Sharing the road
Who is in the driver’s seat of autonomous cars? Official Journal of the Canadian Indeépendent Adjusters’ Association
The SPECS Diï¬€erence
Contents May-June 2018 • VOLUME 12 • NUMBER 2
Spotlight 10 A northern light
Rocca Claims aims to attract talent to Ontario’s north BY EMILY ATKINS
Cover Feature 14 Sharing the road Who will be in the driver’s seat when autonomous cars hit the streets? BY EMILY ATKINS
News Features 18 Rise of the machines BY MAZEN HABASH
20 The obligation to defend additional insureds
BY TALAAL F. BOND
22 The evolving nature of business interruption BY ALEKSANDRA ZIVANOVIC
24 Myth busting: Three-day drying, Part 2 BY KRIS RZESNOSKI
Departments 4 First Notice 26 On the Scene
Columns 7 President’s Message
• first notice FN Brace for bigger floods By Jason Contant
If you think the most expensive floods in Canadian history were big, you haven’t seen anything yet. “The manifestation of climate change and extreme weather events is still yet to come,” said Blair Feltmate, head of the Intact Centre on Climate Adaptation at the University of Waterloo, at a panel discussion hosted by the Economic Club of Canada in Toronto recently. “The Calgary floods, the Toronto floods, the Burlington floods – those are not the big floods,” Feltmate said. The Calgary and Toronto floods in 2013, he referenced were Canada’s third- and fourth-largest disasters, respectively. Burlington, Ontario, residents experienced flooding in early August of 2014 when about 200 mm of rain hit that city, located immediately northeast of Hamilton.
“Those are a prelude to the bigger floods that are coming,” Feltmate said during the panel, Climate Change and the Financial Sector. The event was moderated by Don Forgeron, president and CEO of the Insurance Bureau of Canada. In June 2013, heavy rains caused widespread flooding in southern Alberta. That resulted in the evacuation of the entire town of High River and the inundation of much of Calgary’s central business district, including the Saddledome, which serves as home ice for the NHL’s Calgary Flames. Industry-wide insured losses were about $1.7 billion, making it the third-most expensive natural disaster in Canadian history after the 2016 Alberta wildfire and the 1998 ice storm. Canada’s fourth-most expensive natural disaster arose July 8, 2013 when two separate storm cells hit the western Toronto area. Effects were widespread, including a flooded commuter rail line that stranded hundreds of riders for hours, as well as a flooded transformer station. Flood is “one of the biggest natural disaster risks” facing Canadian consumers today, Forgeron warned. Climate change “is affecting Canadians now,” Forgeron added. “We are feeling its effects across the country and on the bottom lines of many businesses and organizations.” Canadian society has to adapt to climate change “in quick order,” Feltmate concluded. ●
Insurer must defend nurse in privacy breach case Oliveira was an additional insured under By Greg Meckbach
Aviva Canada has a duty to defend a nurse who is being sued for privacy breach by a patient whose medical records were accessed in a Simcoe, Ontario, hospital, the Court of Appeal for Ontario ruled in a decision released March 28. The patient, known in court records as J.L., is suing Norfolk General Hospital as well as Nancy Oliveira, a nurse who used to work there. J.L.’s allegations against Oliveira have not been proven in court. Court records indicate that Oliveira was not involved in J.L.’s care at the Simcoe hospital. In a separate proceeding, Oliveira was disciplined by the Ontario College of Nurses. In an agreed statement of facts, the College reported that Oliveira accessed health records of about 1,300 clients; for some of these clients, she was not part of the health care team and did not have a “professional purpose” for accessing the health records, the college found. 4
a “Professional and General Liability and Comprehensive Dishonesty, Disappearance and Destruction Insurance Policy” written for Norfolk General Hospital by Aviva, wrote Justice Markus Koehnen of the Ontario Superior Court of Justice in Oliveira v. Aviva Canada Inc. et al. The policy insures “all employees of the insured while acting under the direction of the named insured,” Justice Koehnen added. Aviva argued it did not have a duty to defend Oliveira under the policy because the alleged conduct did not “arise” from the operations of a hospital (i.e. being responsible for the care of the patients), nor could it be considered to be “at the direction of the name insured.” Among other things, Aviva argued that Oliveira’s “conduct did not arise from the Hospital’s operations” because J.L. was not in the nurse’s “circle of care”. Justice Koehnen’s initial ruling against Aviva was upheld by the Court of Appeal for Ontario.
“By offering coverage for breach of privacy, Aviva was offering coverage for intrusion upon seclusion and was, by definition, offering coverage for highly offensive conduct,” Justice Koehnen wrote. “That must by definition cover access to records by hospital employees outside of the circle of care.” What Oliveira is alleged to have done “is precisely the sort of conduct” that the Aviva policy “was intended to respond to,” the Court of Appeal for Ontario ruled in its unanimous decision. ● www.claimscanada.ca
• first notice FN Free flood insurance
The trouble with banning cannabis
By Jason Contant
By David Gambrill
One Canadian insurer is not waiting for consumer take-up of its flood insurance coverage — it is automatically tacking the endorsement onto the policies of eligible clients who live in low-risk areas. Desjardins General Insurance Group (DGIG) said its flood coverage, Endorsement 16d, is automatically bonded to an eligible client’s policy. “We have reviewed our clients’ profiles that can benefit from this endorsement and added it to their policies automatically and free of charge,” Desjardins spokesman John Bordignon said in an interview. “We believe we have taken proactive steps to help them deal with the added risks of increasing water-related claims events.” Asked how “low-risk” was defined, Bordignon said the addition of flood protection is based on certain criteria such as the overall risk of flooding, ground water seepage, and sewer back-up. The coverage offers protection against sudden and accidental damage caused by water that reaches the premises and that originates from the rising or overflow of body of water (stream, river, pond, lake, etc.) or from a dam break, as well as the damage caused by the impact of water-borne objects that reach the premises (including ice). ●
Employers may be hard-pressed to ban marijuana outright from the workplace once The Cannabis Act is implemented in Canada, a lawyer told delegates attending the Ontario Mutual Insurance Association (OMIA). “Both bills [related to The Cannabis Act, Bills C-45 and C-46] are actually silent when it comes to employment and occupational safety,” said Sandra Gogal, practice leader at Miller Thomson LLP. “At present, there is no Canadian law that regulates mandatory drug testing of employees, so when the recreational market opens up, it creates a number of interesting issues.” For one, employers will be challenged to uphold outright prohibitions on marijuana in the workplace, based on the difference between recreational and medicinal forms of cannabis. While proposed bills allowing recreational use are still up for debate, medical use of marijuana has been legal in Canada since 1999. “I had a call from a company the other day that said one of their employees was injured on the job, and as a matter of standard practice, they get drug-tested,” Gogal recounted. “The results came back positive, and they said, ‘Can we fire him?’ And I just said, ‘We don’t know yet whether that was for medical purposes or not.’” The issue promises to get murkier once recreational drug use is legalized. THC is the substance known to cause the psychoactive effects or the ‘high’ felt from cannabis. On the other hand, cannabidiol (CBD), as noted by CanniMed Ltd., “lacks nearly any psychoactive effect and is showing promise with epilepsy. CBD has also been used successfully by patients with genetic brain disorders, Crohn’s disease and ulcerative colitis, and Parkinson’s disease.” Understanding the difference between the medical and the recreational marijuana is going to be a challenge for employers, “because I don’t think any of us are really chemists,” Gogal said. “There are over 100 cannabinoids and each of them has a different effect on your body.” Whether or not safety-sensitive workplaces can ban marijuana use raises the question of impairment, she added. A positive test for cannabis may not necessarily mean a person is impaired, based on the distinction between THC and CBD. Another issue for employers will be the duty to accommodate. “Does that mean a duty to accommodate a preference in medicines?” Gogal asked rhetorically. ●
Usage-based travel insurance By Jason Contant
An AIG company has launched a pay-as-you-go travel insurance app. Travel Guard Group Canada launched the iPhone app to allow Canadian customers (except Quebec residents) to purchase travel insurance coverage in blocks of time ranging from one to 90 days. GPS technology enables travelers to use the coverage from the moment they leave their home province to the moment they return, with the app tracking the number of hours used. Coverage includes emergency medical expenses, emergency dental expenses, trip delay, baggage and personal effects, and assistance benefits. This new method of buying and utilizing travel insurance allows travelers to customize their protection period for each trip – down to the hour, AIG asserted. Marc Lipman, AIG Canada’s chief operating officer, said the app allows customers to gain protection only 90 seconds after filling out four required fields. “When the app’s geolocation feature senses that the customer has arrived at an airport or a border crossing into the United States, a notification is sent to the customer’s iPhone to ask whether he or she wants to activate the purchased insurance,” AIG said. The app is powered by JAUNTIN’, a Canadian insurance technology company. The start-up won the AIG Canada Innovation Challenge. ● www.claimscanada.ca
continued on page 6... May-June 2018
• first notice FN
...continued from page 5
Newfoundland and Labrador cuts tax on car insurance By Jason Contant
Drivers in Newfoundland and Labrador can thank the province’s improved financial situation for a lower tax burden on auto insurance premiums in 2018. If the province’s financial situation continues to improve, the government said it might consider reducing the tax even further, Insurance Bureau of Canada (IBC) said. When Newfoundland and Labrador announced it would reduce its retail sales tax (RST) on auto insurance premiums from 15 percent to 10 percent over the next four years, it was a rare example of a government reducing a tax shortly after it was elected – as promised. In an effort to reduce a $1.83-billion deficit in 2016, the provincial government two years ago reintroduced its RST on property and casualty insurance premiums. However, when applied to auto insurance premiums in Newfoundland (which were already 40 percent higher than in the other Atlantic provinces), the 15 percent RST essentially elevated the province’s auto insurance premiums to 55 percent higher in total.
