. Nous travaillons à bonifier le site Web en collaboration avec Claims Canada... Revenez donc nous voir régulièrement pour profiter des dernières fonctionnalités et améliorations. n
NATIONAL EXECUTIVE 2011-2012 2011-2011 PRESIDENT John D. Seyler, AIIC ProFormance Group Inc. 5080 Timberlea Blvd., Suite 214 Mississauga, ON L4W 4M2 Phone: (905) 238-4985 • Fax: (905) 238-2735 E-mail: jseyler@prospecialty.ca 1ST VICE-PRESIDENT Marie C. Gallagher, FCIP, CRM Granite Claims Solutions 71 King Street, Suite 204 St. Catharines, ON L2R 3H7 Phone: (905) 984-8282 • Fax: (905) 984-8290 E-mail: marie.gallagher@graniteclaims.com 2ND VICE-PRESIDENT E. Grant King, BA, B.Ed., CIP Crawford & Company (Canada) Inc. 120 – 237 Brownlow Avenue Dartmouth, NS B3B 2C7 Phone: (902) 468-7787 • Fax: (902) 468-5822 E-mail: Grant.King@crawco.ca SECRETARY Paul Hancock, B.Sc., CIP Crawford & Company (Canada) Inc. 300 – 123 Front Street West Toronto, ON M5J 2M2 Phone: (416) 867-1188 Fax: (416) 867-1925 E-mail: Paul.Hancock@crawco.ca
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TREASURER Russell Fitzgerald, CIP Kernaghan Adjusters Limited 203 – 4246 97 Street N.W. Edmonton, AB T6E 5Z9 Phone: (780) 488-2371 Fax: (780) 488-0243 E-mail: rfitzgerald@kernaghan.com
DIRECTOR James B. Eso, BA, CIP Crawford & Company (Canada) Inc. 539 Riverbend Drive Kitchener, ON N2K 3S3 Phone: (519) 578-5540 Fax: (519) 578-2868 E-mail: Jim.Eso@crawco.ca
PAST-PRESIDENT Greg G. Merrithew, CIP, FIFAA Arctic West Adjusters Ltd. 201 – 5204 – 50 Ave. Yellowknife, NT X1A 1E2 Phone: (867) 920-2212 Fax: (867) 873-2244 E-mail: gregm@arcticwest.ca
DIRECTOR John Jones, BA Granite Claims Solutions Suite 300, 5915 Airport Road Mississauga, ON L4V 1T1 Phone: (905) 671-3164 Fax: (905) 671-1889 E-mail: john.jones@graniteclaims.com
EXECUTIVE DIRECTOR Patricia M. Battle Canadian Independent Adjusters’ Association/ L’Association Canadienne des Experts Indépendants Centennial Centre, 5401 Eglinton Avenue West, Suite 100 Etobicoke, ON M9C 5K6 Phone: (416) 621-6222 Toll Free: 1-877-255-5589 Fax: (416) 621-7776 E-mail: pbattle@ciaa-adjusters.ca
DIRECTOR Craig J. Walker, CIP, FCIAA, FIFAA Maltman Group International 3550 Victoria Park Ave., Suite 301 Toronto, ON M2H 2N5 Phone: (416) 492-4411 Fax: (416) 492-5657 E-mail: cwalker@maltmans.com
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Adjusters Adapt to a Changing Claims Adjusters adapt to changing Environment claims environment.
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ndependent adjusters face an evolving array of challenges – internally, these range from hiring and retention practices (including succession planning), continuing education, new technology trends, fluctuating claims volumes, revenue targets and client satisfaction. Externally, the developments are arguably even more daunting, which include catastrophic claim handling, competition amongst regional/local and national firms, insurance company (and adjuster) consolidations, in-house insurer adjusting trends, procurement models, service/volume contracts, task assignments and uncertain business relationships. We asked five leading adjusters of top-ranked firms to sketch out what they think are the key trends that claims professionals will be facing in the immediate – and long-term – future.
Fred Plant, President, Plant Hope Adjusters Ltd. The independent adjusting profession is in a crucial period of transition. Three important issues are pushing us towards a point of crisis. They demand positive action over the next three to five years. The first issue is economic. Several years of “soft” markets have meant very little increase in the flow of money to Insurers. At the same time, claim settlement costs have continued to rise. Faced with flat revenues, increased payouts, and ongoing demand for improved financial results, Insurers seek
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to make up the difference by reducing operating expenses. If we independent adjusters fail to adapt to this environment by demonstrating continuing relevance, our services may come to be viewed as dispensable. Already, some Insurers view independent adjusters’ fees as pure expense and cutting them as a logical first step in cutting costs. There is risk in this reasoning. If those insurers were running a restaurant, their solution would be to fire most of the kitchen staff and bring in frozen food to heat in microwaves. That strategy might reduce labour costs, but customer dissatisfaction and declining revenues could more than offset savings. In the current market, what insur-
ers want from independent adjusters has changed. An increasing number are seeking to replace detailed, comprehensive investigation and customer contact with a more mechanical process. They want photographs sent to an analyst in a far-off place to determine the amount of settlement. They still need statements from involved parties, but want to pay only a flat fee for getting them. They expect skilled professionals to extract statements that will deal with the whole matter; yet, they don’t want them to deal with the matter as a whole. That disconnect will come home to roost one day when insurers find they no longer have the resources necessary to deliver on their promise to act in
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utmost good faith; the golden thread that has traditionally held the fabric of the property and casualty insurance business together. Historically, adjusters, independent or staff, have handled claims from start to finish. The process would involve trade-offs and compromises between the parties and the claim would be resolved as a whole. Today, the claim process is divided into silos with each silo operator working in isolation. The challenge to our profession is to transition successfully from the historic total-service model to the task environment of today where only bits and pieces of information are required at a time. The second issue challenging independent adjusters is technology. In an era where people assume that there’s an app for everything, there is a widespread expectation that if you can do it on a smartphone, it must be better. Some believe claims service can be improved by technology alone. If only adjusters could deliver reports right from the middle of the sewage-filled basement or the burnt-out kitchen, they reason, costs would be saved and service improved. That’s the theory. But it’s not clear that we’ve reached the point where it works dependably in practice. A common saying back in the 80’s, as computers became increasingly involved in business functions, was: “Garbage in equals garbage out.” We need to focus on quality assurance as an integral element in our use of technology. The third issue facing our profession has been around so long it seems like a no-brainer: recruitment. To deal with economic and technological change in our business, we need a steady stream of energetic, intelligent new recruits. Yet, how are we to attract candidates with the potential to become first-rate claims investigators and evaluators when the environment we want them to enter is under fire and in decline? People are leaving the profession faster than they are entering. Eventually, if we don’t find a solution, that shortfall will catch up with us. Taken together, these three issues add up to one big challenge: regaining the trust of Insurers. We can blame 14 Claims Canada
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outside forces all we like but the fact is, we have done it to ourselves. By our failure to keep abreast of economic and technological realities, we have undermined the confidence of many Insurers in the value of our service. Trust is the foundation of any functional relationship. As I see it, our profession’s greatest challenge is to win back that trust so that insurers will believe in the value of our service. It’s a tall order at a time when adjusters are being asked to do less and less in the field. However, if we are serious about winning back our customers we have to deliver our best. We are at a turning point. The outcome may not be entirely in our hands but we need to wake up, adapt to changing demands, and make the most of our knowledge and integrity to keep our profession alive. John Sharoun, Chief Executive Officer and President, Crawford Canada
At this time last year I talked about the challenges faced by Independent Adjusters over the previous year. In no particular order of importance I listed CAT response, IT technology, succession planning, frequency, internalization, industry consolidation
December/January 2013
and regulatory compliance, and governance impacts. This year, we were asked what two or three issues would impact the adjusting profession over the next year and beyond. From my perspective, there are more than two or three significant issues facing the profession and frankly tomorrow’s issues look a lot like the issues I set out last year. Their order of importance, and where they sit in priority, may have changed but my suggestion is that the scope and urgency with which these issues must be addressed has increased. Catastrophes and weather events, either singularly or cumulative, seem to be here to stay. CAT response has been in the headlines in Canada and certainly around the world over the past year. I think we’ve come to the conclusion finally that these are permanent fixtures of our claim landscape. These events seem to be getting more widespread and more severe – the past two years have seen some of the most expensive catastrophes in the period 1970 - 2011 (five of 16). Canada did not go unscathed by CAT activity. As we contemplate these issues, thousands of claims professionals have been deployed in the Eastern United States to handle claims related to Superstorm Sandy, a late-season storm that has created significant damage across the Eastern seaboard. No doubt this event will produce lessons for our industry and emphasize the importance of pre-event planning and postevent coordination of resources on an industry-wide basis. Our profession needs to do more to engage our Insurance Carrier customers on these critical pre-planning activities to ensure that we are able to deliver on the customer service promise at the moment of truth. Some rumblings on our West coast this past year have industry pundits suggesting that an event on Canada’s Western coast is not measured in “if ” but “when.” Are we truly ready to support such an event? Technology is involved in every aspect of the claims adjusting business with each independent for the most part utilizing a combination of their own internal systems, third party soluwww.claimscanada.ca
12-12-13 3:47 PM
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tions, vendor portals, and systems over and above each insurance carrier’s system. I know that during our own business process review this past year, we completed an inventory of software tools required to be accessed by our claims professionals on a regular basis. The number was startling. A total of 14 different systems were being utilized in addition to our proprietary Claims Management System as mandated by our clients. On its own, while each system offers a promise of increased ef-
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ficiency and effectiveness for the claim adjuster and the carriers we serve; collectively these systems have the potential to inhibit the Adjuster’s ability to provide optimal levels of customer service. With the continuing technological explosion on the claims side, this is a situation that will more than likely get worse before it gets better. As an industry we need to collaborate on ways to let these systems talk to each other and ensure the technology is working for the claim adjuster instead
December/January 2013
of having the claim adjuster work for the technology. Witness the banking industry not so long ago making the decision to use a common ATM platform to service customers rather than creating individual technologies. Frequency and internalization has created significant business challenges for adjusters over the past year. Weather patterns that have been fairly benign have created an environment of feast or famine for outsource claim handlers. While peaks and valleys are not new challenges for independent adjusters, the gaps have been amplified with Insurers achieving their internalization targets in recent years. The industry must work with our insurance carrier customers to enhance and improve our value proposition and find ways to maintain a sustainable level of resources during the valleys so that we are adequately equipped to respond to the peaks. Solutions can take many forms ranging from the traditional approach of supplying agreed volumes to optimize capacity, to newer approaches involving pricing models that cover the adjusters’ cost for maintaining unused capacity. An expectation that our industry can absorb huge increases in CAT volume during 30 – 60 day surges simply isn’t aligned with the factual realities of our day-to-day operating expenses. Last but certainly not least, succession planning has been a looming issue for the industry and for our adjusting profession for many years. The economy has likely given us a mild break in the action in recent years as many of our seasoned professionals have deferred retirement dates. This situation however, is only temporary. The industry’s efforts have been excellent in communicating, recruiting and training community college graduates and university graduates in the last number of years. We still see and expect there will a skills gap as the current generation retires and the next generation gains the skills and expertise they need to lead a very different insurance industry tomorrow. As independent adjusters, we have the opportunity to provide the www.claimscanada.ca
12-12-13 9:15 AM
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industry with the needed talent and expertise when it is required, but that’s going to require us to find creative ways to do that against the backdrop of our own recruiting and retention challenges. I think we all recognize the current business model of recruiting from your competitors is not sustainable over time. Working in lockstep with our carrier clients and various industry stakeholders to communicate and solve some of these issues would result in a more seamless transaction from inhouse to outsource and should resolve capacity issues in times of great need. Michael Holden, President and Chief Executive Officer Granite Claims Solutions As we have seen, especially in the past couple years, the P&C Claims market is hard to predict. While some influencing factors – such as legislative changes or demographics – are easier to pin down, factors
such as weather or particular risk appetites make it difficult to say with certainty where we are headed. However, there are some noticeable trends in the market today. In particular, the future of independent adjusters in Canada will focus on Third Party Administration for corporate client programs and the ability to mobilize for catastrophe events. With the insurer market adapting well to new legislation and sustainable in-house adjustment, a reversion to specialty lines adjusting and niche insurance products are coming to the forefront. Independent adjusters should focus their skill development on both traditional and niche areas. In the end, you will really stand out for your abilities as a niche adjuster. As well, developing that personal relationship with the insurer market and becoming known for a specific skill set will be the most effective method of staying viable and valuable to the market. As for catastrophic events, they need not be solely weather-related
anymore. Cyber insurance and the effects of organized hacking rings throughout the world can affect people and corporations so quickly and drastically that the organization must be prepared to deal with the response, investigations, and adjudication quickly and effectively. Clearly, this is a new high-risk area of insurance, and it is still a mystery to many. Those adjusters who educate and prepare themselves for potential cyber crime will be best equipped to deal with these needs. Granite Claims Solutions has a dedicated complex loss team, catastrophe management team, and cyber risk team in place to be prepared for these events. And since they are so interrelated, we continue to engage our teams in numerous cross-discipline training exercises. Developing knowledge and expertise has been one of the core values of Granite Claims Solutions, and these teams are no exception. Preparing for the market needs of the future has been at the forefront of our planning and training.