“In 2016, they weren’t getting a lot of credit for considering to reduce it at some point in the future,” Tom O’Handley, IBC’s manager of government relations in the Atlantic region said in an interview. When the tax was introduced two years ago, the government indicated that if the financial situation in the province improved, it would look at reducing the tax or taking it off auto premiums altogether. “They put out a budget yesterday that still has a deficit of about $800 million, but it was much better even than they had anticipated it was going to be, so that’s why they decided to go with putting in some relief for the amount of tax on insurance,” O’Handley said. When asked what is contributing to such high auto insurance premiums in Newfoundland and Labrador, O’Handley noted it is the only province that doesn’t have a cap on minor injuries. A closed claims review of auto insurance in the province is currently underway, the results of which are expected in about a month. “We are quite certain that study is going to show that minor injuries are much higher in Newfoundland and Labrador than anywhere else in any of the other Atlantic provinces, and the reason for that is that there is no cap,” O’Handley said. “Once those costs go up, premiums go up as well.” ●
Message from the President La Plume du président MONICA KUZYK
At a recent Conference Board of Canada National Summit on Ethics and Integrity, research was shared that suggests trust levels in business, media and government is on the decline and with that a lack of credibility exists in the leadership of these institutions. For those of us working in insurance, these results are troubling. Insurance is a business founded on the principle of trust. It starts at the time of sale of a policy through to claim resolution. Consumers expect that insurance professionals will guide them to purchase the right coverage and at the time of claim, when an economic tragedy has occurred, claims professionals will guide them through the process to help make them whole again. On reflection, we need to ask ourselves what has caused trust to decline. As we know, consumers’ expectations about insurance are being shaped outside of the insurance industry. Historically consumers trusted brands and businesses. However, in today’s complex and fast paced digital environment, an insurer’s brand can be destroyed in a single tweet, and Google reviews have become the new testimonial. Now, more than ever before, claims professionals must work to rebuild trust. This is done through sound judgment, and courteous, fair and responsible claims handling. At all times, claims professionals must act within a defined code of conduct that puts “trust” into action. At the CIAA we call this our Code of Ethics. The CIAA Code of Ethics details a CIAA adjuster’s responsibilities to policyholders, to insurers and to those self-insured at the time of claim. In addition, CIAA members are obliged to take responsibility to promote, encourage understanding, cooperation and good relations within the profession, the industry and the public. This is the fabric of our culture at the CIAA. Why is this so important? Because insurers know that trust is measured in the worst conditions. When a CIAA member is assigned to a loss, insurers know the CIAA adjuster will give voice to their corporate values by engaging with their policyholder in accordance with that strict Code of Ethics. This code is founded on the principles of respect, transparency and ac-
Lors du récent sommet national sur l’éthique et l’intégrité du Conference Board du Canada, des recherches ont révélé que les niveaux de confiance dans les affaires, les médias et le gouvernement sont en déclin, et que le leadership de ces institutions manque de crédibilité. Pour ceux d’entre nous qui travaillent dans l’assurance, ces résultats sont troublants. L’assurance est un milieu qui repose sur le principe de la confiance. La confiance commence au moment de la vente d’une police et se poursuit jusqu’au règlement de la réclamation. Les consommateurs s’attendent à ce que les professionnels de l’assurance les guident dans l’achat de la bonne couverture et au moment de la réclamation, lorsqu’une tragédie économique survient, les professionnels des réclamations les guideront tout au long du processus. Nous devons nous demander ce qui a fait baisser la confiance. Comme nous le savons, les attentes des consommateurs en matière d’assurance sont façonnées en dehors du secteur de l’assurance. Historiquement, les consommateurs ont fait confiance aux marques et aux entreprises. Cependant, dans l’environnement numérique complexe et rapide d’aujourd’hui, la marque d’un assureur peut être détruite en un seul gazouillis, et les critiques de Google sont devenues les nouveaux guides. Maintenant, plus que jamais auparavant, les professionnels des réclamations doivent travailler à reconstruire la confiance. Cela s’obtient par un jugement éclairé et par un traitement des réclamations courtois, juste et responsable. En tout temps, les professionnels des réclamations doivent agir selon un code de conduite défini qui met la «confiance» en action. À l’ACEI, nous appelons cela notre Code d’éthique. Le code de déontologie de l’ACEI détaille les responsabilités de ses experts en sinistres vis-à-vis des assurés, des assureurs et des auto-assurés au moment de la réclamation. En outre, les membres de l’ACEI sont tenus de prendre la responsabilité de promouvoir et d’encourager la compréhension, la coopération et les bonnes relations entre la profession, l’industrie et le public. C’est le tissu de notre culture à l’ACEI. Pourquoi est-ce si important? Parce que les assureurs savent que la confiance est mesurée dans les pires conditions. Lorsqu’un membre de l’ACEI est affecté à un sinistre, les assureurs savent que l’expert de l’ACEI respectera leurs valeurs d’entreprise en s’engageant avec son souscripteur conformément à ce code de déontologie strict. Ce code est fondé sur les principes de respect, de transparence et de responsabilité. Ce code honore les informations confidentielles et sensibles, reconnaît les erreurs et s’en
“ When a CIAA member is assigned to a loss, insurers know the CIAA adjuster will give voice to their corporate values by engaging with their policyholder in accordance with that strict Code of Ethics.This code is founded on the principles of respect, transparency and accountability.” www.claimscanada.ca
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CIAA REGIONAL PRESIDENTS 2017 – 2018 NEWFOUNDLAND & LABRADOR Gejapathy Gopal, CRM ClaimsPro 27 Duffy Place, P.O. Box 8686, Station A St. John’s, NL A1B 3T1 Phone: (866) 726-7815 Fax: (709) 726-6106 E-mail: firstname.lastname@example.org NOVA SCOTIA M. Kenneth MacLeod, CIP Crawford & Company (Canada) Inc. 210 – 500 Kings Road Sydney, NS B1S 1B1 Phone: (902) 564-4519 Fax: (902) 539-0071 E-mail: Ken.Macleod@crawco.ca NEW BRUNSWICK & PRINCE EDWARD ISLAND Greg Potten, BPE, CIP, CFEI, CRM, CLA AMG Claims Inc. 212 Queen Street, Unit 308 Fredericton, NB E3B 1A8 Phone: (506) 458-9000 Fax: (506) 458-9595 E-mail: email@example.com QUEBEC/AESIQ Michel Lacelle, PAA/CIP ClaimsPro 255 Crémazie Est, 2e étage Montréal, QC H2M 1M2 Phone: (514) 340-8959 Fax: (514) 342-5474 E-mail: firstname.lastname@example.org ONTARIO Niki McConnell, BA (Hons.), CIP, CRM TC Insurance Adjusters Ltd. 6-2400 Dundas Street West, Suite 388 Mississauga, ON L5K 2R8 Phone: (877) 663-0701 Fax: (905) 916-0242 E-mail: email@example.com MANITOBA Craig Shanks, BA, CIP Wheat City Claims Services Ltd. 64 Regent Cres. Brandon, MB R7B 2W9 Phone: (204) 725-7436 Fax: (204) 725-7437 E-mail: firstname.lastname@example.org SASKATCHEWAN Lee Dixon, B. Comm., CIP Midwest Claims Services #3 – 2217 Hanselman Court Saskatoon, SK S7L 6A8 Phone: (306) 668-0873 Fax: (306) 249-4114 E-mail: email@example.com WESTERN Jody Schmidt, B. Comm., CIP Crawford & Company (Canada) Inc. 203, 3114 Calgary Trail NW Edmonton, AB T6J 6V4 Phone: (780) 486-8024 Fax: (780) 486-9001 E-mail: Jody.Schmidt@crawco.ca PACIFIC Pat Lodewijkx, FCIP, CRM Discovery Claims Services Ltd. P.O. Box 36009 Hillcrest Village RPO Surrey, BC V3S 7Y5 Phone: (604) 579-0191 Fax: (604) 579-0192 E-mail: firstname.lastname@example.org