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R
e
David Riddell, President Canadian Claims Services “Where is the industry heading and where do we need to be?” is something that we spend a lot of time on at CCS. The past several years have seen a lot of changes in the industry, but many of the same issues still prevail for the independent adjusting field. Market consolidation is an interesting problem for the independent industry. M&A activity, coupled with the prospect of demutualization of P&C Insurers, should have every independent adjuster asking, who are my customers going to be in the future? Now more than ever, it is important to understand who your customer really is, and what their needs are. A diverse client base, while always good business, is imperative to avoid disaster as consolidation continues, and vendor selection potentially changes along with your client’s name. Strong relationships and a solid repu-
tation are essential to long term survival, in this ever changing environment. Independent adjusters need to be able to offer creative claims handling options to these clients, which in many respects require a departure from traditional reporting, and billing structures. Generally, this change requires the ability to introduce and effectively apply the use of technology. Technology in the insurance industry has not evolved as fast as other industries. There are numerous examples of old “legacy” systems still widely in use in the industry, which is further complicated with consolidation of companies. It is not uncommon for companies to be operating multiple systems. The cost of procuring new systems, coupled with expensive and time-consuming conversion projects, has led to the current state of affairs. Many of the systems used by Independent Adjusters large and small are more advanced than those of their clients. This is largely as a result of the fact that most independent adjusting firms
have only embraced Claims Management Systems within the past 10 years. Going forward, Independent adjusters have to have systems in place that will allow for, at a minimum, electronic reporting. At CCS, we are increasingly asked for client access to our Claims System, allowing clients access to view their claims information “online and in real-time”, with the ability for the clients to pull their own management reports from these systems. Recognizing this CCS has full time IT staff, which is relatively unprecedented for an organization our size. Finally, the biggest challenge that faces the entire industry, not just the independent field, is people. This is not a new issue, but it is certainly one of the most serious. More and more, experienced people are being offered modified work conditions or being coaxed out of retirement to fill senior technical roles, given the overall lack of experienced people who are able to get involved in large and/or complex claims. Historically, the independent adjusting industry has relied on the
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insurance companies to train new adjusters for the industry. With few exceptions, only the large national adjusting firms have been able to consistently hire and train new adjusting staff, by virtue of their call centers. As a result, recruiting new adjusters to the independent field continues to be a tricky prospect, when independent adjusters attempt to recruit some of the best and brightest adjusters away from the very clients who are supporting them, especially when fewer of the best and brightest are entering the field to begin with. Independents need to find ways to recruit, and train new adjusters to the industry, without raiding their shrinking client base. Overall, I believe that a strong independent adjusting industry is essential to the long-term success of the insurance industry as a whole. Independent adjusters have always been, and will continue to be an integral part of how the industry meets its obligations to policyholders. Many of the challenges we face are not new, but are becoming more prevalent as the consumer demand for faster and better quality and service increases. Independent adjusters must find ways to work more closely with our clients to provide proactive solutions to that increasing consumer demand. At the end of the day, it is in all of our best interest! Patti Kernaghan, President and Chief Executive Officer Kernaghan Adjusters The future trends and challenges facing independent adjusters can be viewed either as a series of issues that will strain the independent adjusting community, or as an opportunity to excel at what we do –– manage claims. The changes in the way businesses have operated in the last 25 years are significant and extraordinary. The property and casualty insurance industry has adapted by slowly incorporating change into their processes. At times it has appeared that those in the independent adjusting field have led change in our industry.
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In the next three to five years one of the most important changes affecting the loss adjusting field will involve technology. First there will be a shift from the “information age” to the “connected age.” As the insuring public becomes more connected in their day to day lives, they will demand the same connectivity in the form of customer service for settling their claims. The second technological shift will be the use of “big data and analytics” by insurance companies to ensure customer service compliance. What do the technological shifts mean for independent adjusters? The shift to a higher level of connectivity will be one of the most important catalysts for change over the next ten years in the claims industry. Insurers and the insuring public will demand a faster and faster turn around time for claims information. The demand for a higher level of connectivity will affect all independents. It will speed up communication, move information quicker, and files will close faster. Adjusters will need to adapt to the pressure of increased connectivity to stay on top of their work loads. The other technological shift affecting loss adjusting will be driven by the use of big data advanced and analytics by insurers. The focus on big data and the analysis to create a competitive edge is here now – but the demand for more information will become the norm. It will drive performance and how independent adjusting companies operate and communicate at a high level with insurers.
December/January 2013
Independent adjusting companies will need to ensure their claims systems provide the right information to their adjusters in an easy to navigate environment that simplifies communication. They will also have to ensure their adjusters are trained to use these tools and stay on top of their files. Independent adjusters will need to keep up-to-date with the various technologies that will help them be more effective in the handling their claims. If companies fail to provide the right technological tools to their adjusters, and/or the adjusters fail to use the technology to their advantage, the big data and analytics used by insurers will point out the deficiencies. The second most important issue facing the field of independent adjusting over the next three to five years will be the shrinking talent pool, as baby boomers with their deep experience start to retire in higher numbers. As the boomer adjusters retire, there will be a huge exodus of critical claims knowledge from our industry. Both insurers and independent adjusters need to recognize the pressure on the independent field to continue performing the very important service they do within the Canadian property and casualty industry. Adjusting firms need to ensure sound recruiting and training plans are in place in order to ensure the next generation of claims professionals will inherit the existing adjusters’ knowledge –– from telephone adjusting small losses to handling large, convoluted specialty claims. www.claimscanada.ca
12-12-13 9:16 AM
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• spotlight S
Being Boutique
Quebec’s Michel Demers offers a recipe for adjusting on a specialized scale. It’s a strategy that has worked over the past 14 years for Montreal-based Demers Insurance Adjusters Inc. BY CRAIG HARRIS Demers Insurance Adjusters’ team (from left): Luigi Tanzini, Alain De Quoy, Frank Colanero, Michel Demers, Vincent Bruzzese, Frank Bruzzese and Pierre Bouchard.
M
ichel Demers distinctly remembers the advice his late father, Marc, also an adjuster for 35 years, gave to him. “He told me: ‘Don’t offer the same services as everyone else; you have to be able to stand out from the rest of the pack by specializing,’” Demers recalls. He has taken that advice to heart. As president of Demers Insurance Adjusters Inc., located in the Montreal suburb of Saint-Lambert, he has carved out a solid reputation as a claims specialist and an enviable client list in a tough marketplace. 22 Claims Canada
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“We are a boutique adjusting firm focused on personalized service to our clients,” Demers notes. This extends to their various divisions, which encompass commercial property, liability, casualty, inland marine/marine cargo, warehouse and environmental risks. Demers Adjusters also handles a significant volume of large and complex claims. “As adjusting professionals, we have built a core of expertise in several areas of business,” Demers says. “I believe this has allowed us to succeed in a challenging claims environ-
December/January 2013
ment of fluctuating volumes, in-house insurer adjusting staffing trends and national insurance company service contracts.” Boutique means that Demers Insurance Adjusters caters to local insurers and multinational firms, including aerospace/transportation companies and utility providers. This extends to petro‑chemical firms, pipeline suppliers and environmental risks. It also means that the firm tends to handle larger claims. For instance, Demers Adjusters recently handled one of the largest claims in Quebec history www.claimscanada.ca
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chard.
– a warehouse theft that resulted in a multi-million loss exposure. “Insurers involved in complex cases know that we can provide the specialized services they require,” he adds. Michel Demers has been building up this area of specialization for a period of 40 years in the loss adjusting profession. Starting his career in 1972, he worked as an adjuster for his late father’s firm Marc Demers Limited, learning the ropes and getting important training. He has since been involved with several Quebec-based firms. In 1987, Demers founded an adjusting firm together with associates, and in 1999, he decided to strike out on his own, creating Demers Insurance Adjusters Inc. “Since the very beginning, we have provided quality claims handling in specialty risks and loss adjustment by giving utmost priority to customer service,” he observes. When asked about the qualities that make a successful adjuster, Demers cites the old adage that all a man really has, when everything else is stripped away, is his reputation. “Integrity is very important in this profession,” he says. “The reputation of your firm amongst insurers and end clients is really what counts at the end of the day.” Another trait that Demers identifies as key to the adjuster personality: curiosity. “If you are not a curious person, I don’t think you can execute a complete investigation. When someone assigns a file to us, they are assured of the quality of the investigation.” For Demers, this also implies keeping up to date on current trends in various fields, including legal, liability and environmental issues. “If someone raises a question or has a concern, I am not satisfied until I get the right answer,” he says. “That is a critical part of being an adjuster.” Service, communication and attention to detail are also vital attributes of an insurance adjusting firm, according to Demers. “We work as a team. What this implies for me and my senior managers is that our doors are always open to staff,” he explains. “If there is a problem or concern with a claim, we need to find the right solution and communicate this to the www.claimscanada.ca
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client to get the proper results. As an adjuster, you must follow the claim through to its final resolution with the client’s best interests in mind.” Expertise and the ability to handle complex losses are crucial characteristics for firms like Demers Insurance Adjusters, he says. His experienced team is well equipped to deal with all losses involving fire, spills, general liability, casualty, warehousemen’s liability, cargo and commercial theft. Demers Insurance Adjusters’ specialization is also reflected in its extensive affiliation with various industry organizations.
Michel Demers: Core of Expertise The firm is a member of the Quebec Independent Insurance Adjusters’ Association (AESIQ), which is linked with the Canadian Independent Adjusters Association (CIAA). In terms of commercial and industrial risks, it is also involved with the Risk Insurance Management Society Inc. (RIMS), Quebec Risk and Insurance Management Association (QRIMA), Canadian Board of Marine Underwriters (CBMU), Canadian International Freight Forwarders Association (CIFFA), Canadian Maritime Law Association (CMLA) and Canadian Association of Fire Investigators (CAFI). Even with its specialized niche, Demers Insurance Adjusters is not immune from the competitive pressures in today’s insurance marketplace. De-
mers says he is fully aware of trends towards fixed adjusting fees, task assignments and national contracts. “All insurance companies are looking to reduce costs,” he observes. “Sometimes, we’re provided with a task assignment, and the first thing we discover is that there is a strong the possibility of litigation, thus requiring a thorough investigation. The reality is that certain claims require extensive resources and investigation.” This is particularly true as it pertains to casualty claims. “We have also seen a notable increase in the number of casualty claims that have been assigned to our firm,” he says. “Most of these losses are very complex; it is imperative to obtain the right information. There are no shortcuts to handling some of these cases, when they may potentially give rise to litigation.” In terms of industry trends, Demers notes he has also seen the effects of large insurance consolidators keen to keep more claims in-house and hire more staff adjusters. But he also says he sees this trend extending to other forms of “service providers.” The concept of “one-stop shopping” and volume claims processing is the opposite of Demers’ boutique business model. “I am looking to work as part of a team with my client, whether this entails receiving claims directly from an insurer or a corporate client,” he explains. When Demers, who is married and a father of three children, is asked about what kind of advice he would provide to his kids who may potentially be pondering a career in loss adjusting, he replies that he would give them the same sound advice as he has received from his late father. “There’s no question independent adjusters are facing a lot of challenges in the marketplace today and it is not an easy profession,” he concludes. “But I am optimistic that specialized firms can survive – and continue to thrive. My father had a clear vision: to specialize and gain expertise in key areas. I would say that if you pursue this sort of specialization and emphasize personalized service, you will always be successful in this business.”
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Property Loss Trends How recent court decisions may affect adjusters BY GLENN GIBSON
On May 1, 1973 I walked in the door of Fireman’s Fund Insurance Company in Hamilton, Ontario to start a job as an insurance adjuster. At age 20, it is difficult to imagine where you might be 39 years later. I had no idea in those early days that my job would be recognized as a profession. My proudest moment was when I qualified to insert the initials, AIIC, behind my name. When then-Governor General Roland Michener presented me with my diploma, it was the start of a lifetime of continuous learning. I have been fortunate during my career to reach a global platform to demonstrate business management skills. But I’ve never forgotten my roots as a loss adjuster. Writing articles and continuing to teach have kept me engaged in my profession. And, continuing to work as an appraisal umpire has accelerated my seamless return into the Canadian marketplace. Now, on to some recent cases.
Tedford v. TD Insurance Meloche Monnex, Ontario Court of Appeal (Lang, Epstein & Hoy), June 22, 2012 This litigation started with the sale of a house. The seller was alleged to have negligently misrepresented information in the “Seller Property Information Statement.” The purchaser sued alleging repair costs and personal injury. The purchaser reported experiencing “anxiety, sleep disturbances, fatigue, stress, headaches and symptoms of depression,” all alleged to be related to the purchase of this property. The seller held a valid homeowner’s policy covering the property at the time of the sale. Did the homeowner’s insurer owe a duty to defend a lawsuit brought by the purchaser? An application court judge reviewed the circumstances, concluding that the “property damage” was not covered but that the allegation of the personal injury triggered a duty to defend. The insurer appealed the decision arguing that the true nature of the claim was for an economic loss resulting from a commercial transaction. The injury claim was a 24 Claims Canada
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derivative loss and therefore should not trigger the seller’s homeowner insurer to pay the full defence costs. The Ontario Court of Appeal, in reviewing this decision, posed some fundamental questions based on case law: 1. Do the pleadings allege facts that, if true, would require the insurer to indemnify the insured? 2. Is there any possibility that the claim falls within coverage? 3. Is the claim advanced entirely “derivative” in nature? 4. Does a reasonable reading of the pleadings infer that there may be coverage? 5. The usual principles governing the construction of insurance contracts apply. Coverage should be interpreted broadly and exclusions narrowly. Where contract language might be considered ambiguous, consideration should be given to the reasonable expectations of the policyholder. The Court of Appeal noted the only cause of action pleaded was negligent representation. There were no allegations of an intentional tort. The General Damage feature of this claim represented a different category of damages from the negligent representation, BUT was not considered a derivative claim. The purchaser’s claim was for $150,000 in repair costs. The purchaser sought $25,000 in health consequences. The claim for repairs was clearly not covered by the homeowner’s policy. The Ontario Court of Appeal instructed the insurer’s lawyer to defend the entire action – both covered and uncovered losses. But the policyholder had to bear the costs of defence that exceeded the reasonable costs associated with defending the covered claims. The court said it would be unfair to the insurer to fix it with disproportionate costs and ordered both parties to seek agreement on allocating costs or return to court for a determination.