National Standing Committees 2017-2018 ADVISORY Troy Quigley, BBA, CIP Cunningham Lindsey Canada Claims Services Ltd. 1102 - 50 Burnhamthorpe Rd. W. Mississauga, ON L5B 3C2 Phone: (905) 896-8181 Fax: (905) 896-0775 E-mail: email@example.com Sarah Hirst, CIP, CRM, FCIP ClaimsPro #101, 5083 Windermere Blvd. S.W. Edmonton, AB T6W 0J5 Phone: (800) 565-3128 Fax: (780) 489-8841 E-mail: firstname.lastname@example.org Heather Matthews, CIP, CRM, CIOP Crawford & Company (Canada) Inc. 539 Riverbend Dr. Kitchener, ON N2K 3S3 Phone: (519) 578-5540 Fax: (519) 578-2868 E-mail: Heather.Matthews@crawco.ca Paul Féron, FCIP, CRM ClaimsPro 210 – 746 Baseline Rd. East London, ON N6C 5Z2 Phone: (519) 645-6500 Fax: (519) 645-2250 E-mail: email@example.com Sean Forgie, BA, CIP, CFEI ClaimsPro 1550 Enterprise Road, Suite 310 Mississauga, ON L4W 4P4 Phone: (877) 753-0753 Fax: (905) 565-0009 E-mail: firstname.lastname@example.org James B. Eso, CIP, CIOP 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 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 Albert Poon, CIP Cunningham Lindsey Canada Claims Services Ltd. 1102 – 50 Burnhamthorpe Rd. W. Mississauga, ON L5B 3C2 Phone: (905) 896-8181 Fax: (905) 896-3485 E-mail: email@example.com Marie C. Gallagher, FCIP, CRM Kernaghan Adjusters Limited 602 – 1 St. Paul Street St. Catharines, ON L2R 7L3 Phone: (289) 786-1074 Fax: (289) 723-1979 E-mail: firstname.lastname@example.org Balu Naidu, B. Comm., FCIP, CRM Claims Tech (Canada) Inc. 2800 Skymark Ave., Suite 300 Mississauga, ON L4W 5A6 Phone: (905) 568-8060 Fax: (888) 239-3234 E-mail: email@example.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: firstname.lastname@example.org COMMUNICATIONS 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: email@example.com
John D. Seyler, CIP Integrated Insurance Resources 5080 Timberlea Blvd., Suite 214 Mississauga, ON L4W 4M2 Phone: (905) 238-4985 Fax: (905) 238-2735 E-mail: firstname.lastname@example.org CONSTITUTION & RULES Paul Féron, FCIP, CRM ClaimsPro 210 – 746 Baseline Rd. East London, ON N6C 5Z2 Phone: (519) 645-6500 Fax: (519) 645-2250 E-mail: email@example.com CONVENTION Troy Quigley, BBA, CIP Cunningham Lindsey Canada Claims Services Ltd. 1102 - 50 Burnhamthorpe Rd. W. Mississauga, ON L5B 3C2 Phone: (905) 896-8181 Fax: (905) 896-0775 E-mail: firstname.lastname@example.org DESIGNATION/EDUCATION Gary Ellis, BBA, FCIP, RF, FCLA, FCIAA, FIFAA AMG Claims Inc. P.O. Box 20102 Sherwood Charlottetown, PE C1A 9E3 Phone: (902) 628-9091 Fax: (902) 628-9093 E-mail: email@example.com Robert V. Pearson, CLA, FCIAA 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: firstname.lastname@example.org Lorne Montgomery, CIP, FCIAA, FCLA Crawford & Company (Canada) Inc. 300-123 Front St. W. Toronto, ON M5J 2M2 Telephone: 416-867-1188 Fax: 416-867-1925 E-Mail: email@example.com EDITORIAL Mary Charman, CIP Crawford & Company (Canada) Inc. 1 – 120 Mulock Dr. Newmarket, ON L3Y 7C5 Phone: (905) 898-0008 Fax: (905) 898-1705 E-mail: Mary.Charman@crawco.ca John M. Sharoun, FCIP, FCIAA, CRM 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 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: firstname.lastname@example.org FINANCE Jeff Edge, CIP, CFEI Leading Edge Claims Services Inc. P.O. Box 1399, 78 Highway 20 West Fonthill, ON L0S 1E0 Phone: (289) 897-8676 Fax: (289) 897-8677 E-mail: email@example.com Monica Kuzyk, FCIP, CRM Curo Claims Services 125 Northfield Dr. W., P.O. Box 218 Waterloo, ON N2J 3Z9 Phone: (866) 952-2876 Fax: (519) 888-9704 E-mail: firstname.lastname@example.org Heather Matthews, CIP, CRM, CIOP Crawford & Company (Canada) Inc. 539 Riverbend Dr. Kitchener, ON N2K 3S3 Phone: (519) 578-5540 Fax: (519) 578-2868 E-mail: Heather.Matthews@crawco.ca
IBC: LIAISON, LEGISLATIVE & FORMS Lee Powell Vericlaim Canada 5915 Airport Road, Suite 201 Mississauga, ON L4V 1T1 Phone: (905) 671-7834 Fax: (905) 671-7819 E-mail: email@example.com LICENSING J. Miles O. Barber, B.Comm. (Hons.), FCIP, CRM, RF Network Adjusters Ltd. 67 Folkestone Blvd. Winnipeg, MB R3P 0B4 Phone: (204) 897-5793 Fax: (204) 897-5797 E-mail: firstname.lastname@example.org MEMBERSHIP & QUALIFICATIONS Marie C. Gallagher, FCIP, CRM Kernaghan Adjusters Limited 602 – 1 St. Paul Street St. Catharines, ON L2R 7L3 Phone: (289) 786-1074 Fax: (289) 723-1979 E-mail: email@example.com NOMINATING Heather Matthews, CIP, CRM, CIOP Crawford & Company (Canada) Inc. 539 Riverbend Dr. Kitchener, ON N2K 3S3 Phone: (519) 578-5540 Fax: (519) 578-2868 E-mail: Heather.Matthews@crawco.ca Monica Kuzyk, FCIP, CRM Curo Claims Services 125 Northfield Dr. W., P.O. Box 218 Waterloo, ON N2J 3Z9 Phone: (866) 952-2876 Fax: (519) 888-9704 E-mail: firstname.lastname@example.org Paul Féron, FCIP, CRM ClaimsPro 210 – 746 Baseline Rd. East London, ON N6C 5Z2 Phone: (519) 645-6500 Fax: (519) 645-2250 E-mail: email@example.com Troy Quigley, BBA, CIP Cunningham Lindsey Canada Claims Services Ltd. 1102 - 50 Burnhamthorpe Rd. W. Mississauga, ON L5B 3C2 Phone: (905) 896-8181 Fax: (905) 896-0775 E-mail: firstname.lastname@example.org Balu Naidu, B. Comm., FCIP, CRM Claims Tech (Canada) Inc. 2800 Skymark Ave., Suite 300 Mississauga, ON L4W 5A6 Phone: (905) 568-8060 Fax: (888) 239-3234 E-mail: email@example.com PRIVACY James B. Eso, CIP, CIOP 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 ClaimsPro 120 Adelaide St. W., Suite 2401 Toronto, ON M5H 1T1 Phone: (416) 777-4479 Fax: (416) 360-7335 E-mail: firstname.lastname@example.org PROFESSIONAL PRACTICES Heather Matthews, CIP, CRM, CIOP Crawford & Company (Canada) Inc. 539 Riverbend Dr. Kitchener, ON N2K 3S3 Phone: (519) 578-5540 Fax: (519) 578-2868 E-mail: Heather.Matthews@crawco.ca
NATIONAL EXECUTIVE 2017 - 2018 PRESIDENT Monica Kuzyk, FCIP, CRM Curo Claims Services 125 Northfield Dr. W., P.O. Box 218 Waterloo, ON N2J 3Z9 Phone: (866) 952-2876 Fax: (519) 888-9704 E-mail: email@example.com 1 VICE-PRESIDENT Troy Quigley, BBA, CIP Cunningham Lindsey Canada Claims Services Ltd. 1102 - 50 Burnhamthorpe Rd. W. Mississauga, ON L5B 3C2 Phone: (905) 896-8181 Fax: (905) 896-0775 E-mail: firstname.lastname@example.org ST
2ND VICE-PRESIDENT Sarah Hirst, CIP, CRM, FCIP ClaimsPro #101, 5083 Windermere Blvd. S.W. Edmonton, AB T6W 0J5 Phone: (800) 565-3128 Fax: (780) 489-8841 E-mail: email@example.com SECRETARY Christopher Bartlett, BA, CIP Crawford & Company (Canada) Inc. 400 – 90 Matheson Blvd. West Mississauga, ON L5R 3R3 Phone: (905) 602-9511, Fax: (905) 602-7297 E-mail: Christopher.Bartlett@crawco.ca
TREASURER Jeff Edge, CIP, CFEI Leading Edge Claims Services Inc. P.O. Box 1399, 78 Highway 20 West Fonthill, ON L0S 1E0 Phone: (289) 897-8676, Fax: (289) 897-8677 E-mail: firstname.lastname@example.org PAST-PRESIDENT Heather Matthews, CIP, CRM, CIOP Crawford & Company (Canada) Inc. 539 Riverbend Dr. Kitchener, ON N2K 3S3 Phone: (519) 578-5540 Fax: (519) 578-2868 E-mail: Heather.Matthews@crawco.ca 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: email@example.com DIRECTOR Paul Féron, FCIP, CRM ClaimsPro 210 – 746 Baseline Rd. East London, ON N6C 5Z2 Phone: (519) 645-6500, Fax: (519) 645-2250 E-mail: firstname.lastname@example.org
DIRECTOR Sean Forgie, BA, CIP, CFEI ClaimsPro 1550 Enterprise Road, Suite 310 Mississauga, ON L4W 4P4 Phone: (877) 753-0753 Fax: (905) 565-0009 E-mail: email@example.com DIRECTOR James B. Eso, CIP, CIOP 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 DIRECTOR 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 DIRECTOR Albert Poon, CIP Cunningham Lindsey Canada Claims Services Ltd. 1102 – 50 Burnhamthorpe Rd. W. Mississauga, ON L5B 3C2 PHONE: (905) 896-8181 FAX: (905) 896-3485 E-mail: firstname.lastname@example.org
DIRECTOR Troy Quigley, BBA, CIP Cunningham Lindsey Canada Claims Services Ltd. 1102 - 50 Burnhamthorpe Rd. W. Mississauga, ON L5B 3C2 Phone: (905) 896-8181 Fax: (905) 896-0775 E-mail: email@example.com DIRECTOR Marie C. Gallagher, FCIP, CRM Kernaghan Adjusters Limited 602 – 1 St. Paul Street St. Catharines, ON L2R 7L3 Phone: (289) 786-1074 Fax: (289) 723-1979 E-mail: firstname.lastname@example.org DIRECTOR Gary Ellis, BBA, FCIP, RF, FCLA, FCIAA, FIFAA AMG Claims Inc. P.O. Box 2102 Sherwood Charlotteton, PE C1A 9E3 Phone: (902) 628-9091 Fax: (902) 628-9093 E-mail: email@example.com DIRECTOR Balu Naidu, B. Comm., FCIP, CRM Claims Tech (Canada) Inc. 2800 Skymark Ave., Suite 300 Mississauga, ON L4W 5A6 Phone: (905) 568-8060 Fax: (888) 239-3234 E-mail: firstname.lastname@example.org
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A northern light
Rocca Claims aims to attract talent to Ontario's north BY EMILY ATKINS
rom his base in Sudbury, Ontario, Giovanni Rocca is working on building his company while also creating a future for independent claims adjusters in Ontario’s near north. Rocca Claims has just celebrated its fifth year in business, boasting four full-time staff and one part-timer, and covering a vast geographical range that extends from north of Barrie, through Muskoka, Parry Sound, and including the area surrounding Sudbury. The firm covers all lines – auto, property, commercial liability, and third-party. Giovanni notes they also have a few control accounts, including one which is national. He is the main adjuster, with a second junior adjuster who is working on her CIP.