Case Summary This is an interesting case for anyone seeking to sell his or her home. The document that the seller must sign will be treated seriously and the sellers will be reaching into their own pocket to pay for a portion of the defence costs. The case also sets out some rules when a derivative claim pops www.claimscanada.ca
12-12-13 9:40 AM
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up, which may bring some portion of the overall plaintiff’s claim into coverage.
relied on this in early denial of coverage. The adjuster did not provide a blank proof of loss. The trial judge felt the insurer had “waived” any requirement for a O’Byrne v. Farmers Mutual Insurance proof of loss to be filed the minute they denied the claim. Company (Lindsay) 2. Up to trial, the plaintiffs had not completed repairs to Ontario Superior Court, J. Sproat, May 8, 2012 the building. The insureds led evidence that they did On March 13, 2005 oil leaked from a second floor furnot have the financial ability to execute on repairs. In nace in a commercial building in Minden, Ontario. Was the this situation, given the judge felt coverage was wrongdamage covered by the policy of insurance? Almost seven fully denied, the insurer forfeited its right to argue that years later, an eight-day trial was needed to determine this the insureds had failed to mitigate their damage claim. issue. 3. The judge reviewed the pollution exclusion. He relied The building owners initially purchased this building as a heavily on the Ontario Court of Appeal decision of rental income property. There was commercial space on the Zurich Insurance v. 686234 Ont. Inc. (2002) No. 4496. main floor and two small apartments on The trial judge referred to traditional the second floor. environmental contamination situaOn the evening of the loss, an aparttions as the risk the insurer was seeking ment tenant returned home to discover to exclude. In this situation, he did not an extremely strong smell of oil. A furnace view it as a traditional environmental repairman attended the next morning loss, pointing out the oil spill was within and discovered that someone had intena 30-foot area of the furnace and did not tionally placed cardboard between a set of escape the building. contacts on the furnace thermostat. This 4. Justice Sprout then examined the memeant the furnace continued to run at an chanical exclusion. The judge referred to excessively high temperature, resulting in the premium charged by the insurer for a the failure of the ignition device. When commercial policy where it knew apartThe judge referred to ments were rented to tenants who might this happened, oil for the furnace continued pumping and overflowed. the premium charged do “stupid” things. He gave examples An independent adjuster attended the where tenant’s acts – such as a grease fire by the insurer for a loss site. Within several weeks, a deteror running water – would result in a covcommercial policy mination was made that the loss was not ered claim. This situation was not the recovered by the commercial policy due to sult of an internal defect to the furnace; where it knew a pollution exclusion. A letter denying therefore the mechanical exclusion did apartments were coverage was sent to the insured. The trinot apply. al judge accepted the plaintiff’s evidence The judge determined that the loss rented to tenants that no blank proof of loss form was atwas covered by the policy of insurance who might do tached to the letter. and awarded damages for the building “stupid” things. At the time coverage was denied, there repairs and rental income loss that would was considerable suspicion that the tenresult while the repairs were being perant of one apartment had tampered with the furnace ther- formed. The judge also noted that the sums awarded would mostat. The local mental health services had ‘placed’ this be adjusted by recoveries agreed upon prior to trial by the tenant in the building and were subsequently named in the tenant’s insurer. action started by the plaintiff. On the eve of this trial, the insurers of the mental health firm settled their case with the Case Summary This is an interesting read to see this particular judge’s plaintiff. No terms were disclosed. views on how two different exclusions should be interpretAs the matter moved to litigation, the insurer of the ed. The decision seems to follow the “Doctrine of Reasonbuilding owner amended their Statement of Defence to inable Expectations.” What was the intent of the policy? In clude new arguments. One issue related to the failure to file this case, it was to provide protection to a building owner a proof of loss form. The second was introducing a second from the stupid act(s) of a tenant. exclusion (mechanical breakdown). The plaintiffs, not to be outdone, introduced an argument that they had never reMourits Trucking Ltd. V Sovereign General ceived a copy of the policy of insurance. Insurance Co. The trial judge did not seem impressed with the new Alberta Queen’s Bench, Belzil R.P., amendments to the Statement of Claim or the Statement of March 28, 2012 Defence. His rulings reflected this with some key points: 1. The adjuster obtained a non-waiver agreement immeOn June 6, 2004 a wiring defect caused a fire that dediately after the loss. The insurer seemed quite confident the pollution exclusion applied to the claim and stroyed a vacant farm property. There was an early dispute 26 Claims Canada
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It is interesting to note that the trial judge states in part that, “the umpire will either accept the valuation of the Applicant or Respondent.” as to whether the policy was underwritten with a building replacement cost endorsement. That issue went to trial. Justice Belzil was appointed as the case management judge. He was able to convince the policyholder that there was no replacement cost coverage on the building. The insured accepted that he had an actual cash value (ACV) policy with limits of $545,000. But what was the ACV? The case turned to determining the ACV. Key points raised by the insurer: 1. Two years prior to the loss, the insured purchased the property for $80,000. 2. A few months prior to the fire, the insured listed the property for sale at $109,500. 3. Prior to the fire, the insured agreed to sell the property for $105,000. The insured hired a real estate appraisal firm, which determined the ACV was $325,000. This matter was referred to the appraisal process under the Insurance Act, RSA 2000. The appraisers for both sides selected a respected lawyer as the umpire. The umpire made a decision that was agreed to by the insured’s appraiser. With two of three people in the process agreeing to a position the matter was concluded. The award was for $325,000. The insurer was not happy with the result. It filed an application for a “Judicial Review” of the umpire’s award. In 2008, the Supreme Court of Canada in (Dunsmuir v. New Brunswick) took significant steps to revamp the law relating to judicial reviews. They concluded there should be two standards of review for administrative decisions: 1. The deferential standard of review of reasonableness. 2. The standard of review of correctness, which is not differential. The judge determined in this case that the differential standard of review of reasonableness applies. In using this test, the judge reviewed a number of decisions relating to determination of ACV. The judge concluded that the umpire’s decision was based on evidence, was transparent and intelligible. It fell within a range of reasonable decisions that could be reached based on the evidence and the applicable law. 28 Claims Canada
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Case Summary It is interesting to note that the trial judge states in part that, “the umpire will either accept the valuation of the Applicant or Respondent.” A simple reading of this statement implies that the umpire was limited to picking one position over the other. In appraisal, an umpire is not restricted to picking one position versus the other. Usually, the process involves a form of mediation approach. This dialogue continues until two parties in the process agree on an outcome either on individual issues or the macro situation. This judgment does not give the impression that this type of process was followed. Rather, it seems the umpire chose to pick the position that provided, in his mind, the right solution. The actual process to arrive at the agreement of two parties is not spelled out in the Act. The process can be quite flexible and lead to a new number other than the initial starting point of either party. Collett et al and S. Szilvasy v. Reliance Home Comfort et al, Ontario Superior Court, J. Pardu, December 7, 2011 In two Small Claims Court decisions, the defendant was found liable for the failure of two hot water heaters. An appeal was launched, with both actions being consolidated for review by one judge. The first issue Justice Pardu dealt with was the “standard of review.” The plaintiff’s lawyers felt the standard of review was “correctness.” They relied on the 2009 Ontario Appeal Court decision in Bell Canada v. The Plan Group. Justice Pardu did not give this case much weight by pointing out that this appeal decision related to the interpretation of an arbitration provision in a written contract. Justice Pardu pointed out that: “In this case, ‘reasonableness’ lay at the heart of the issues before the trial judge.” He added: “the issues determined by the trial judge raised issues of mixed fact and law, and that a palpable and overriding error must be established to justify appellate intervention.” www.claimscanada.ca
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The judge then examined the facts of this case, which included: 1. All hot water tanks will corrode and eventually leak. 2. There was no plan in place to replace tanks before they leaked at any stage in their life span. 3. There was no process in place to determine when a tank actually might fail. 4. In this instance, the defendant had 1.2 million tanks leased out to customers. 5. In any given year, there was a .005% chance of a tank failure happening. 6. If any tank failed, the defendant would replace it. If it needed to be serviced, the defendant responded. They always retained ownership of the tank. The judge felt that it would be “illogical to conclude that there was not a continuing warranty as to the proper functioning of the tank.” Having reached that conclusion, Justice Pardu felt he was in no position to conclude that the lower court decision(s) involved a “palpable and overriding error.”
Case Summary It was interesting to see this appeal from a Small Claims Court judgment. There do not seem to be many appeals to this court level but, given the increase in limits to $25,000, perhaps we will see more in the future.
But for those who do experience such an event, it can be a life-altering moment. You leave with your eyes wide open, realizing just how high the bar is to become a true professional. You will approach your work differently in many ways, including: • The quality, volume and style of your note taking. • The method and quality of how you protect and preserve evidence. • The importance of proving that you have kept an open mind in your investigation. • Proving that you acted in good faith to the insurer at every step in your investigation (a different paradigm than defending bad faith allegations). • Proof that you have eliminated, or confirmed all investigative leads. • Recognition that rumor, innuendo and speculation are not evidence. I make these points because it is easy to read judgments and cast opinions from the bleachers. Trials take on a life of their own where the momentum can change quickly. What seemed like a good case for trial can collapse. The best way to manage this risk is by improving the professional quality of your work.
Concluding Thoughts Some adjusters consider themselves fortunate that they never have to get “in the box” and give evidence at a trial.
Glenn Gibson, CIP, CLA, FCIAA, CFE, CFEI, CFII-c, is the Chief Executive Officer of Crawford & Company Consulting (Canada).
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Regulating Health Care Clinics How Ontario Represents a Key Test Ground for Increased Supervision BY WILLIE HANDLER
The Auto Insurance Anti-Fraud Task Force appointed by the Ontario government has now completed its work and provided the Minister of Finance with its final report. One of the key sets of recommendations made by the Task Force involves the licensing of health care and assessment facilities operating in Ontario’s auto insurance sector.
Why is licensing needed? There are 21 health regulatory colleges in Ontario, with another 5 colleges about to come online in 2013. As many as 30,000 health professionals work in the auto insurance sector in some capacity. Although most professionals are regulated, the facilities in which they work are not. Health care facilities treating and assessing auto insurance claimants range from sole practitioners to publicly traded companies, from public hospitals to private offices, from regulated professionals to unlicensed providers. Little is known about these service providers other than the number of facilities that have registered with 32 Claims Canada
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Health Claims for Auto Insurance (HCAI) and the number of providers working in the facilities. Although the 2010 reforms have reduced costs in Ontario, premiums remain the highest in Canada and there is ongoing concern about how sustainable those reforms will be over time. Fraudulent or questionable business practices of clinics have contributed to the high cost of auto insurance in Ontario. These abuses have been well documented and include: billing for services not provided, identity theft and involvement in staged accident rings.
What are other jurisdictions doing? There is no Canadian jurisdiction that has developed a health facility licensing system for their auto insurance sector. There are few examples of health care facilities that are required to meet additional licensing and regulatory requirements beyond the regulatory requirements of an individual professional’s regulator college. In the U.S., state governments are responsible for licensing both health professions and health care facilities. The U.S. regulators are primarily focused on protecting the public and
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quality of care. Typically, facilities in many states are licensed, regulated, inspected, and/or certified by a number of public and private agencies at the state and federal levels. Many state governments also operate some form of fraud bureau usually under the auspices of the state Department of Insurance. The state fraud bureaus’ mandate is to detect, investigate and prevent insurance scams. Most fraud bureaus deal with all insurance fraud, but some investigate only certain types, such as workers compensation or auto insurance. The largest type of insurance fraud in the U.S. is health care fraud. Florida is the only state where a separate licensing regime has been created for facilities that receive auto insurance (referred to as personal injury protection or PIP) payments. Clinics are licensed by the Agency for Health Care Administration. However, many providers, such as clinics affiliated with medical schools, don’t need to be licensed. These requirements were introduced during the most recent legislative session and are effective July 1, 2012. Only licensed clinics are allowed to receive PIP reimbursements. Many www.claimscanada.ca
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of the so-called “pain clinics” taking on PIP claims were unlicensed, and law enforcement officials have demonstrated the link between unlicensed providers and staged accidents Two Florida counties have gone even further in an effort to combat fraud. Hillsborough County passed an ordinance in September 2011 and Miami-Dade County in February 2012 imposing additional licensing requirement on facilities operating in those jurisdictions. The National Insurance Crime Bureau reports a significant drop in fraud following the introduction of licensing requirements in Hillsborough County.
Features of a possible regulatory system 1. Barriers for facilities that wish to operate in the Ontario auto insurance system to ensure that business activities are conducted with high standards of market practice and integrity. 2. Those that fail to conduct themselves within acceptable standards should be subject to sanctions. Depending on the type and severity of non-compliance, sanctions would range from warnings to a prohibition from operating in the Ontario auto insurance sector. 3. A regulator (most likely FSCO) with appropriate powers to oversee the market conduct of facilities. 4. Develop HCAI into a regulatory tool to support FSCO. HCAI should only register facilities that have been licensed by FSCO and only licensed facilities should be able to bill auto insurers. 5. Improve the transparency of health care and assessment facilities in terms of ownership, the cost of services and conflicts of interest. An oversight model would include new disclosure requirements for facilities and their owners. 6. The health regulatory colleges would continue to be responsible for maintaining the clinical practice standards of the regulated health professionals employed by theses facilities. 7. Licences should be valid for one year and should be renewed by sub34 Claims Canada
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mitting an acceptable Annual Information Return.