Foundations Giovanni came to claims adjusting from an education in public relations. When he found few jobs in that field after graduation, relatives suggested insurance would be a good fit. So, in 1996 he enrolled in the business of insurance program at Algonquin College, and fast-tracked his program to complete it in two years. Partly thanks to being elected valedictorian in his class – which he attributes to being more focused on his second time through school – before he had even graduated he landed a job at Economical Insurance in Toronto as part of their 16-week training program. The program at Economical taught participants every aspect of claims adjusting, Giovanni says. From there, with the full-time job, he was 12 Claims Canada
on three-month rotations, focusing on a different aspect of claims handling each time. “You’re in a fast-paced environment, but the amount that you learn in such a short time really stuck with you,” he says. “Economical was great in providing in-house training. I was really fortunate to get out of school and go straight there without the proverbial start at the mailroom.” While it was a fantastic start, it also highlighted that he “wasn’t meant to be in an office five days a week.” And with that he heeded the call of independent adjusting. He found himself back in northern Ontario, where he had grown up, working for a couple different IA firms in Sault Ste. Marie, Kapuskasing, and then Sudbury. After three years in the north, Giovanni returned to Toronto, taking a job with Marguerite Locke at McAdam Insurance Adjusters. At first he did all lines, but Locke gave him the golf program to run. He became a control adjuster on almost every golf course in Canada. “That was a great learning experience, as well, in how to deal with people in different provinces and different methods of adjusting, and knowing people in a different manner,” Giovanni says. “Every customer wants something different, or needs to be treated differently. Dealing with that control account across Canada helped me better understand claimants moving forward and to be more empathetic.”
With a series of mergers and acquisitions that followed he ended up back in northern Ontario as regional manager for Granite. His objective was to develop offices in Thunder Bay, Timmins, North Bay, Parry Sound, Muskoka, and Sudbury. But, just before Granite was acquired by ClaimsPro he decided it was time to start his own business. After taking six months off to evaluate what he wanted to do, he decided to launch his own IA shop. With a commitment to building roots in Sudbury, he made five-year and 10-year plans and opened Rocca Claims in November 2012. “I felt like I was going at a nonstop pace from the point I went back to school in ‘96. So it was a good time to reevaluate,” he says. “I didn’t want to make the decision lightly to go on my own. If I went for it, I wanted to make sure I took the time. And then I created long-term plans.”
The vision In his evaluation, Giovanni realized there was a claims-adjusting service gap in northern Ontario, and he sought to fill it. “Part of our vision is to become the face of the north. So when people look from down south, or other parts of Canada or North America, or north of London, for example, they automatically think of Rocca Claims in northern Ontario.” His philosophy is to deliver a consistent, high-level of quality and service to all clients, and to take pride in the company’s customer service commitment. www.claimscanada.ca
Left to right: Franca Chiarello, Danica Lavergne, Jenna Levac, Melissa d’Entremont, Giovanni Rocca
From its home in Sudbury, Giovanni sees the company expanding with branches across the north in Timmins, Sault Ste. Marie, Parry Sound, and Muskoka. He says that within the next year he plans to open another office in the Muskoka area, and within the next five years to have built up to four outposts in the key northern cities. Another important piece of his plan is to make the next generation of adjusters feel they can work in the north. He wants to encourage students, those looking for meaningful work, to consider the profession of adjusting, and understand that there are opportunities in places other than southern Ontario. “There is opportunity in northern Ontario,” he says. “It’s great to have young people come back in this industry this way versus down south. And there’s a great crop of adjusters in northern Ontario, but there’s going to be an age gap. And somebody needs to fill that and why not be me?” www.claimscanada.ca
Looking back, the early opportunities he had – at Economical and with Marguerite Locke – gave him a passion for helping bring along the next generation, he says. “I’m not a millennial,” he laughs. “But, giving them a chance and providing structure and leadership is a great opportunity. It’s a great way to attract the millennials, and with their technological efficiency, they can become great assets to a company. I feel you have to be open to their input.”
going to fall by the wayside. I definitely would like CIAA to be more of an advocate and a leader in providing avenues of education,” he says. His concern is that without enforced standards new adjusters will have just a bit of education and they will be “thrown into a situation they’re not ready for, and in the end the person that’s going to lose the most out of that is the customer, is the claimant.”
In keeping with his passion for training and recruiting the next generation to work in the north, Giovanni places a lot of value on helping his community. He believes that if you want to be a part of a place, you have to be involved. “Whether it’s politics or world events or helping your neighbour, I believe people need to step up and not just focus on their own life, but always be able to help somebody else. And in that brings you more reward than you can imagine.” •
As a longtime volunteer and president of the Northern region of OIAA, Giovanni would like to see the CIAA step up to create more structure for adjuster qualification. Practically, that would mean “more input on an adjuster’s responsibility versus a contractor’s responsibility. If we don’t have a mothership to guide us and to enforce these policies and to encourage designations, then it’s just
Shining a light
Claims Canada 13
Sharing the road
Who will be in charge as autonomous vehicles and human-driven cars operate side by side on our highways?
By Emily Atkins
14 Claims Canada
n March this year an Uber-owned Volvo XC90 operating in autonomous mode – but with a human minder in the driver’s seat – ran over and killed a pedestrian in Tempe, part of Phoenix, Arizona. Until then the route to self-driving cars integrating onto our roads seemed to be relatively smooth. But with this tragic event autonomous vehicles are hitting the brakes. Uber took autonomous vehicles off the road in all four cities where it was testing them, Pittsburgh, San Francisco, Phoenix and Toronto. In Arizona the governor suspended the company’s autonomous driving privileges. About 10 days after the incident, the victim’s family lawyer told Associated Press the “matter had been settled”. From Uber to heavy trucks and private passenger cars, research and experimentation with autonomous driving (AD) is making news, some good, and some, like the recent death in Arizona, sobering. This incident raises numerous questions about the technology’s readiness to safely interact with its surroundings, and highlights many issues that will affect automobile insurance in the future. But even without the Uber crash to prompt the conversation, the rapid evolution of automated driving technologies promises to alter government regulations and industry practices, while the potential obsolescence of human drivers will also change the legal landscape for consumers, car manufacturers, the legal profession, insurance companies and others. With this in mind, it’s time for a look at why AD matters, available technologies on the road today, how autonomous and human-driven cars will interact, and how this evolution might affect the insurance industry.
The case for automation It’s dangerous on the road. According to an Insurance Institute of Canada (IIC) report (Automated Vehicles: Implications for the Insurance Industry in Canada), in the last 30 years 6.7 million Canadians suffered injuries in collisions, while more than 94,000 have died on our roads. The Conference Board of Canada estimated that in 2011 the annual cost of fatalities and injuries from motor vehicle accidents was $46.7 billion. What’s at the root of this terrible toll in suffering and cost? Driver error. Human mistakes have been found to be responsible in upwards of 90 percent of motor vehicle crashes. Self-driving cars promise to alleviate the carnage, reduce costs and confer many other benefits as well. If the unpredictable, unreliable, potentially intoxicated and distractible human is taken out of the driving equation, and sleepless, smart machines take over, that 90 percent could be all but eliminated, AD proponents say. On the cost side the Conference Board notes that, conservatively, the 2011 costs could have been reduced by $37.4 billion if 80 percent of crashes had been eliminated. Clearly, it’s not a simple calculus, with factors such as the changing value of repairs to increasingly sophisticated autonomous vehicles moving the goal posts around, but the underlying logic holds true: anything we can do to reduce car crashes will save lives and unnecessary costs. Other benefits include reclaiming productivity and wellbeing lost in long commutes at the wheel. Public health studies the www.claimscanada.ca
world over show that the stress of a congested commute shortens lifespans and reduces quality of life. The 2017 Canadian census found that while the average Canadian driver spends 24 minutes on the road to work each day, there were more than 850,000 people working in 2016 who spent at least one hour getting to work in a private vehicle each day. In Vancouver, Montréal and Toronto the average one-way commute time is around 30 minutes. Self-driving cars could alleviate not only the stress and tedium of driving, but would also help minimize congestion by being good drivers – staying in the correct lane, keeping a safe distance and preventing the accordion effect from developing on busy rush-hour roads. Fully autonomous vehicles also promise greater freedom and mobility for those who cannot drive themselves, ending their reliance on family, public transit or taxi services to get around.
A few caveats Along with these benefits analysts also see some roadblocks to increasing automation. A recent University of Victoria study written by Todd Litman notes that with increasing sophistication, cars will become more expensive, and given their longevity it will take years before even currently existing technologies achieve a high adoption rate. As well, the price of error will be much higher, as the Uber crash bears out. “System failures by cameras, telephones and the Internet can be frustrating, but are seldom fatal,” he notes. “System failures by motor vehicles can be frustrating and deadly to occupants and other road users.” The risk is not just from failures, either. Litman notes that cyber security for cars will become a major concern, with the danger that a car might be taken over by a malicious hacker. Either hacking or system failure may result in collisions, he says, meaning that the anticipated reductions in crash costs may not materialize as many hope. Hacking also poses personal privacy and data breach concerns, Litman points out. From a societal and economic perspective there may be larger costs resulting from lost employment in the transport sector, and higher infrastructure costs due to the necessity of sensors and high tech equipment being built into our public roads.
Who’s driving now? Already, many of us are driving vehicles with semiautonomous capabilities. If you have advanced collision prevention technology aboard your car or truck, or even adaptive cruise control, you are piloting a partly autonomous vehicle. The Society of Automotive Engineers (SAE) came up with a classification system for the degree of autonomy in vehicles (see chart next page). It groups cars into five levels based on the amount of human versus system control over driving tasks. At present most cars and light trucks with automation technology on the road are at level one or two. Uber and other self-driving cars currently being tested are at level-three and level-four automation, with a human driver still expected to take over some tasks when needed. Level one and two technologies are becoming increasingly commonplace, and have been part of the Insurance Institute for Highway Safety’s rating program since 2013, as well as earning discounts from many insurers. May-June 2018
Claims Canada 15
These include numerous aids such as: • Adaptive cruise control keeps a constant distance to the car in front, and slows or possibly stops the vehicle when the car in front is moving too slowly. • Forward collision prevention uses sensors to measure distance and relative speed and warns the driver if a collision is imminent. While the warning takes place, the system warms up the brakes and if the driver is too slow to respond some systems will engage the brakes automatically. Some systems also prepare the car for a collision by tightening seatbelts and closing windows to minimize the effects of a crash. • Rear backover prevention stops the car in reverse before it hits something. • Lane departure warning alerts the driver they are wandering outside the lines and in some cases will return the car to the lane. • Blind spot detection notifies the driver there is a vehicle that cannot be seen and in some cases prevents the vehicle from changing lanes into the other car. With each successive model year, manufacturers are adding technology, bumping previous years’ innovations up from expensive options to standard equipment, and pushing cars further to the autonomous end of the SAE scale.
Complex calculations Given that fully autonomous driving is not likely for at least another 30 to 40 years – the Institute of Electrical and Electronics Engineers believes it will take until at least 2040 before 75 percent of vehicles are autonomous – there will be a long period in which these new technologies will interact on the roads with human-driven vehicles as well as pedestrians, cyclists and others. And it will be a challenge.
Thanks to the complexity of the unpredictable street and highway environment, with multiple moving objects, signs, lines, guardrails, traffic signals, pedestrians, animals, weather, lighting conditions, even cultural differences in driving styles, and so on, the amount of computing power required for AD is astronomical. The US General Accounting Office explained in a 2016 report that a Boeing 787 Dreamliner aircraft, one of the most sophisticated in the air today, requires about 6.5 million lines of code to operate. A modern luxury car, on the other hand, needs 100 million lines to manage all its systems and options, and that’s before autonomous driving capability is introduced. It will require extremely complex algorithms to allow autonomous cars to make decisions the way humans do. Sure, computers have quicker reaction times and can calculate myriad probabilities in a split second, but it will take sophisticated machine learning for cars to come to the level of decision making that an average human demonstrates. One area where this is often cited as a challenge is in the ethics of decision making. If the car has no choice but to hit something, will it be able to distinguish between a dog and a toddler and make the right choice? “There’s no value-free way to determine what the autonomous car should do,” say Brett Frischmann and Evan Selinger, both professors and co-authors of Re-Engineering Humanity, in a recent op-ed on Vice.com. “The choices…shouldn’t be seen as a computational problem that can be ‘solved’ by big data, sophisticated algorithms, machine learning, or any form of artificial intelligence. These tools can help evaluate and execute options, but ultimately, someone – some human beings – must choose and have their values baked into the software.”
Execution of Steering and Monitoring of Driving Acceleration/ Environment Deceleration
Fallback Performance of Dynamic Driving Task
System Capability (Driving Modes)
Human driver monitors the driving environment
the full-time performance by the human driver of all aspects of the dynamic driving task, even when enhanced by warning or intervention systems
the driving mode-specific execution by a driver assistance system of either steering or acceleration/deceleration using information about the driving enviroment and with the expectation that the human driver perform all remaining aspects of the dynamic driving task
Human driver and system
Human driver Human driver
Some driving modes
the driving mode-specific execution by one or more driver assistance systems of both steering or acceleration/deceleration using information about the driving enviroment and with the expectation that the human driver perform all remaining aspects of the dynamic driving task
Some driving modes
Automated driving system (“system”) monitors the driving enviroment
the driving mode-specific performance by an automated driving system of all aspects of the dynamics driving task with the expectation that the human driver will respond appropriately to a request to intervene
Some driving modes
the driving mode-specific performance by an automated driving system of all aspects of the dynamic driving task, even if a human driver does not respond appropriately to a request to intervene
Some driving modes
the full-time performance by an automated driving system of all aspects of the dynamic driving task under all roadway and enviromental conditions that can be managed by a human driver
All driving modes
Copyright © 2014 SAE International. Source: SAE International; J3016, Taxonomy and Definitions for Terms Related to On-Road Motor Vehicle Automated Driving Systems.
16 Claims Canada
As manufacturers work to develop ever-more sophisticated self-driving capabilities that move responsibility from the human driver to the designers and programmers building the machines, they will have to figure out how to take this into account. “Engineers will embed the ethics in decision-making algorithms and code,” say Frischmann and Selinger, but should they be the ones making those decisions? It’s a question industry and society will have to address, and before the arbitrary ethics become entrenched in the technology, the authors warn.
Taking responsibility The IIC report highlights the challenge of figuring out who is responsible for collisions. “Personal liability for most collisions will begin to shift to include a mix of personal and product liability,” the report notes, as cars increasingly take on the chore – and risks – of driving. Insurers will need to design policies to cover the human driver, the driver of the semi-autonomous vehicle and the fully automated car, as all three share the road. Mercedes-Benz, one automaker with sophisticated semi-autonomous technology on the road in many of its vehicles and which is testing its E-Class AD cars in Nevada, believes that most currently existing liability laws will serve the changing model. “The legal framework that applies to the current driver assistance systems also forms a reasonable basis for the next stages of development. However, changes need to be made to the technical regulations as well, in view of the future of autonomous driving,” says Renata Jungo Brüngger, member of the board of management of Daimler AG, responsible for integrity and legal affairs. With regard to current, partially automated systems, under the laws of many countries the driver remains responsible. Although safety systems support the driver, the driver must maintain control of the vehicle and intervene in case of an emergency. If the driver causes an accident, he or she is liable for the resulting damage, along with the owner of the vehicle. Manufacturers are responsible for damage flowing from product defects. “This shared combination of liability among the driver, owner and manufacturer offers a balanced distribution of risks, protects victims and has proven itself in practice,” says Jungo Brüngger.