Who should be licensed? There are 22 regulated professions (including social workers) working either in sole practices, group practices or multi-disciplinary treatment facilities. As of May 2012, there were 8,515 facilities registered on HCAI, although 1,291 had never submitted a document to the HCAI system. These facilities had collectively registered with HCAI a total of 29,537 health providers employed at their facility.
Facilities licensed by FSCO should be required to maintain a set of standards developed by FSCO. The standards should relate to the operational side of these businesses and not the clinical practice standard of the regulated health professionals employed by the facilities. A licensing system should cover all health care facilities and clinics whether they are sole practitioners or multi-disciplinary settings. However, a regulated health professional who is an employee of a facility should not require individual licensing.
Why should assessment facilities be licensed? Dissatisfaction with the assessment sector has been well documented. There are assessors who are deliber-
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ately facilitating a fraudulent claim by falsely establishing causation or impairment and by providing opinions outside their scope of competence or not based on scientific evidence. In some cases, an incompetent assessor may unintentionally be participating in fraud because of poor clinical or business practices. As well, there is a form of “doctor shopping” that occurs by both insurers and the plaintiff bar where clinicians with known beliefs are selected in the expectation of a specific opinion. These behaviours have put the assessment industry in disrepute. Requiring assessment facilities to be licensed by FSCO will have some impact, at least with respect to business practices.
Business practice standards Facilities licensed by FSCO should be required to maintain a set of standards developed by FSCO. The standards should relate to the operational side of these businesses and not the clinical practice standard of the regulated health professionals employed by the facilities. Regulated health professionals should continue to be accountable to their health regulatory college with respect to clinical practice standards and professional misconduct. Business practice standards should be a compilation of licensing requirements, regulatory requirements, HCAI terms and conditions and Superintendent guidelines and directives. The following are a number of proposed business practice standards: 1. No facility owner or clinical director shall have a felony conviction in the five years prior to submitting a licence application. 2. Facility owners must disclose to FSCO all conflicts of interests in relation to other business interests of the owners and their family members as it relates to insurance, health care and legal/paralegal representation. 3. If the facility conducts insurer examinations, all professional staff conducting the examinations shall have at least five years of applicable clinical experience and the cliniwww.claimscanada.ca
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cal director shall attest that the assessors work within their scope of practice. 4. A facility shall cooperate with compliance audits or investigations by a FSCO investigator, law enforcement officer or any other person authorized by FSCO to enforce compliance. 5 A facility shall file all fees with FSCO and shall not invoice for amounts that unreasonably exceed amounts charged by others for similar goods and services.
Sanctions for non-compliance FSCO should have a range of regulatory tools available to sanction facilities for non-compliance. The tools should include the ability to issue an order to a facility regarding deficient business practices, suspend or revoke a facility’s licence for non-compliance, impose an administrative penalty, charge a facility under the Provincial Offences Act and recommend criminal charge when suspected criminal activity is uncovered. Funding the licensing system Resources will be required to develop policies and programs, create the registration and licensing system, develop a web-based licence application, set up monitoring and compliance functions and train and develop enforcement capabilities. Licensing fees be established to fund the system without creating a financial barrier for facilities and practitioners. Licensing fees should be sufficient to cover the majority of the costs associated with the proposed licensing system. But recognizing that the insurance industry will benefit from the new system therefore, the industry should be expected to bear some of the costs through their FSCO assessments. Challenges The size of the rehabilitation sector (over 8,500 facilities are registered with HCAI) is likely the biggest challenge in establishing a licensing system. The rehabilitation sector has been undergoing some contraction and introducing a licensing system may bring about some further contraction. Still, www.claimscanada.ca
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a licensing system for a sector this size will need to be automated. It is unclear whether auto insurance stakeholders are all supportive of these changes. The cost of doing business for providers will go up while revenues have been falling. Some facilities will welcome these changes if it will eliminate fraudulent operators from the sector. The political environment may also pose a challenge. Introducing a licensing system will require legislative and
regulatory changes. However, the Ontario government is currently going through a period of renewal and it is unclear whether there is political will to see these reforms through. Willie Handler is a consultant with Willie Handler and Associates, and was involved in researching and preparing the Ontario Auto Insurance Anti-Fraud Task Force’s report.
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Big Brother 2013
Event data recorders, aka vehicle “black boxes,” are at a tipping point BY MARK FABBRONI
Over the past 15 years, the topic of motor vehicle “black boxes” has been discussed and written about ad nauseam in industry circles, and with good reason. The technology has changed the science of accident reconstruction and provided invaluable insight into driver behaviour in the moments leading up to a collision. However, it would be foolish to believe based on the past that the biggest changes are behind us, and that we have a full understanding of the black box effect. In fact, it is now that we are reaching the true tipping point for the technology. For years we have been told that regulatory changes in the United States would one day push more manufacturers to provide access to the coveted data in their event data recorders (‘EDR’s, i.e. ‘black boxes’), and that changes would be mirrored in Canada. Despite some delays, that day has finally come and gone. In its wake it is worthwhile to review what has changed and why. The changes were spelled out in the National Highway Traffic Safety Association (NHTSA) Final Ruling on the matter contained in the United States Code of Federal Regulations The scope of the regulation is best spelled out within the code itself: 36 Claims Canada
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“This part specifies uniform, national requirements for vehicles equipped with event data recorders (EDRs) concerning the collection, storage, and retrievability of onboard motor vehicle crash event data. It also specifies requirements for vehicle manufacturers to make tools and/or methods commercially available so that crash investigators and researchers are able to retrieve data from EDRs.” The code requires that if an automaker manufactured a vehicle which was equipped with an EDR on or after September 1, 2012, then the data in the EDR must comply to the standards in the code, and perhaps most importantly to our industry: “Each manufacturer of a motor vehicle equipped with an EDR shall ensure by licensing agreement or other means that a tool(s) is commercially available that is capable of accessing and retrieving the data stored in the EDR that are required by this part. The tool(s) shall be commercially available not later than 90 days after the first sale of the motor vehicle for purposes other than resale.” Thus, as of December 1, 2012 the days of automakers being the only ones with access to black box data, which in some cases had been secretly recorded, were over. The playing field
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was officially levelled. There was, however, a catch: the code does not require automakers to install EDRs in their vehicles, it only controls what must happen if they do. So if an automaker chooses not to install an EDR device in the vehicles it manufacturers, then it is of course under no obligation to provide a commercially available tool to extract data from the nonexistent event data recorder. These changes to the governing regulations essentially forced all manufacturers to make a choice: release a tool to allow others to readily access and download the information stored in their EDRs, or do not install EDR devices in their vehicles at all. Because the regulatory changes involved input from the manufacturers and were in the works for years, the manufacturers were aware of the changes well in advance. While some chose to adapt to the changes and introduced tools years ago, others waited until the very end. Ultimately, the decisions that were made can essentially be split along geographic boundaries: the Japanese manufacturers joined the North American manufacturers that had already released their tools years ago, while the European and Korean manufacturers chose to sit this one out. The result is the present state of the technology (which may well be out of www.claimscanada.ca
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date by the time you read this article). As of the time of writing, commercially available tools are capable of downloading EDR data from select models made by the following manufacturers: Acura, BMW, Buick, Cadillac, Chevrolet, Chrysler, Dodge, Fiat, Ford, GMC, Geo, Holden, Honda, Hummer, Infiniti, Isuzu, Jeep, Lancia, Lexus, Lincoln, Mazda, Mercury, Mitsubishi, Nissan, Oldsmobile, Opel, Pontiac, Rolls-Royce, Saab, Saturn, Scion, Sterling, Suzuki, Toyota, and Volvo. This list represents approximately 77% of the vehicles sold in Canada in 2012, according to sales data collected by Desrosiers Automotive Consultants Inc. If Hyundai/Kia were to make the decision to follow suit by installing EDRs in their vehicles, that number would instantly jump to almost 90%. This is a point worth reflecting on for a moment: going forward, at least three out of every four vehicles sold in Canada will contain some form of black box that can be interrogated after a collision to provide useful information about what was happening in the moments leading up to the crash. With so many black boxes in the general vehicle population, imagine how many will start to show up in the claims you handle every day. In the very near future, it will be almost impossible for at least one vehicle in a multi-vehicle collision to not contain a black box that can help answer the questions surrounding the collision. In fact, it will become increasing likely that every vehicle involved in a multi-vehicle collision will be equipped with a black box that can be readily accessed by a trained professional. The explosion of this technology clearly has very real consequences for our industry. It is now crucial to have plans in place for the extraction and secure storage of black box data after a motor vehicle collision has occurred in order to ensure that a full picture of what happened is obtained and to avoid allegations of evidence spoliation. The good news is that thanks to the new regulations, the extraction www.claimscanada.ca
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process is possible without the involvement of the original equipment manufacturers, thus making it quick and cost-effective while producing valuable evidence in a digital format that is cheap and easy to store. As for the contents and interpretation of the extracted data, that is a topic that would fill volumes rather than pages, and is perhaps the most diverse and rapidly changing part of the technology. Those changes are sure to
continue as the technology continues to evolve. The best and most powerful information from these data recorders may be yet to come, however it is unlikely that we will ever experience such a rapid, wide-spread expansion in the availability of EDR data as we have over the past six months. Mark A. Fabbroni, B.A. Sc., M.A. Sc., P. Eng., is a Forensic Engineer with Giffin Koerth Inc.
Bersenas, Jacobsen, Chouest, Thomson, Blackburn LLP BARRISTERS, SOLICITORS
We advise and act for a large number of domestic and international insurers and for their insureds in our areas of specialty, which include: • Professional Liability & Indemnity • Transportation • Media, Libel & Slander • Financial Institutions
• Directors and Officers • Fidelity and Surety • Property and Casualty • Surplus and Reinsurance
The services that we provide include: · representation of insureds in defending litigation of claims that are subject to insurance coverage; · representation of underwriters’ interests in monitoring litigation conducted by other counsel and providing second opinions regarding the conduct of such litigation; · advice regarding coverage matters and representation of insurers and insureds in coverage disputes; · advice to insurers regarding licensing and regulation, including advice to foreign insurers interested in participating in the Canadian marketplace; and · policy drafting and interpretation.
V.R.P. (Sas) Bersenas • Peter M. Jacobsen • Gerard A. Chouest • James P. Thomson Janice E. Blackburn • James R. Lane • Carlos Martins • Adrienne Lee • Tae Mee Park Ioana Bala • Christopher C. Dearden • Andrew MacDonald For information contact: James P. Thomson jthomson@lexcanada.com 416-982-3805
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Claims Canada 37
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Minding the
Millennials
Understanding, Motivating and Retaining the New Generation Workforce BY GINO FIORUCCI
The new generation workers, aka ‘Generation Y’ or ‘Millennials,’ seem to change jobs annually. We see it every day; we hire a twenty something year old and within one year, he or she is gone. We run into the same person five years later and find he or she has changed jobs four times since we last worked together. What happened to the stalwart individuals who worked at one company for 25 years? During the next few years, we will see an unprecedented number of Baby Boomers retiring. There will actually be more Gen Xers retiring than Gen Yers coming into the workforce. With the smaller number of Gen Yers coming into the workforce, there will be a shortage of workers and the competition to attract and keep new employees will be greater than ever. Nowhere is this trend as prevalent as in the insurance industry! Like it or not, the insurance industry will be competing to hire and retain Gen Y employees. HR policies will have to be revised in order to attract and motivate this group. Here are my observations of the key traits of Millennials – and some ideas on how to retain them as part of your employee team. The first step to attract, motivate and retain Millennials is to understand what makes this generation tick. Born between the years of 1982 and 2000, some of the significant events they experienced were the Air India bombing, Persian Gulf War, the unraveling of the banking industry, Canada US Trade agreement and 9-11, just to name a few. Most Millennials have been around computers, the Internet and mobile devices for the majority of their lives. They live in a world of constant immediate interaction and
prefer to communicate with a device rather than in person. Their work and personal lives are blended and they believe there must be a higher purpose in what they are doing, both personally and professionally. Another interesting, but not surprising, fact is that data from 2011 census shows that 42% of adult children between the age of 20 and 29 are living with their parents, as opposed to 27% in 1991. Some challenges faced by Millennials are independence, work ethic, realistic expectations, patience and communication. The fact that this generation is perpetually connected to their parents, peers and friends hinders their ability to make decisions on their own. Millennials are more interested in lifestyle than working overtime and are not interested in personal sacrifice to advance their career. At the same time, there is a disconnection between effort and outcome. They believe a university degree entitles them to a six-figure salary with a corner office… on their first day! Spending most of their lives in front of a computer or mobile device, Millennials have poor face-to-face communication skills and prefer online communication (email, text, BBM). Now, for the good news on this generation. Since they are tech savvy, they can definitely find information needed to complete any assignment. This comes with one caveat; they believe if something is not on the In-
The ‘Generation Y’ workers seem to change jobs annually.
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www.claimscanada.ca
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“CIAA is dedicated to fair practice and integrity on all claims-related services” To contact the member firms below go to www.ciaa-adjusters.ca/find.asp NOVA SCOTIA Action Investigations Incorporated Dartmouth AMG Claims Inc. Halifax ASAP Claims Adjusting Limited Sydney Crawford & Company (Canada) Inc. Halifax/Dartmouth Kentville Stellarton Sydney Yarmouth Fundy Adjustment Bureau Ltd. Yarmouth Granite Claims Solutions Halifax Sydney Kernaghan Adjusters Limited Halifax Sydney Marsh Adjustment Limited Antigonish Bridgewater Halifax Kentville Lawrencetown Sydney Truro Yarmouth G.E. Morgan Adjusters Limited Halifax N.S. TASKS Ltd. Truro
NEW BRUNSWICK AMG Claims Inc. Fredericton Crawford & Company (Canada) Inc. Bathurst Fredericton Grand Falls Moncton Saint John Granite Claims Solutions Moncton Greater Moncton Adjustment Bureau Inc. Moncton C. Landry Adjustment Ltd. Caraquet Lawrence & Associates Ltd. Fredericton Marsh Adjustment Limited Bathurst Moncton Plant Hope Adjusters Ltd. Bathurst Campbellton Edmundston Fredericton Grand Falls Miramichi Moncton Saint John Robichaud Claims Services Cocagne Young’s Claim Service Moncton
PRINCE EDWARD ISLAND CKS Holdings Inc. Charlottetown Crawford & Company (Canada) Inc. Charlottetown DeLong & Associates Inc. Charlottetown Summerside Granite Claims Solutions Summerside Prince Edward Claims Services Inc. Charlottetown NEWFOUNDLAND Best Elliott Consulting St. John’s Colonial Adjusting & Appraisal Services St. John’s Crawford & Company (Canada) Inc. Mount Pearl Penninsula Adjusting Services Ltd. Marystown Pike and Associates Adjusting Ltd. Holyrood
For more information about membership in CIAA, our professional standards or our goals and objectives, please call one of our Regional Officers…. NS President – Grant King • 902-468-7787 or Grant.King@crawco.ca NB/PEI President – Luc Aucoin • 506-853-8500 or laucoin@planthope.com NL President – Marcel Pitcher • 709-753-6351 or Marcel.Pitcher@crawco.ca Canadian Independent Adjusters’ Association 5401 Eglinton Avenue West, Suite 100 Etobicoke, ON M9C 5K6 Phone: (416) 621-6222 Fax: (416) 621-7776 E-mail: info@ciaa-adjusters.ca Website: www.ciaa-adjusters.ca
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ibility in their work schedules. This could ternet, it does not exist. Millennials also take the form of a four-day workweek, summer can get along well with members of diverse hours or flex scheduling. Since their lifestyle is groups. Again, this stems from their early convery important to them, these practices could help nection with technology and social media, which keep them in your employ versus moving to the comhas no geographic, social, religious or race limitapetition. tions. Another way to retain the Gen Y generation is to Since they are not used to making independent offer growth opportunities. Of course, career addecisions, they enjoy working in teams and, in turn, vancement and educational oppormake great team members. Worktunities are important, but this is ing on multiple projects is second Keeping this group more about personal growth. Renature for this young group. They happy and employed with lationships are very important to have grown up with many things your company will definitely Millennials. Working in a friendly going on around them at once, so multi-tasking comes easy. Millen- reap bottom line rewards and relaxed culture that promotes idea sharing is something Millennials nials are cause-driven and want to will be a competitive enjoy. They want to become friends be part of a ‘movement’ and ‘make advantage in the long run. with people they work with and a difference.’ Going green and being eco-friendly is something they can work with their friends. They enjoy get behind. Just recently, the Occugetting together with co-workers py movement made headlines and it outside business hours. They want comes as no surprise that the majorto have a great boss who is not only ity of participants were Millennials. friendly but also a mentor who will A better understanding of the take interest an in their entire career. The boss should provide conGen Y group should lead to better ways to engage and retain them. One great way is to offer stant feedback and allow opportunities for socializing with them more time, as in vacation, holidays, personal time and others in the office. Another opportunity that will help retain Millennials is paid time off. Another form of time management is flexallowing them to be part of a cause, providing a sense of purpose. This can be achieved through paid time off to volunteer at a charity, organized food drive or fundraiser. 24 hr - 365 Days Immediate The reality is that there is a need to hire and retain memspill response and bers of this new generation workforce. We have to learn to remediation services. manage their wants and needs. Although some of these tips Excavating services, would be a good policy when dealing with all staff, they haulage, disposal, restoration and clean up. are particularly effective with Gen Yers. Genuine interest must be shown when dealing with this group. They must Excavating equipment, dump truck and bins, feel you are interested. Stop typing, don’t answer the phone compact equipment, and make them your sole point of focus. Create more oppower generators, water pumps, traffic portunities for teamwork. This will ensure they can work control equipment and with their ‘friends.’ fleet of equipment to Follow the Platinum Rule versus the Golden Rule – treat cover every aspect of remediation. others like they would like to be treated, not how you would like to be treated. A Baby Boomer or Gen Xer does not want FREE consultation and quotation for any size the same things a Millennial wants. It is also important to project. acknowledge and reward good behaviour. Most importantMain: 519-732-3015 ly, create a work culture that they enjoy with many opportunities for socialization; one where getting the job done is 24 Hr Emergency Response: 519-209-5947 / 519-771-6220 more important than a fixed work schedule. Times are changing. The insurance industry must adapt www.kgservice.ca its workplace to accommodate the Gen Y workforce. KeepLicensed by MTO, MOE and MOL. Compliance approval by MOE. ing this group happy and employed with your company will definitely reap bottom line rewards and will be a competitive advantage in the long run. Always remember, if Gen Yers don’t like where they work, they will gladly quit and just hang out with their roommates: Mom and Dad. Your Environmental Remediation Specialist
Gino Fiorucci is the CEO of ISB Canada. 40 Claims Canada
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National Standing Committees 2012-2013 ADVISORY Marie C. Gallagher, FCIP, CRM Granite Claims Solutions 71 King Street, Suite 204 St. Catharines, ON L2R 3H7 Phone: (905) 984-8282 Fax: (905) 984-8290 E-mail: marie.gallagher@graniteclaims.com E. Grant King, BA, B.Ed., CIP Crawford & Company (Canada) Inc. 120 – 237 Brownlow Avenue Dartmouth, NS B3B 2C7 Phone: (902) 468-7787 Fax: (902) 468-5822 E-mail: Grant.King@crawco.ca
John M. Sharoun, FIIC, CFE, FCIAA Crawford & Company (Canada) Inc. 300 – 123 Front Street West Toronto, ON M5J 2M2 Phone: (416) 867-1188 Fax: (416) 867-1925 E-mail: John.Sharoun@crawco.ca Dennis N. Schembri, CIP, CFEI Granite Global Solutions 133 King Street East, 3rd Floor Toronto, ON M5C 1G6 Phone: (647) 789-2438 Fax: (647) 789-2449 E-mail: dennis.schembri@graniteglobalsolutions.com
Greg G. Merrithew, CIP, FIFAA Arctic West Adjusters Ltd. 201 – 5204 – 50 Ave. Yellowknife, NT X1A 1E2 Phone: (867) 920-2212 Fax: (867) 873-2244 E-mail: gregm@arcticwest.ca
Jo-Ann Eccleston, CIP Aviva Canada Inc. 2206 Eglinton Ave. East Toronto, ON M1L 4S8 Phone: (416) 689-3328 Fax: 1-866-805-8585 E-mail: jo-ann_eccleston@ avivacanada.com
James B. Eso, BA, CIP Crawford & Company (Canada) Inc. 539 Riverbend Drive Kitchener, ON N2K 3S3 Phone: (519) 578-5540 Fax: (519) 578-2868 E-mail: Jim.Eso@crawco.ca
Bob Grouchy, BA, FCIP, CRM Allianz Global 1600 – 130 Adelaide Street West Toronto, ON M5H 3P5 Phone: (416) 915-4247 Fax: (416) 849-4555 E-mail: bob.grouchy@agr.allianz.ca
John Jones, BA Granite Claims Solutions Suite 300, 5915 Airport Road Mississauga, ON L4V 1T1 Phone: (905) 671-3164 Fax: (905) 671-1889 E-mail: john.jones@graniteclaims.com
Carol Jardine, FCIP, CRM TD Insurance 2161 Yonge Street, 4th Floor Toronto, ON M4S 3A6 Phone: (416) 486-2507 Fax: (416) 545-6022 E-mail: Carol.Jardine@tdinsurance.com
Craig J. Walker, CIP, FCIAA, FIFAA Maltman Group International 3550 Victoria Park Ave., Suite 301 Toronto, ON M2H 2N5 Phone: (416) 492-4411 Fax: (416) 492-5657 E-mail: cwalker@maltmans.com
Justin J. MacGregor Martin Merry & Reid Limited 3 Church Street, Suite 404 Toronto, ON M5E 1M2 Phone: (416) 366-3333 Fax: (416) 366-0730 E-mail: jmacgregor@mmr.ca
CIAA NATIONAL INSURANCE INDUSTRY ADVISORY BOARD Patti M. Kernaghan, FCIP, CRM Kernaghan Adjusters Limited 300 - 1575 West Georgia Street Vancouver, BC V6G 2V3 Phone: 1-800-387-5677 Fax: 1-800-387-5644 E-mail: pkernaghan@kernaghan.com
Mark Stewardson, FCIP Royal & SunAlliance 2225 Erin Mills Parkway, Suite 1000 Mississauga, ON L5K 2S9 Phone: (905) 403-2333 Fax: (905) 403-2326 E-mail: Mark.Stewardson@rsagroup.ca
John D. Seyler, CIP ProFormance Group 5080 Timberlea Blvd., Suite 214 Mississauga, ON L4W 4M2 Phone: (905) 238-4985 Fax: (905) 238-2735 E-mail: jseyler@prospecialty.ca Marie C. Gallagher, FCIP, CRM Granite Claims Solutions 71 King Street, Suite 204 St. Catharines, ON L2R 3H7 Phone: (905) 984-8282 Fax: (905) 984-8290 E-mail: marie.gallagher@graniteclaims.com Greg G. Merrithew, CIP, FIFAA Arctic West Adjusters Ltd. 201 – 5204 – 50 Ave. Yellowknife, NT X1A 1E2 Phone: (867) 920-2212 Fax: (867) 873-2244 E-mail: gregm@arcticwest.ca Craig J. Walker, CIP, FCIAA, FIFAA Maltman Group International 3550 Victoria Park Ave., Suite 301 Toronto, ON M2H 2N5 Phone: (416) 492-4411 Fax: (416) 492-5657 E-mail: cwalker@maltmans.com Patricia M. Battle Canadian Independent Adjusters’ Association/L’Association Canadienne des Experts Indépendants 5401 Eglinton Ave. West, Suite 100 Etobicoke, ON M9C 5K6 Phone: (416) 621-6222 Toll Free: 1-877-255-5589 Fax: (416) 621-7776 E-mail: pbattle@ciaa-adjusters.ca
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Mark Weir Intact Financial Corporation 700 University Avenue, 13th Floor Toronto, ON M5G 0A1 Phone: (416) 341-1464 Fax: (416) 217-0562 E-mail: mark.weir@intact.net Peggy Wong, CIP The Economical Insurance Group 111 Westmount Road South Waterloo, ON N2J 4S4 Phone: (519) 570-8500 Fax: (519) 570-8690 E-mail: Peggy.Wong@teig.com CAREER RECRUITMENT PLANNING Richard Swierczynski, BA, CIP AZ Claims Services Inc. 1500 Upper Middle Rd., Unit #3 P.O. Box 76041 Oakville, ON L6M 3G3 Phone: (905) 825-0027 Fax: (905) 825-5543 E-mail: Richard@azclaims.ca COMMUNICATIONS Teresa Mitchell, FCIP, CRM, FCLA, FCIAA, FIFAA Crawford & Company (Canada) Inc. 14 – 431 Bayview Drive Barrie, ON L4N 8Y2 Phone: (705) 728-5597 Fax: (705) 728-2167 E-mail: Teresa.Mitchell@crawco.ca CONSTITUTION & RULES John Jones, BA Granite Claims Solutions Suite 300, 5915 Airport Road Mississauga, ON L4V 1T1 Phone: (905) 671-3164 Fax: (905) 671-1889 E-mail: john.jones@graniteclaims.com
CONVENTION David S. Riddell, FCIP, CRM Canadian Claims Services 17958 – 106 Avenue Edmonton, AB T5S 1V4 Phone: (780) 443-1185 Fax: (780) 443-1893 E-mail: driddell@canclaims.com DESIGNATION Paul W. Greening, CLA, FCIAA Greening Aviation Claims Inc. 26C Palliser Park, Box 190 Riverhurst, SK S0H 3P0 Phone: (306) 353-2000 Fax: (306) 353-2200 E-mail: pgreening@sasktel.net E. Brian Gough, FCIP, CLA, FCIAA Marsh Adjustment Bureau Limited 1550 Bedford Highway, Suite 711 Bedford, NS B4A 1E6 Phone: (902) 469-3537 Fax: (902) 469-2396 E-mail: ebgough@marshadj.com Robert V. Pearson, CLA, FCIAA Hansen Labelle Adjusters Ltd. 1328 17th Avenue N.W. Calgary, AB T2M 0R1 Phone: (403) 284-2211 Fax: (403) 284-2299 E-mail: bob@hansenlabelle.ca DISCIPLINE Greg G. Merrithew, CIP, FIFAA Arctic West Adjusters Ltd. 201 – 5204 – 50 Ave. Yellowknife, NT X1A 1E2 Phone: (867) 920-2212 Fax: (867) 873-2244 E-mail: gregm@arcticwest.ca EDITORIAL Mary Charman, CIP Crawford & Company (Canada) Inc. 1 – 120 Mulock Drive Newmarket, ON L3Y 7C5 Phone: (905) 898-0008 Fax: (905) 898-1705 E-mail: Mary.Charman@crawco.ca John M. Sharoun, FIIC, CFE, FCIAA Crawford & Company (Canada) Inc. 300 – 123 Front Street West Toronto, ON M5J 2M2 Phone: (416) 867-1188 Fax: (416) 867-1925 E-mail: John.Sharoun@crawco.ca EDUCATION Santo Carbone, CRM, FCIAA Crawford & Company (Canada) Inc. 300-123 Front Street West Toronto, ON M5J 2M2 Phone: (416) 364-6341 Fax: (416) 435-0546 E-mail: Santo.Carbone@crawco.ca EMERGENCY MEASURES Richard Van Horne Action Investigations Inc. 2 Catelina Court Dartmouth, NS B2X 3G9 Phone: (902) 462- 1222 Fax: (902) 462-3688 E-mail: richardvanhorne@actioninvestigations.ca FINANCE Russell Fitzgerald, CIP Kernaghan Adjusters Limited 203 – 4246 97 Street N.W. Edmonton, AB T6E 5Z9 Phone: (780) 488-2371 Fax: (780) 488-0243 E-mail: rfitzgerald@kernaghan.com John D. Seyler, CIP ProFormance Group Inc. 5080 Timberlea Blvd., Suite 214 Mississauga, ON L4W 4M2 Phone: (905) 238-4985 Fax: (905) 238-2735 E-mail: jseyler@prospecialty.ca Greg G. Merrithew, CIP, FIFAA Arctic West Adjusters Ltd. 201 – 5204 – 50 Ave. Yellowknife, NT X1A 1E2 Phone: (867) 920-2212 Fax: (867) 873-2244 E-mail: gregm@arcticwest.ca