Damage Report Medium Heavy
YEAR: 2013 MODEL: Veloster MAKE: Hyundai VIN #:...XXXXXX
The road ahead While Berkshire Hathaway’s Warren Buffet believes self-driving cars will limit the insurance business, as he told the company’s annual meeting in a year ago, a recent report by Accenture (Insuring Autonomous Vehicles) takes the opposite tack. It suggests that while individual insurance premiums will fall, they will be offset by the need for new kinds of car insurance, related to the cyber risks noted above, including new kinds of liability insurance and cyber-infrastructure coverage for the computing systems that keep the cars running. The consulting firm believes new premiums for these coverages could be worth US$15 billion by 2025. As well, while the frequency of collision claims may decline if AD lives up to its safety promise, the severity and expense of collision claims is expected to climb. With sophisticated sensors and technology aboard, self-driving cars will be much more expensive to repair, says Tom Super, director of the property and casualty insurance practice at J.D. Power. The consensus is that auto insurance is not going away, but as with so many facets of the industry, it will have to change to accommodate the new kind of driving. “What we’re going to see for the next 20 years is a messy, complex and uneven transition that raises a number of questions,” said IBC’s Don Forgeron in a speech on the future of insurance this April. “How do we begin to adapt to a transportation system in which the concept of liability is going to be transformed?...How [do we] price liability that is going to shift from the driver to the manufacturer?” Likewise, in its AD report IIC raised numerous questions that will need answers before there can be clarity around auto insurance in this evolving environment. How will insurers get information about what happened in a collision? Will they have access to onboard data? How will they collect from automakers when the technology is found to be at fault? How will costs be shared when both driver error and system failure contribute to a crash? While these and many other questions remain to be resolved in the continuing journey to autonomous driving, one thing is certain: There’s no rush to make decisions. While selfdriving technology is advancing rapidly, it is still in its formative years, and not at all ready to take the wheel. It’s barely got it a learner’s permit. The Uber Volvo crash is proof enough that there is much to be learned and put into practice before we can sit back and let our car play chauffeur. Even Raj Rajkumar, head of the GMCarnegie Mellon University’s AD lab and one of the world’s preeminent AD researchers said after the Uber crash: “Companies need to take a deep breath. The technology’s not there yet.” • www.claimscanada.ca
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Claims Canada 17
Rise of the Machines
Appliance Fire and Flood Claims – Part 1 BY MAZEN HABASH
Fears surrounding appliance failures in the wake of technological innovations are by no means new. A New York Times article published in 1984, “The Digital Revolution Breeds Smart New Appliances”, stated, “For better or worse, the digital revolution has come to the laundry and kitchen. Appliances are beeping, blinking, flashing messages and signaling when doors are ajar, cycles over and motors burned out…Quality has improved because of increased automation in factories – but so has appliance complexity, oftentimes with irksome results.” Fast-forward 30 years and that still holds true. Innovation in the home continues to move forward at a rapid pace and appliances are more complex than ever. Today, however, that can lead to more than just “irksome results”; in many cases, it means an increased risk of fire and flood. In Canada, approximately one out of five residential fires starts in the kitchen – more than in any other room in the house – and water damage (caused by water main breaks, overflowing appliances and hot water tank leaks) has replaced fire and theft as Canada’s largest source of claims. A significant number of the residential fires and floods we investigate start in the kitchen or laundry room. In this two-part article, I am going to walk through the typical appliances found in these rooms and explore how and why each one can fail, starting in the kitchen.
Ovens and Ranges In Ontario, 18 percent of fires in kitchens are cooking fires, and of those, nearly three quarters start on the range cooktop. You may be surprised to know that both 18 Claims Canada
electric and gas ranges are equally likely to be involved in a fire. However, the risk for a fatality is four times greater with gas appliances due to gas leaks and because the open flame from a burner can ignite combustible materials such as curtains, loose clothing, towels, etc. On the other hand, electric ranges are much more likely to be accidentally activated than gas appliances, either by the user or by a defect in the controls. Between 2009 and 2012, electric ranges from Kenmore, Frigidaire, Electrolux and LG were all recalled for one thing, defective digital controls that caused the heating elements to either: Turn on spontaneously without being switched on; or fail to turn off after being switched off; or, unexpectedly increase in temperature. One important thing to note with respect to recalls – and certainly something that has changed since 1984 – more appliances and components are now being manufactured overseas. Consumer Reports says that almost four of every five recalls involved products made outside of the U.S., with the majority coming from China. And in the case of ranges, these malfunctions have the potential to cause extensive physical damage if any food or combustible materials are left on the cooktop.
One of the first things I check when investigating a kitchen fire is whether a recall has been issued for any appliance on the scene. If not, and assuming no evidence of failures is discovered, I then have to consider user-related causes. When it comes to ovens and ranges, most user-related causes boil down to carelessness, distraction or haste. As previously mentioned, one common user-related cause of fire is the accidental activation of a cooktop. Again, electric ranges are prone to this, but also any model with front controls – both electric and gas. Self-cleaning ignition scenarios often simply come down to people keeping combustible materials too close to, or even inside, the oven. Self-clean is a feature that works by raising the temperature to over 800 degrees Fahrenheit and incinerating any food inside to ash. Towels, cookbooks or oven mitts left inside the warming or storage drawer can ignite during the self-clean cycle. In the case of gas ranges, those items can even ignite during normal use. There are many variations of user-related causes, but unattended cooking is the number-one cause of range fires, by far. That said, one should never assume. Sometimes a seemingly open-and-shut www.claimscanada.ca
case, where the insured says they left the stove unattended, turns out to be a not-soinnocent incident upon further investigation. When a range is used to stage an arson, certain clues may survive the fire, such as combustible materials like towels that people place over the cooktop as a mechanism to spread the fire beyond the range.
Microwaves and blenders Microwaves present two common causes of fire: Improper usage and internal defects. Improper usage includes unintentionally over-heating items (accidentally setting the timer to 30 minutes instead of three minutes), or microwaving foods that can ignite, like bacon or carrots (carrots are effective conductors of electricity and can act as miniature lightning rods under certain conditions created inside a microwave). The second common cause of fires in microwaves is internal defects, usually related to circuit board failures. Blenders do not commonly catch fire for two reasons: They are not heat-producing appliances and they are generally only used for short durations. However, where early blenders only had an on/off switch, modern blenders have circuit boards and processors, as well as high-powered motors, so the potential for a defect is present, especially since they are exposed to liquids. Coffee makers and kettles During the 1990s coffee maker fires became so common that arsonists started tampering with them to simulate a wellpublicized mode of fire ignition. Due to tightened safety regulations, coffee maker fires have become less common, but they still have the potential to fail. Both coffee makers and kettles can overheat if their internal safety devices malfunction and they do not shut off as they should. Refrigerators People do not normally think of refrigerators as posing a fire hazard, but they have heaters and draw plenty of electrical current. And, unlike ranges, fridges are constructed with more combustible materials that can provide fuel in the event of a fire. A common defect in fridges is a relay failure. A relay is an electrical component that turns on a fridge’s compressor. The compressor circulates coolant which absorbs the heat inside the fridge, cooling www.claimscanada.ca
down the air. However, an electrical phenomenon called arc tracking can cause the relay to overheat and ignite the surrounding plastics.
Dishwashers Before the rise in popularity of dishwashers in the late 1970s, dropping a plate was the worst thing that could happen while doing the dishes. This past October, over half a million dishwashers sold between January 2013 and May 2015 were recalled because the power cords could overheat and catch fire. However, the most common causes of dishwasher fires are the infiltration of water, detergent or rinse-aid on the control circuit board(s), and the heating element overheating. Failure of the heating element, which frequently results in the ignition of the plastic tub, can be especially destructive. Toasters The two most common causes of toaster fires are misuse and product defects. Misuse includes overheating greasy, oversized or sugary foods to the point where they ignite. The most common product defect in toasters is the failure of the switch that provides power to the heating elements. This causes the toaster to stay on indefinitely, igniting food inside and anything else in its path, including curtains, paper towel rolls, and low cabinets. The future From the time that New York Times article was written in 1984 there is hardly a kitchen appliance, device or gadget that has not been significantly upgraded. Everything has been redesigned to do more, more efficiently and more effectively. But those improvements often mean more components, greater complexity, and increased opportunities for errors and failures that can result in fire. Fortunately, knowing is half the battle. Armed with this knowledge we have been able to determine cause of numerous kitchen fires, originating from all of the above mentioned appliances. Next month we will pick up where we left off and examine appliances found in the laundry room. • Mazen Habash is president and consulting forensic engineer at Origin and Cause.
When customers need restoration services, Total Textile Solutions (TTS) is there. We are a national network of hand selected operators who have more than 150 years of experience in the restoration industry. Our expertise has been proven time and time again. We have restored millions of items such as shoes, clothing, window coverings, bedding and many precious family heirlooms with sentimental value. Across Canada water losses, fire and smoke damage, sewer backup and much more….
Every disaster can be stressful But not when you call our Team - TTS. Stephen Lowe, recently appointed as the national sales manager, is committed to building on the company’s quality people and service. Our current members in B.C., Alberta, Manitoba, Ontario and Quebec welcome and look forward to our expansion into the Maritimes and Saskatchewan completing our coverage across Canada this year. “Our objective is to build strong relationships with national property restoration contractors, insurers and independent adjusters,” Lowe says. “As we continue to expand our footprint we will provide even more benefit to our customers. Companies operating regionally and coast to coast want consistent service from a textile restoration company, so it makes sense for them to deal with a company that has a national presence.” TTS’s goal is to mitigate the insured’s loss, cost-effectively and efficiently. The relationships that the TTS network have formed over the decades help make that happen. We pride ourselves on being able to collaborate with the home owner, adjusters and restoration company to fully restore items to pre-claim conditions. The process is meant to be fair and costconscious every step of the way so that the insurer and homeowner are satisfied with the final result.
“One Call” That’s All. Claims 1-855-303-2273 Visit us online to join the team www.textilesolutions.ca May-June 2018
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The obligation to defend additional insureds
BY TALAAL F. BOND
It was snowing heavily on February 8, 2013 when Antonio Carneiro Jr. drove his car downhill on Brock Rd. near Pickering, Ontario. He lost control. His vehicle slid into the path of an oncoming vehicle at the intersection with Whitevale Road. Carneiro was killed. His grieving family sued a number of parties including the Regional Municipality of Durham and Durham’s road maintenance contractor, Miller Maintenance. Zurich had issued a CGL to Miller. Miller was the named insured. Durham was an additional insured. Zurich immediately defended Miller. As for Durham, Zurich said that it would defend those allegations against Durham that were subsumed in the defence of Miller. Durham said that Zurich owed Durham a complete defence with counsel separate and apart from Miller; anything less would mean that its status as an additional insured would be meaningless. This dispute gave rise to a common coverage problem: What is the decision tree to determine the scope of an insur20 Claims Canada
all defence costs relating to a claim, those costs do not increase because they also assist the insured in the defence of an uncovered claim. The insured receives nothing more than what it bargained for: payment of all defence costs related to covered claim. This includes uncovered claims so long as they are related. Costs are not payable for uncovered claims unrelated to the defence of covered claims. In Hanis, the insurer was required to indemnify the additional insured (an insured under the policy) for 95 percent of the defence costs – around $2m. The court in Hanis identified the different classifications of claims: covered, uncovered-related and uncovered-unrelated. So, the question is what is an uncovered-related claim? This is dependent on a factual analysis. If the covered and uncovered claims share the same factual foundation, then it is next to impossible to allocate with any precision the legal expenses incurred with respect to covered, mixed and uncovered claims. However, if the factual foundations are different, then the defence of the uncovered claims will not be indemnified. In Carneiro the court then held the duty to defend was triggered if the allegation the deceased lost control of his car because of the ice and snow was true. Any claims, covered or uncovered, related to this allegation, triggered the duty to defend the additional insured, per Hanis. It was noted that there was no authority for Zurich’s argument that it could satisfy its duty to Durham by defending Miller. Indeed, this would render meaningless Durham’s status as an additional insured. As in Hanis, Zurich had to indemnify Durham for defence costs associated with counsel of its own choosing.
er’s duty to defend an additional insured?
A duty to defend? The duty to defend is triggered on the mere possibility that a claim falls within the policy (Progressive Homes v. Lombard General Insurance, 2010 SCC 33). Given the laundry list of allegations in the claim, there was little doubt that the court was going to find at least some allegations that would trigger the duty to defend. However, Zurich agreed it would defend only those allegations against Durham that were subsumed in the defence of Miller. It argued that by defending Miller it was also defending Durham. Durham argued that the duty was broader. The motions judge agreed with Zurich. Durham appealed. The Court of Appeal followed its decision in Hanis v. Teevan, 2008 ONCA 678, a nasty employment case with allegations of theft, wrongful dismissal and malicious prosecution. In that case, it held that the insurer had to pay all defence costs associated with defending covered claims whether or not they furthered the defence of uncovered claims. If the insurer contracted to cover
Applying Carneiro Insurers have sought to find the boundaries of the extent of the duty to defend an additional insured. This is not always so clear, since each determination must be based on a review of the allegations and the characterization of their factual underpinnings. In Riocan Holdings Inc. v. Intact Insurance Co., 2017 www.claimscanada.ca
ABCA 73, the plaintiff sued the property manager and its contractor in relation to a slip and fall. Again, the insurer was sued for coverage, but in this case, it argued that the judge should have looked at the nature of each of the plaintiff's specific claims. This turned out to be essentially the same argument as Zurich attempted in Carneiro. The judge ordered the insurer to provide a defence in respect of all covered and uncovered related claims. In Markham (City) v. Intact Insurance Co., 2017 ONSC 3150, another similar slip and fall case, the insurer took the position that the City was not entitled to a defence to plaintiff action because the contractor performed no work on the day of the fall. Rather than challenge the law, the argument focused on the interpretation of the factual underpinnings for the claim. The judge did not accept the insurer’s characterization of the facts and ordered it to defend the additional insured. (The insurer also argued that the City was not an additional insured under the policy, but this too was rejected.) More recently, in National Gallery of
Canada v. Lafleur de la Capitale, 2017 ONCA688 (September 6, 2017), a man was killed during the course of his employment. As in Carneiro, his family sued both the employer and additional insured. However, in this case, there was an exclusion in respect of claims arising from employer’s liability. The judge agreed with the additional insured but did not provide sufficient reasons explaining why. The insurer was successful on appeal for that reason and the matter was returned to the lower level for a second hearing before a different judge.
Conclusion To determine the extent of the duty to defend for additional insureds, an insurer should first look to the factual underpinnings of a claim and determine if there is coverage. If so, then it should identify the additional insureds and examine whether the claims are related-uncovered. It is often the case that the additional insured maintains that the named insured is fully or largely liable for the event giving rise to the lawsuit and in that
event, the insurer has to consider whether it must appoint separate adjusters, examiners and lawyers for the defence of the additional insured. Losing control of the defence is the penalty for failing to consider the implications of that conflict. In cases of conflict between an insured and an additional insured, parties should be put on notice. If the insurer wants to avoid losing control of the litigation and costs, it should consider reconciling conflicts where possible. In some cases, it would make sense to simply extend coverage to the additional insured, regardless of conflict, to avoid splitting the defence, particularly where unrelated-uncovered claims have a very low chance of success. It would not make sense to split the defence because the plaintiff used a “laundry list” of allegations. In any event, good communication with the various insureds ought to be fostered. • Talaal Bond is a member of Canadian Defence Lawyers Board of Directors and a Partner at Matthews Abogado LLP in London, Ontario.
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The evolving nature of business interruption BY ALEKSANDRA ZIVANOVIC
In the face of climate change, cyber risks, and mass terror plots affecting entire regions and sometimes economic sectors, business interruption coverage is a challenging coverage to both write and adjust. This challenge is multi-faceted and directly impacted by global trends resulting in evolving both the insurance products on the market and the risk and claims management process. It will also continue to be a growing issue in litigation as businesses seek coverage for an increasing number of events. Much of the challenge will be how the scope of business interruption coverage will evolve to meet the needs of a modern business. The Allianz Risk Barometer: Business Risks 2017, [Risk Report, 2017] surveyed more than 1,200 risk experts from 50plus countries and businesses. According to the report “actual and anticipated losses from a business interruption” is the risk that troubles them the most. It is the top risk for the fifth year in a row. Of particular interest is the increasing shift of risk towards non-damage events such as a cyber incident or the indirect impact of an act of terrorism, as these are events that can result in large losses without causing physical damage. According to the Risk Report, 2017, more of these types of events are expected. The Risk Report, 2017, highlighted that the average large business interruption property insurance claim was $2.3m, 36 percent higher than the average direct property damage loss of $1.75m. These numbers show the significant impact business interruption can have on busi22 Claims Canada
nesses’ revenues. As reported, physical perils like fire and explosion (44 percent) and natural catastrophes (43 percent) remain the highest risk. Though physical perils like fire, explosion and natural catastrophes are the causes of business interruption that businesses fear most, an increasing issue is the non-physical or non-damage causes of business interruption. The Risk Report, 2017 identifies supplier failure (33 percent), cyber incidents (29 percent) and the wider disruption caused by a terrorist event (10 percent) as some of the many incidents that can cause global large losses for businesses without causing property damage. The problem remains that new triggers for business interruption emerge constantly. For Canada, Robert Fellows, head of market management, AGCS Canada, indicated that the Fort McMurray wildfires highlight the issues businesses face with interruptions. He also indicated that the tendency toward just-in-time manufacturing made business interruption a critical concern. What we can glean from the insight of industry leaders as it applies to business interruption coverage is the following: globalization has had a significant impact on the property and casualty market as it runs at an ever-increasing pace. The commercial community is an interconnected economy that will continue to face unpredictable changes in the legal, geopolitical and market environment around the world. A range of new risks is emerging, beyond the perennial perils of fire and natural catastrophes, and which require rethinking of current monitoring and risk management tools.