IBC: LIAISON, LEGISLATIVE & FORMS Paul Hancock, B.Sc., CIP Crawford & Company (Canada) Inc. 300 – 123 Front Street West Toronto, ON M5J 2M2 Phone: (416) 867-1188 Fax: (416) 867-1925 E-mail: Paul.Hancock@crawco.ca LICENSING J. Miles O. Barber, B.Comm. (Hons.), FCIP, CRM Network Adjusters Ltd. 67 Folkestone Blvd. Winnipeg, MB R3P 0B4 Phone: (204) 897-5793 Fax: (204) 897-5797 E-mail: mbarber@mts.net MEMBERSHIP & QUALIFICATIONS Georgiana Chen, CIP ProFormance Group Inc. 1101 Kingston Rd., Suite 280 Pickering, ON L1V 1B5 Phone: (877) 539-3111 Fax: (905) 554-3776 E-mail: gchen@proadjusting.ca NOMINATING Greg G. Merrithew, CIP, FIFAA Arctic West Adjusters Ltd. 201 – 5204 – 50 Ave. Yellowknife, NT X1A 1E2 Phone: (867) 920-2212 Fax: (867) 873-2244 E-mail: gregm@arcticwest.ca John D. Seyler, CIP ProFormance Group Inc. 5080 Timberlea Blvd., Suite 214 Mississauga, ON L4W 4M2 Phone: (905) 238-4985 Fax: (905) 238-2735 E-mail: jseyler@prospecialty.ca James B. Eso, BA, CIP Crawford & Company (Canada) Inc. 539 Riverbend Drive Kitchener, ON N2K 3S3 Phone: (519) 578-5540 Fax: (519) 578-2868 E-mail: Jim.Eso@crawco.ca Craig J. Walker, CIP, FCIAA, FIFAA Maltman Group International 3550 Victoria Park Ave., Suite 301 Toronto, ON M2H 2N5 Phone: (416) 492-4411 Fax: (416) 492-5657 E-mail: cwalker@maltmans.com PRIVACY James B. Eso, BA, CIP Crawford & Company (Canada) Inc. 539 Riverbend Drive Kitchener, ON N2K 3S3 Phone: (519) 578-5540 Fax: (519) 578-2868 E-mail: Jim.Eso@crawco.ca Keith P. Edwards, FCILA, CLA, FUEDI-ELAE CIAA Honorary Life Member c/o CIAA National Office 5401 Eglinton Ave. W., Suite 100 Etobicoke, ON M9C 5K6 Phone: (416) 621-6222 Fax: (416) 621-7776 E-mail: info@ciaa-adjusters.ca
CIAA REGIONAL PRESIDENTS 2012 – 2013 NEWFOUNDLAND & LABRADOR Marcel Pitcher, CIP, CRM Crawford & Company (Canada) Inc. 96 Clyde Avenue, Suite 100 Mount Pearl, NL A1N 4S2 Phone: (709) 753-6351 Fax: (709) 753-6129 E-mail: Marcel.Pitcher@crawco.ca NOVA SCOTIA E. Grant King, BA, B.Ed., CIP Crawford & Company (Canada) Inc. 120 – 237 Brownlow Avenue Dartmouth, NS B3B 2C7 Phone: (902) 468-7787 Fax: (902) 468-5822 E-mail: Grant.King@crawco.ca NEW BRUNSWICK & PRINCE EDWARD ISLAND Luc Aucoin, BBA, FCIP Plant Hope Adjusters Ltd. 85 Englehart Street Dieppe, NB E1A 8K2 Phone: (506) 853-8500 Fax: (506) 853-8501 E-mail: laucoin@planthope.com QUEBEC/AESIQ Charles A. Berthiaume Reclamations C. Berthiaume 44, Chemin d’Oka Saint-Eustache, QC J7R 1K5 Phone: (450) 491-6165 Fax: (450) 491-6230 E-mail: rcb@reclamationscberthiaume.ca ONTARIO Teresa Mitchell, FCIP, CRM, FCLA, FCIAA, FIFAA Crawford & Company (Canada) Inc. 14 – 431 Bayview Drive Barrie, ON L4N 8Y2 Phone: (705) 728-5597 Fax: (705) 728-2167 E-mail: Teresa.Mitchell@crawco.ca MANITOBA Timothy W. Bromley J.P. Hamilton Adjusters Ltd. 125 Enfield Crescent Winnipeg, MB R2H 1A8 Phone: (204) 944-1057 Fax: (204) 944-1606 E-mail: tbromley@mts.net SASKATCHEWAN Cheryl Hanson Crawford & Company (Canada) Inc. 210 – 227 Primrose Drive Saskatoon, SK S7K 5E4 Phone: (306) 931-1999 Fax: (306) 931-2212 E-mail: Cheryl.Hanson@crawco.ca WESTERN Russell Fitzgerald, CIP Kernaghan Adjusters Limited 203 – 4246 97 Street N.W. Edmonton, AB T6E 5Z9 Phone: (780) 488-2371 Fax: (780) 488-0243 E-mail: rfitzgerald@kernaghan.com PACIFIC David Porter, LL.B., FCIP, CRM Granite Claims Solutions 400-4370 Dominion Street Burnaby, BC V5G 4L7 Phone: (604) 699-6550 Fax: (604) 659-6570 E-mail: david.porter@graniteclaims.com
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Against Their Better Judgement
Why Insurers Should Love the Accounting Report Benefit BY MICHAEL SIGSWORTH AND DARRELL SHERMAN
Relying on an insured’s accountant to prepare an Income Replacement Benefit (IRB) report? That’s like letting the fox guard the henhouse, isn’t it? Yet what initially looks like just another expense for insurers to cover, may turn out to be a quicker, easier and more comprehensive way to obtain the information necessary to determine an entitlement to and calculation of an IRB. This is not your standard accounting article. Only two years after the new SABS was introduced, there are no current decisions on which to base this article. Instead we give you our thoughts on what we are doing, seeing and responding to what we call the Accounting Report Benefit (ARB), and how we believe insurers can best utilize this section. The Accounting Report Benefit is named for its value to insurers, as much as for insureds. In September 2010, the new SABS introduced the ARB, subsections 7(4) and (5). The ARB requires an insurer to pay for an incurred expense for the preparation of a report calculating the insured’s income from either employment or self-employment. However, there are conditions. 1) The insured is applying for an IRB that is based on the employment considered in the report. 2) A licensed accountant has prepared the report. 3) The expense is reasonable and necessary. And, 4) the insurer is not required to pay in excess of $2,500. 42 Claims Canada
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For the insured, this coverage is a great addition. We often hear grumblings about underpaid or unpaid IRBs, or the length of time required to perform the calculation. While the dissatisfaction is sometimes justified, the insureds’ complaints often really stem from their mistaken notion that IRBs are intended to fully cover lost income or lost opportunity. Those in the industry know this is not the case. But whether a payment to assist with the insured’s tax preparation when funds are low or having an IRB calculated with their consultation and involvement, the ARB gives insureds a voice and a central role that they may not have otherwise felt they had.
Four Key ARB Benefits Our understanding that the ARB is a benefit to insurers is predicated on the fact that an insurer’s goal, when calculating the IRB, is to achieve the correct calculation at a reasonable cost with the greatest efficiency and without undue animosity.
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The following are 4 key reasons the insurer should love the ARB for selfemployed insureds – the group for which we are seeing this benefit most often used.
Access to the insured One of the biggest problems when dealing with represented insureds is the lack of access often afforded the insurer. Addressing this point, although in an indirect manner, is likely the biggest advantage of the ARB for insurers. The ARB provides for a licensed accountant to access the insured in a way that often isn’t otherwise available early in the claims process. Now, before requesting a single document, the insurer has answers that otherwise could have required months and many exchanges to obtain. This leaves the insurer in a position to focus on the issues, rather than the minutiae.
Co-operative approach In an ideal world, the insurer and insured can work together to find the correct solution when funds are most www.claimscanada.ca
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urgently needed. But this ideal is not achieved as often as we would all hope. We are now experiencing an increased level of co-operation when working directly with insureds, which we rarely saw during the many years we worked solely on behalf of insurers. Not only do we get direct access, but we get assistance, guidance, background, and follow-up. The insured feels a part of the process, and this feeling shows itself in how the insured interacts with us. This increased sense of involvement and collaboration is most certainly carrying forward to the adjuster’s desk, at least until the focus of issues begins to narrow.
Reduced Turnaround time The accountant working on behalf of the insured has a distinct advantage in moving the IRB process ahead at a much quicker pace than the insurer. The points above – access and a cooperative approach – both play a role, in addition to documentation requests that are limited to only what is truly necessary because the facts are better understood from the outset. The result: a quicker and accurate payment to the insured, and less back and forth for the adjuster. Cost saving You are probably chuckling now. Okay, maybe you will buy all the previous points we’ve made, but cost saving? Not likely. Bear with us. Let’s start with “time is money.” An unhappy insured and rep can absorb a lot of time, as can dealing with multiple exchanges of requests. But the ARB shifts much of this work to the insured’s accountant, who is working collaboratively with the insured and under a fee cap. And while there are still steps the adjuster has to take, the file can progress without the early hiring of an accountant by the insurer just to chase documentation that is already being collected. Of course, this cost saving, both adjusters time and insurer’s accounting fees, are offset by the fee for the ARB, but here “reasonable and necessary” plays a role. That brings up our last point about cost savings. We continue to see reports being prepared from scratch www.claimscanada.ca
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by insurer’s accountants, after the insured has presented a report. The result: an insurer pays for two calculations. We are suggesting to our insurer clients that a review or critique would suffice. The documentation has been collected, the back story provided, the calculations laid out. You’re in a position to focus on the issues and discuss the impact, and these reports should cost substantially less.
Getting the Most out of the ARB We believe that the starting point for an insurer is to outline their expectations at the outset, when notified that the insured has retained an accountant. The following are our suggestions, based on what we have seen.
While it is unlikely that the documentation will always be as comprehensive as the insurer may wish, with more background available, it is now appropriate to determine whether the calculation presented is reasonable. Established up front, these could arguably be the basis for “reasonable and necessary.”
The Reports Similar to the expectations of an insurer’s accountant, reports outlining the IRB should be written in accordance with the SABS and current decisions. The reports need to be clear, concise and easy to read, as all parties, including the insured, should be able to understand them. Of course, not all interpretations will be the same, so transparency is critical. The insurer should expect that the key points and issues are clearly laid out, and all methodologies supported.
Documentation The documentation collected by the insured’s accountant should be made available to the insurer. Without this key evidence, the main benefits of the ARB to the insurer no longer exist. While it is unlikely that the documentation will always be as comprehensive as the insurer may wish, with more background available, it is now appropriate to determine whether the calculation presented is reasonable (McLellan and Aviva, FSCO A06 B001263). Collaboration Differences in interpretation do occur. While this process can become adversarial, it is not intended to be so when dealing with one’s own insurer or insured. So, here’s one final and important recommendation – request that communication takes place between the opposing accountants. While clearly not common practice within this industry, in most situations when we have been requested to meet or discuss with the opposing accountant, it is our experience that the two parties are able to close the gaps considerably on the issues. Take advantage of this great opportunity made available by the ARB. The ARB can open up possibilities to overcome obstacles that have hindered insurers during the early stages of a claim, in what is becoming a more litigious environment. By clearly laying out the expectations when an insured retains an accountant, much the same as would be done for an insurer’s own accountant, the insurer can obtain a level of value that may have otherwise been difficult. So in answer to our initial question about the fox guarding the henhouse – we believe that rather than it being the case of a predator protecting the insurer’s interests, you should harness the adeptness, agility and adaptability of the fox to your advantage. Michael Sigsworth, CGA, CIP, is a partner with ADS Forensics Inc. Darrell Sherman, CA, CIP and Specialist in Forensic and Investigative Accounting (IFA), is also a partner with ADS Forensics Inc.
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Driver Test
Driving Assessment, Road Safety and Catastrophic Impairment Determination JOHN SHEARD AND ELANA SCHNEID
Safety on our roads is an important public health concern given motor vehicle accident statistics and the prevalence of driving in our society. According to Transport Canada (2010), motor vehicle accidents accounted for 2,227 fatalities, 11,226 serious injuries and a total of 170,629 injuries. Ensuring drivers with medical conditions are able to drive safely is mandated by legislation and is a responsibility shared by motor vehicle licensing authorities, health care professionals, driver rehabilitation specialists, patients and their families. In Canada, all physicians have a statutory duty to report patients to licensing authorities if they believe they are unfit to drive. This duty supersedes doctor-patient confidentiality and depending on the province, may be mandatory or discretionary. In Ontario, The Highway Traffic Act was enacted in 1968 out of the medical community’s concern that doctors could not convince medically unfit patients to stop driving. Not surprisingly, patients are very reluctant to give up the independence and freedom driving provides in their daily lives. When making licensing decisions for drivers with medical conditions, motor vehicle licensing authorities rely on medical reports; expert medical advisors, functional driving assessments and current medical guidelines (i.e. Canadian Medical Association (CMA) 44 Claims Canada
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Drivers Guide 7th Edition; Canadian Council of Motor Transport Administrators (CCMTA) Medical Standards For Driving). In Ontario, in addition to vision requirements, basic medical standards that individuals must meet in order to drive are specified as follows: “…an applicant for or a holder of a driver’s licence must not, (a) suffer from any mental, emotional, nervous or physical condition or disability likely to significantly interfere with his or her ability to drive a motor vehicle of the applicable class safely; or (b) be addicted to the use of alcohol or a drug to an extent likely to significantly interfere with his or her ability to drive a motor vehicle safely.” (Highway Traffic Act, s. 14.)
Evidence-Based Resources The Canadian medical guidelines and standards for driving are excellent evidence-based resources for understanding the breadth and complexity of medical conditions that can affect the ability to drive safely. The CMA Driver’s Guide 7th Edition for example, contains alerts, guidelines, toolkits and questionnaires for a broad range of medical conditions. With respect to driving assessment, The Guide recommends: “A driver with a medical condition that can compromise cognitive or motor skills may require a functional assessment to determine fitness to drive. Any compromise of the ability to perform daily activities should trigger some sort of functional driving assessment.” Functional driving assessments for drivers with medical conditions are conducted by those experienced in
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driver rehabilitation and typically involve the following standardized protocol: 1. An in-clinic evaluation by an occupational therapist that includes: history taking and testing of physical abilities, cognitive functioning, perception, vision, road knowledge and driver related insight and judgement; and 2. An on-road evaluation by an occupational therapist and certified driving instructor to assess driving performance on residential, commercial, and highway roads. Driving assessments conducted under auto insurance accident benefits schedules have been vital for determining fitness to drive, vehicle modifications for patients with a variety of physical impairments, remedial driver training needs for patients with cognitive impairment due to brain injury and designing desensitization programs for patients suffering from driver-related fear due to psychologically traumatic accidents. Driving assessments have also played an important role for evaluating disability and income replacement benefits for those employed in driving occupations. In Ontario, driving assessments have not been commonly used in the auto insurance system for catastrophic impairment determination. However, considering our obligation to ensure road safety, driving assessments can make a significant contribution in this area. For example, in an evaluation of a patient for Catastrophic determination based on mental and behavioural impairments (i.e. Criterion 8 of the Ontario Statutory Accident Benefits Schedule - SABS), assessors are required to apply the American Medical www.claimscanada.ca
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Association (AMA) Guides to the Evaluation of Permanent Impairment, 4th Edition, 1993.
A complex and poorly understood process The AMA Guides note that determining mental and behavioural ratings is a complex and poorly understood process. The Guides direct evaluators of mental and behavioural impairments to indicate and explain, with examples, the impact of the diagnosed psychiatric condition on normal life activities. This involves determining the ability of the patient to function in four major areas: (1) activities of daily living; (2) social functioning; (3) concentration, persistence and pace; and (4) decompensation/deterioration in work or work-like settings. Extreme (Class 5) or Marked (Class 4) impairment must be demonstrated in order to reach Catastrophic threshold under the SABS. When assessing drivers with mental and behavioural impairments, the CMA Drivers Guide offers important infor-
mation for evaluators. For example, assessing fitness to drive for psychiatric conditions, it is recommended that all 5 Axes in the American Psychiatric Association DSM-IV diagnostic system be carefully considered and that a Global Assessment of Functioning (GAF) score of less than 50 be used to indicate the need for further assessment. For psychiatric illnesses, the CMA Drivers Guide states that immediate contraindication to driving includes: “acute psychosis; condition relapses sufficient to impair perceptions, mood or thinking; medication with potentially sedating effects initiated or dose increased; lack of insight or lack of cooperation with treatment; lack of compliance with any conditional licensing limitations imposed by motor vehicle licensing authority; suicidal plan involving crashing a vehicle; an intent to use vehicle to harm others… A patient seen or reported to have any of these problems should be advised not to drive until the condition is evaluated and treated.”
Catastrophic impairment determination In the Financial Services Commission of Ontario (FSCO) Arbitration decision A09-001224, the issue of the patient’s ability to drive was relevant to arguments regarding mental and behavioural ratings for catastrophic impairment determination. In this case, the applicant had been employed as a professional truck driver. As a result of the accident, he was reported to have developed (among other quite severe psychiatric symptoms) driving and passenger anxiety, increasing road rage, avoidance of driving during busy times and occasional dependence on others to drive him. The neurologist for the insurer argued that because the applicant reported he was able to drive, and given the complexity and demands of being able to drive safely, the level of mental and behavioural impairment could not exceed Mild (Class 2) at least for the areas of: (1) activities of daily liv-
24HR
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ing; and (2) concentration, persistence and pace, and that it would preclude a Marked (Class 4) impairment for (4) adaptation to work. It was also noted that if any assessor believed the mental and behavioural impairments could affect the applicant’s ability to safely operate a vehicle; this must be reported to the motor vehicle licensing authority. The arbitrator took a different view and agreed with the testimony of the neuropsychologist for the applicant (who gave Marked impairment ratings
in 3 of 4 areas including concentration, persistence and pace). The arbitrator indicated that: “… driving is an “overlearned” activity – an experienced driver does not typically need to devote much conscious thought to this activity – and this is probably even more accurate for a professional driver like the Applicant. The idea that being able to drive would automatically mean that a person would be placed in the mild impairment category for three of four functional areas seems far too simplistic an approach and not one that
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is mandated by the Guides. According to the Guides, a person with moderate impairment levels can still have some useful functioning in all four areas of function. A person with marked impairment levels will find useful functioning significantly impeded (but not precluded). Therefore, even at the marked level of impairment, one can expect some useful function in multiple areas of functioning.” The arbitrator also noted in the decision that the applicant’s licence eventually was suspended pending the licensing authority’s review of further information concerning the patient’s psychological and cognitive condition and his medications.
Role of functional driving assessment This case illustrates the important role a functional driving assessment could have played in the catastrophic impairment determination process. In this case, such an assessment could have clarified whether the applicant was able to safely operate a motor vehicle and this would have informed the mental and behavioural ratings in each of the four areas of functioning. As well, a driving assessment from a health professional qualified in the field of driver rehabilitation could have provided the arbitrator and the assessors with expert opinions about driving for their decision making. Although driving is a complex activity involving the coordination of physical, cognitive and emotional abilities, it can be evaluated reliably with current standardized driving assessment protocols. Driving assessments are designed to measure functional driving skills in real time on-road situations. This makes them particularly valuable for assessors, arbitrators and judges who are evaluating the extent and severity of medical impairments. More importantly, however, for road safety reasons, driving assessments should be conducted when impairments due to medical conditions become serious and potentially Catastrophic in nature. John Sheard is President of DriveLab and Elana Schneid, B.A. (Hons. Psych), M.Sc., OT, is a Driver Rehabilitation Therapist with DriveLab. www.claimscanada.ca
Official Journal of the Canadian Indeépendent Adjusters’ Association
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THE CIAA COMMITMENT Commitment Over 1,000 Canadian Independent Adjusters FROM COAST TO COAST have pledged to follow the Rules and Regulations and adhere to the CODE OF ETHICS and PRIVACY CODE of the association. The Canadian Independent Adjusters’ Association is committed to maintaining the highest possible degree of PROFESSIONALISM. • By striving to IMPROVE THE QUALITY of service through education, keeping members involved regionally and nationally to be current on the latest trends.
• By SPEAKING WITH ONE VOICE on matters of national concern. • By fostering mutual COOPERATION and maintaining HIGH STANDARDS of performance through networking.
2013
And Now...The CIAA/ACEI Claims Manual 2013 For 50 years CIAA Members have been providing the tools and expertise that claims professionals have come to rely on. The CIAA Claims Manual is just one example of their commitment to education, service and professionalism.Focusing on the key issues involved in claims management and showcasing CIAA’s premier membership list, the CIAA Claims Manual serves as an invaluable reference tool and resource book for the Canadian Insurance Industry.
Claims Manual
Canadian Indep endent Adjusters L’Association ’ Associatio Canadienne des Experts Indép n/ endants
National Claims Manual www.ciaa-ad
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CIAA - Dedicated to fair practice and integrity on all claims-related services. Canadian Independent Adjusters’ Association L’Association Canadienne des Experts Indépendants Centennial Centre, 5401 Eglinton Avenue West, Suite 100 Etobicoke, Ontario M9C 5K6 416-621-6222 Toll Free 1-877-255-5589 Fax 416-621-7776 E-mail info@ciaa-adjusters.ca
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EF
• education forum
A SERIES OF ARTICLES PROVIDED BY THE INSURANCE INSTITUTE OF CANADA
CRUNCHING THE
NUMBERS Will “big data” have a big impact on claims adjusters?
N
orth American insurance companies are increasingly investing in analytics and “big data” to seek competitive advantages, assess risk more sensitively and combat fraud. For claims professionals, this may mean learning new processes and acquiring new insights.
What’s the big deal? Many billions of bytes of data are created around the world every day. Some of this data comes from comparatively traditional sources such as databases; and other data – increasing quantities of it – comes from non-traditional sources such as online search records, blogs, customer comments on websites, messaging via mobile devices, and other social media. “Big data” is any type of data that flows in large volumes – structured or unstructured data; text, audio or video files; sensor data, click streams, log files and more. The volume and diversity of big data make it hard for businesses to navigate and assess. Yet new insights emerge when these disparate data types are analyzed together, potentially allowing a firm to improve its competitiveness, efficiency and profitability. This potentially creates a huge market for big-data technology and services. Some insurers are already investing significant sums in analytics, and others have plans to do so. Advanced analytical techniques can iden48 Claims Canada
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tify meaningful patterns and highlight emerging themes by very quickly processing big data.
Mining and modelling In data mining and predictive modelling, historical data is carefully examined to identify patterns. Predictive modelling solutions can process an ever-growing list of risk characteristics in order to more effectively segment and price business, especially in commercial p&c lines. Rating plans using predictive analytics can assign a unique price to any risk, making pricing a more potent underwriting tool. This allows an insurer to better manage risks in lines of business like business owner’s policy, commercial package, commercial property, and directors’ and officers’ liability by identifying policies that are likely to incur losses. On the claims side, many companies are looking at their costs and asking whether they’re spending more than they should to settle claims, or whether there are specific claims that could be handled more efficiently. Predictive modelling can improve a company’s workflow efficiencies by providing claims handlers with timelier loss insights, allowing handlers to better focus on the right claims at the right times. Analysis techniques can identify patterns in the data that would be difficult for adjusters to spot because of
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the vast amount of information involved and the limited time available. Proper use of predictive modelling can facilitate the early identification of potentially costly claims and the recognition of claims practices that are unnecessarily increasing payments. Another area of claims cost leakage is subrogation. Carriers often have only partial information concerning the circumstances of a loss, the degree of negligence across involved parties, and the extent to which recovery is available or is pursued against another carrier. Improved data can help.
Foiling fraud The use of predictive analytics also has significant implications in the fight against fraud. Fraudsters are very adept at masking their identities, but technological tools can examine hundreds of elements across millions of records to provide real-time alerts. Fraud prevention is especially effective at two key points: underwriting and claims intake. For example, if the named insured or vehicle has been involved in previous claims, technology tools can identify which policies are being purchased for the purpose of conducting a staged accident. The same technology can also confirm a person’s identity, the relationships between claimants, and the activities and names of individuals and businesses involved in the claim. Armed with these insights about the www.claimscanada.ca
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individuals, adjusters can change the questions they ask of claimants. A legitimate claimant will consider probing questions part of the normal process, but a fraudulent claimant may be exposed under the pressure of questioning if they feel they’re suspected.
Functional requirements Detecting fraud is a time-sensitive process, so a company needs to be able to analyze data as it comes in so as to maximize its value. And where data is used to support critical decision-making, establishing the reliability of the information is critical. For predictive models to function effectively, they must be developed using the company’s own historical claims data, since this allows the model to recognize the specific nature of a company’s exposure and its claims practices. The process of developing such a model reveals the strengths and weaknesses of an organization’s document and record management practices, which are critical for ensuring the reliability of the data. Integrating social media Despite the excitement about the potential value of social data, use of this information is still in its formative stages. Integration of social data into core underwriting and claims processes remains a significant hurdle. Authentication methods, data extraction tools and advanced analysis tools are just some of the techniques that must be developed or improved before social data can become standard inputs into risk evaluation and claims settlement activities. Insurers will need to investigate the best ways to integrate this data into their existing process and automation environments. A similar integration hurdle exists at the claims investigation stage. While there are stories of insurers uncovering claims fraud by reviewing claimants’ social media websites, such practices have not become standard procedure. Moreover, claims searches are still manual and are heavily reliant on the experience and creativity of the individual investigator. www.claimscanada.ca
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Implementing change As with any new process, claims staff needs to be prepared for the implementation of new technologies and supported through the introduction. Change management processes involving all relevant staff, including individual claims handlers, may need to be implemented to ensure that the technology is not just adopted but routinely embedded in each adjuster’s practice. In addition to the operational and technical challenges, companies need to keep sight of the legal issues connected with use of social data, especially privacy and consent. Culling information from social networking sites such as Facebook, Twitter and blogs may potentially infringe federal or provincial privacy legislation. Under certain circumstances, though, companies can collect and use personal information that has appeared in a publication that is available to the public (including a publication in electronic form) where the individual has provided the information. This is an evolving area of the law. Technology often promises to make business easier and more efficient. For these promises to be fulfilled, change must be well managed so that the technology is adopted and embedded in routine practice. In the case of analytics, an organization’s records management system must also be strong, so that information can be catalogued and retrieved at the appropriate time; and integration processes will need to be established. Finally, privacy and consent issues will remain front-andcentre for some time as governments, companies and individuals adjust to the new possibilities. This article is based on excerpts from ADVANTAGE Monthly, a series of topical papers on emerging trends and issues provided to members of the CIP Society. The Chartered Insurance Professionals’ (CIP) Society is the professional organization representing more than 16,000 graduates of the Insurance Institute’s Fellow Chartered Insurance Professional (FCIP) and Chartered Insurance Professional (CIP) programs.
APPOINTMENT
Bruce Martin Michael Holden, President and CEO of Granite Claims Solutions, is very pleased to announce that Mr. Bruce Martin has joined the GCS team as Vice President, Strategic Solutions. Bruce has over 20 years experience in the insurance business, having held senior claims, sales, and leadership roles at both insurers and independent adjusting firms. Bruce’s role in Strategic Solutions will be to act as a liaison between Granite’s adjusters and insurers throughout Canada. “Bruce’s broad experience and in-depth knowledge of the claims industry will allow him to take a very technical approach to working with our clients,” says Holden, “and that fits perfectly in line with our rigorous approach to quality. Bruce will create a lot of value for our clients, working with them to find new services, better efficiencies, and help provide higher-quality adjusting services.” Based out of Toronto with a national scope, Bruce will be liaising with insurers across Canada. To contact Bruce, email: bruce.martin@graniteclaims.com About Granite Claims Solutions: Since 1976, Granite Claims Solutions has provided claims handling, risk management and third party administration services to local, national and international insurance markets, risk managers, brokers and public entities. Headquartered in Toronto, Ontario, Granite offers a national presence to the domestic property and casualty insurance industry, with over 300 specialty claims adjusters, marine surveyors and Third Party Administrators across Canada.
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• on the scene OTS CIAA Nova Scotia Region President, Grant King presenting the CIAA Nova Scotia award to Debbie Oliver - Fairway Insurance Services- Best Result in Essentials of Loss Adjusting at the Insurance Institute of N.S Awards Dinner, Halifax, November 1. l
The International Institute of Loss Adjusters held its Annual General Meeting in Boston, October 17-21 during which a new Executive Board was elected; (L to R) Tom Moss, Nashville Tennessee (Secretary); Hakan Ileri, Istanbul, Turkey (First-Vice President), Ted Wheeler, Sydney, Australia (Director at Large), Walid Jishi, Dubai, UAE (President); John Michalek, Houston, Texas (Second Vice President); Fred Plant, Moncton, New Brunswick (Immediate Past President and Treasurer). l Since 2005, Plant Hope Adjusters has presented the Top New Brunswick CIP student with the Brain Taylor Professional Award to recognize superior performance in completing the CIP program. Brain was a colleague at Plant Hope and a longtime and much admired member of the Insurance Industry in New Brunswick who passed away due to liver disease in 2004. Here Fred Plant, President of Plant Hope Adjusters presents Aimee Chapman, CIP of the Co-Operators, Moncton NB with the 2012 award. l Plant Hope Adjusters is proud to announce the attainment of Chartered Insurance Professional standing with the Insurance Institute of Canada by Jonathan Frenette (left) and Rob Corbett. Both Jonathan and Rob started their adjusting careers with Plant Hope as part of the company’s drive to bring new people into the independent adjusting business. l
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CIAA Nova Scotia Region President, Grant King presenting the CIAA Nova Scotia award to Gregory Blacklock, Intact Insurance Canada, Best Performance by First Year CIP Student, N. S. at the Insurance Institute of N.S Awards Dinner, Halifax, November 1. l
CIAA New Members — November 2012 CORPORATE MEMBERSHIP G. Rocca & Associates Consulting Inc. Sudbury, ON INDIVIDUAL MEMBERSHIP Kernaghan Adjusters Limited Eric Godfreyson Revelstoke, BC Barbara Norman Kelowna, BC Simon Buckley Kelowna, BC Cliff Derksen Winnipeg, MB Brian Churchill Halifax, NS
Level 2 Level 1 Level 2 Level 3 Level 3
Crawford & Company (Canada) Inc. Caitlin Soto Calgary, AB Jonathon Soto Calgary, AB Shalise Vansh Mississauga, ON
Level 1 Level 1 Level 1
Granite Claims Solutions Maria Dickout
Level 2
Abbotsford, BC
Townsend & Leedham Adjusters Ltd. Courtland Gilliam Edmonton, AB
Level 2
Algom Insurance Adjusters Cheryl Sharratt
Level 1
Elliot Lake, ON
Sedgwick CMS Canada Inc. Ian Encarnacion Toronto, ON Matthew Arbuckle Toronto, ON
Level 2 Level 1
G. Rocca & Associates Consulting Inc. Giovanni Rocca Sudbury, ON
Level 3
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PPG Canada Inc. Automotive Refinish has announced new appointments in its business development and sales divisions. Norm Angrove has been appointed national business development and business solutions manager, expanding his Canadian business development responsibilities to include the business solutions division in his portfolio, the company announced. PPG also announced two new territory managers, Teresa Masotti and Melanie Rice, both with extensive sales experience. Masotti will join PPG’s Greater Toronto Area sales team, while Rice will join the South-Central Ontario sales team. l Itech is pleased to welcome Mario Orellana to the Electronics and Equipment Restoration team, as he takes on the role of Electronics Restoration Manager. Itech – a Division of STRONE - is an environmentally-conscious company offering restoration and remediation services throughout Ontario. Headquartered in Brantford, ON, Itech serves the needs of its clients from additional locations in Barrie, Markham, Ottawa, and Sudbury. l Paul Davis Systems Canada, Ltd. has appointed Rory MacKinnon to the role of Field Operations Specialist. In his new role Rory will be working in conjunction with the Franchise & Field Operations team to provide timely support our franchisee partners and their respective teams. l FirstOnSite Restoration announced in December the opening of a new branch in Thunder Bay, Ontario. The company’s newest branch will provide disaster restoration services to the residents and businesses of Thunder Bay and the surrounding area. l WINMAR Franchise Corp. in London announced in December the opening of its newest location in Kamloops, British Columbia, owned and operated by Karen Nicholson and Ken Jackson. In November, WINMAR also announced the opening of a new location in Tisdale, Saskatchewan owned and operated by Roy Skoglund, his wife Sandy and son Daniel; and a new location in Whitehorse, Yukon, owned and operated by Ray Guenette. l On Side Restoration Services Ltd. of Vancouver is pleased to announce that it has acquired Higgins ProTeam Restorations Inc. a southern Ontario multi branch restoration contractor. The deal, which was formalized in December, will expand On Side’s number of branches to 25 across Canada. l www.claimscanada.ca
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CarProof Vehicle History Reports is offering a free flood damage check on its website so that individuals thinking about buying a used car from the United States can check for water damage, including as a result of Superstorm Sandy. After entering the vehicle identification number or VIN, the check will indicate if the car has ever sustained water damage in the U.S. and if it has been registered in an area affected by a significant storm, notes a statement from the London, Ontario-based company. CarProof searches its extensive database in the U.S. to look for flood titles and storm area registration. l
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• on the scene OTS The Insurance Institute of Canada has completed its third research report on the industry’s workforce issues, set to be released in January 2013. “A Demographic Analysis of the P&C Insurance Industry in Canada 2012 – 2022” focuses on “the impact of recent economic and other events on employment trending, if any, and forecasts the future human resource requirements of the industry,” according to the institute. l
STRONE, an emergency and restoration company headquartered in Oakville, Ontario, is pleased to announce the opening of its new location in Sudbury, at 1739 Old Falconbridge Road. STRONE has provided emergency and restoration services to the insurance and facility management industries since 1987. l
Audatex, the world leader in information data, technology software, and services for the automobile and insurance claims processing industry, is pleased to announce the appointment of Vic Wiwchar as Director of Business Development for the Insurance Claims Services division of Audatex Canada. l
SPECS Limited, the country’s leading provider of independent property damage and construction consulting services is pleased to announce the appointment of Andrew Ross as the new Director of Operations. In his new role, Andrew will oversee all aspects of the Appraisal Operations for SPECS Limited nationally. l
APPOINTMENT
Concordia Collision Centres and Assured Automotive announced in November the establishment of a joint venture between their respective organizations for the Greater Ottawa market. This Joint Venture includes the two Concordia Collision Centres combined with the recently acquired Assured Frank & Guy locations for a total of 5 locations in Ottawa. l
PPG Products recently earned the Good Housekeeping Seal for its Envirobase High Performance and Aquabase Plus. Envirobase® High Performance and Aquabase® Plus advanced waterborne basecoats are premium-quality refinish coatings that are extremely popular throughout the United States and Canada with collision centers as they shift to low-VOC products. l Granite Claims Solutions announced in December that Bruce Martin has joined the GCS team as Vice President, Strategic Solutions. Bruce has over 20 years experience in the insurance business, having held senior claims, sales, and leadership roles at both insurers and independent adjusting firms. Bruce’s role in Strategic Solutions will be to act as a liaison between Granite’s adjusters and insurers throughout Canada. l
Laurel DiMaso Mark English and Bill Hanlon are pleased to announce the executive appointment of Laurel DiMaso to President. In her new role, Laurel will be responsible for the day to day operations and strategic management of Masterclean. Laurel has over 15 years of experience in the insurance restoration industry. She has a wealth of knowledge in all aspects of business, gained throughout her tenure in sales, marketing and senior management roles. Masterclean is a full service cleaning and restoration company proudly serving Southern Ontario’s Insurance Industry since 1971. Your only call for Residential, Commercial and Industrial Property Losses.
CSN Collision & Glass announced in November that it will be partnering with Quebec-based Carrossier ProColor to create Canada’s largest national collision network. Carrossier ProColor will now represent the interest of CSN in Quebec as a Proud Member of CSN Collision & Glass. This new strategic alliance will create the largest network of collision repair facilities in Canada with over 265 locations. In other company news, Peterborough’s Carlaw Collision joined CSN Collision & Glass November 26. l More than 220 guests boarded the Yankee Lady III on August 23rd for the 4th Annual WINMAR Toronto/Brampton Cruise fundraiser, which collectively raised $5,000 for Dog Guides Canada. This will contribute to the following… “ From guiding their handlers through their daily lives to getting help when it’s needed most, Dog Guides play a crucial role in the lives of Canadians with disabilities, with dog specialities: Canine Vision; Hearing Ear; Autism Assistance; Special Skills (medical/physical); and Seizure Response.” Winmar Toronto/Brampton Property Restoration is a specialist in: Structural Drying, Vital Document Recovery, Flood, Fire, Temporary Climate Control, Temporary Power and Hazardous Environmental Clean Up. l
Claims Canada Wants You!
www.masterclean.ca 1215 Kerrisdale Boulevard Newmarket, ON. L3Y 8W1 • 905-841-8000
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Claims Canada magazine wants you to send us your company news, appointments and event photos for possible inclusion within our ‘On the Scene’ department. Please help us share your items with the claims industry across the country. For more information, please email: craig@editinsight.com
www.claimscanada.ca
12-12-13 10:33 AM
Crawford & Company (Canada) Inc. held its annual RIMS Canada Conference dinner on Sept. 8 at The Saskatoon Club in downtown Saskatoon, Saskatchewan. l
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• on the scene OTS Granite Claims Solutions, CKR Global, Rochon Engineering and Sibley & Associates (Granite Global Solutions companies) held their annual RIMS Canada Saskatoon Conference ‘KickOff’ reception on Sept. 8 at Hudsons Canadian Tap House in downtown Saskatoon. l
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• on the scene OTS More than 70 companies and organizations providing products and services filled the Exhibit Hall at the 2012 RIMS Canada Conference in Saskatoon. l
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FirstOnSite Restoration hosted a Meet & Greet reception at the Saskatoon RIMS Canada Conference on Sept. 10 at 2nd Avenue Grill in downtown Saskatoon. l
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• on the scene OTS ARC Group Canada hosted a reception at the RIMS Canada Conference in Saskatoon at Staqatto Piano Bar on Sept. 10. The event included an entertaining evening of duelling pianos, industry mingling and delightful appetizers and beverages. l
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• on the scene OTS Delegates of the 2012 National Insurance Conference of Canada (NICC) held in Quebec City, Sept. 30-Oct. 2, enjoyed the opportunity to share refreshments and conversation at the opening night of the conference. The conference raised $18,000 through donations made in lieu of speaker gifts and a silent auction and raffle for WICC, the 2012 NICC charity of choice. Over $87,000 has been raised for WICC at NICC since 2008. l
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12-12-13 10:49 AM
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• on the scene OTS More than 1,000 people made their way through the exhibit hall to visit the 75-plus exhibitors at the Insurance Brokers Association of Ontario (IBAO)’s 92nd Annual Convention and Exhibition in Toronto at the Fairmont Royal York Hotel on Oct. 17-19.l
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