As a result, business interruption is expanding from damage-driven events such as natural catastrophes, fire incidents to intangible hazards that could have a crippling effect on the loss of income for businesses. By consequence, it is more than likely that there will be an increased scrutiny on business interruption claims. The takeaway is that standard business interruption coverage as we know it is limited or wholly inadequate to respond to the needs of today’s business. Business interruption coverage is an extension to property insurance and, simply put, can be defined as property damage coverage with insurance to cover the ongoing expenses created by that damage that stems from an insured loss. In the event of a covered loss, an insured expects their policy to provide the net income that the business would have received if the covered loss had not occurred, up to and including the limits that they agreed to. Examples of this type of coverage would include business interruption, contingent business interruption, extra expense, loss of rental or rental value, additional living expenses and leasehold expenses. These policies typically cover profits, fixed costs, temporary locations, extra expenses and civil authority ingress/egress service interruption. As business interruption losses are the less tangible consequence of covered losses, they are often the most contentious. The most common areas of dispute that make their way to Canadian courts are: The nature of indemnity; the relationship between business interruption and the insured peril; and, specific issues associated with the valuation of business interruption claims. www.claimscanada.ca
As we continue to watch for trends in Canadian courts, we will likely see a fourth category: Coverage cases arising from supply chain disruptions involving first, second or third tier suppliers. These sub-tier suppliers are out of the business’s control, making it difficult to trace and control the disruption. This is often because the time element of the policy is not designed to meet exposures that occur at third-party premises. The suppliers’ extension clause is typically first tier or direct suppliers only, for physical damage events and insured perils only, subject to restricted perils. According to the Risk Report, 2017, what we will likely continue to see is an increasing trend that physical damage is not the most prevalent cause of supply chain disruption but more often related to, for example, cyber issues. In an article for the Federation of Defense & Corporate Counsel (FDCC) Winter Meeting, (March 2017), When A Disaster Turns The Insured’s Address to the Boulevard of Broken Dreams, Dull Business Interruption Coverage Becomes Contentious (Broken Dreams) the authors, Heather Sanderson and James Eastham discussed, among other topics, the implications of the different business interruption coverage interpretations globally. The authors stressed that one cannot assume business interruption coverage in one country is identical to those used by others. Though there may be similarity between United States, United Kingdom and Canadian policy wordings, similar is not identical, and even subtle differences can have a direct impact on coverage. The authors summarized that in Canada, insurers do not use a common business interruption form nor do they use the same form for each jurisdiction. Instead, each insurer has its own form, resulting in variances in wording. In some instances, the “wording is similar to that used in the United Kingdom, others are influenced by American and Australian wording. In other cases, the wording is ‘broker wording’; wording offered by an international broker, which in turn was influenced by policies issued in multiple jurisdictions.” As a result, Canadian insurers www.claimscanada.ca
deliver business interruption insurance products with some commonalities between them, but also with differences in their wording, resulting in the possibility of different interpretations. This consequence can also therefore result in different coverage interpretations for the same event. Further, as business interruption forms do not contain a formula as to how a loss is calculated, certain losses will prove more difficult to calculate and therefore increase the uncertainty of what is, or is not, payable under business interruption coverage. It is for this reason that a further layer of uncertainty arises as Canadian courts, when asked to interpret the wording of business interruption coverage, will have to rely on the traditional rules of insurance contract interpretation to provide meaning to the coverages and exclusions. Adding to that mix of uncertainty is the increasing frequency of a minor covered loss producing major business interruption. As insurers look to enhance their collaboration with brokers and businesses to determine relevant and competitive insurance products, a key
area will be the development of business interruption policy coverage and wording. The questions will likely stem not from identifying an event first, but rely on a global matrix to examine a business’s own investment into managing its actual and anticipated business risks and then determining whether any of those risks, actual or anticipated, ought to be a covered peril. The complexity of the matter should not be underestimated as we have all become increasingly aware that an impact to one business will not only cause a business interruption for it but can have a ripple effect on an entire sector or a critical infrastructure. It is for this reason that business interruption events will continue to be a primary challenge for insurers and their respective risk and claims processes. It will also present unique challenges in law and the dispute resolution process when an event or loss occurs. • Aleks practices complex general liability and commercial litigation at Boghosian & Allen LLP.
Knowledge And Experience That Has You Covered
Philip Turner TORONTO
Alain Viger MONTREAL
Kevin Copeland CALGARY
Edward Robinson VANCOUVER
FORENSIC ACCOUNTANTS TORONTO | MONTREAL | CALGARY | VANCOUVER AKRON | BEACHWOOD | BOSTON | CHARLOTTE | CHICAGO | CLEVELAND | COLUMBUS LONDON UK | LOS ANGELES | MIAMI | NEW YORK | ORLANDO | PITTSBURGH | WOOSTER
Claims Canada 23
could otherwise be dried if more time were allocated. Statistics coming out the U.S. suggest an average drying job takes five days.
IICRC S500 Standard 2015, V-4 Not one document gets more misquotes than the S500. Let’s break down this document and show how you can use it to make your insurance company more profitable. First, please do not call this a manual. It is not a how-to book of drying. You will not find the process for drying structures. You will not find the term “3-Step Bio-wash”, but you will find the general principles that restorers use to successfully perform the “3-Step Biowash”. Did you know that the S500 is separated into two documents in the same book? If you have ever read one, you will notice there is a blue section and a white section. The blue section is the ANSI/ IICRC S500 Standard; this is the Standard you quote and discuss. The white section is the ANSI/IICRC S500 Reference Guide for Professional Water Damage Restoration and is used for greater context for understanding the standard. It is not the standard. So, let’s talk about the standard (blue section). If your contractor calls this a manual, you might want to think twice. The S500 is a summary of the significant procedures and methodologies of a water damage project. These are principles and a foundation for understanding proper restoration practices. The S500 provides the user with general principles and practices to help guide a restorer to arrive at a logical conclusion as to what needs to happen on a job and to apply their knowledge to restore the structure or the contents. Why is this important? Every structure is different, materials are different, so guidelines provided to the restorer are outlined to assist in processing a site. What about the white section, the ANSI/IICRC S500 Reference Guide for Professional Water Damage Restoration? The reference is only there to help explain and broaden the explanation of the standard.
Three-Day Drying BY KRIS RZESNOSKI
In the last article we talked about threeday drying as a myth that is not supported by the restoration industry. We also discussed the change in science from the 2000s to today and how it has opened insurers to expanded risks. Finally, we defined the difference between stabilization and restorative drying. Let's take a look at where some insurer guidelines and initiatives can hamper your results.
Science: Truths and Myths Green is good! Many companies put in their mission statement that they are going to be environmentally friendly, and thus ask restorers to use green products. Green is good for both the environment and for profitability. It is good to want to keep trash out the landfill. My family recycles and we care about saving the environment, but when I am restoring, the reality of this is I don’t care about the global environment. When it comes to drying, I only care about the indoor environment of the structure I am working on. If the materials or contents can’t be saved they are heading to the landfill. But a lot of carriers are applying time limitation rules on what you will pay for that impede successful rescue of materials. Limiting the number of days for drying means materials are being torn out and send to the landfill that 24 Claims Canada
Get back in the box Have you ever heard the S500’s reference equipment calculation quoted? “You can only have this much equipment based on size of the building.” Did you know that those calculations are only an initial starting point and after the first minute they are obsolete? The scary part is insurers and contractors have been quoting these numbers like they are relevant. Contractors get asked to reduce their equipment on jobs because the calculation states it only needs 181 www.claimscanada.ca
pints of drying. The chart most often quoted and referred to is the “Initial Dehumidification Factors for Simple Calculation” This chart was found in the previous S500s. Does your company apply those standards as the rule? If so, you are walking into a litigation minefield (and if we learn anything from the U.S., competent attorneys are waiting for you), that you and your lawyers may have a very hard time settling out of, and the science in restoration will work against you.
2015: New calculations In the 2015 standard new calculations were introduced to deal with different weather conditions, building construction, building uses and occupancy. These calculations are found in the white reference section of the S500. They are there to help you, not act as your “rules”. But let science walk you through this lesson on liability increase. Ever heard a restorer in Vancouver or Newfoundland say that it takes them longer to dry at certain times of the year? What is important to acknowledge here is that when you use this detailed calculation there can be a 7.5 times difference in starting point dehumidification. One 2,000-square-foot structure could require 228 pints per day as a starting point and another building of the same size could require 1,712 pints per day. Who's responsible for the mould that is left behind when you have undersized the dehumidification and have not allowed enough equipment and time for drying? Restoration science The laws of thermodynamics get applied in water damage and as the drying process progresses you must change the environment to achieve your drying plan. When you are drying materials that are harder to dry, like wood, framing, cement board, ceramic tiles, cabinets, hardwood flooring or plaster, those materials will need more vapour pressure. They take more energy to release the moisture. www.claimscanada.ca
Think about all those jobs where you referred a less-than-competent contractor into the job and the job was completed in three days or less and no readings were provided. Are you scared of the mould liability that lies beneath wet materials? Are you starting to grasp the large potential for problem buildings that have been left behind by an industry of three-day drying protocols? If you do not collect material readings and only have the psychrometric readings you probably should question if the location was dried properly. When you place restrictions on equipment usage or "we only pay for three days", then materials that cannot be dried in three days are removed and your claims costs are escalating because contractors are forced to remove materials from your structures to ensure they dry. The rules create a box and if you work outside that box you are ridiculed for not being an effective contractor. I would argue the box is creating incompetent contractors. Liability increases and claims costs increase, but your emergency invoices are reduced. The only area where you have a chance to substantially reduce your claims cost is in the emergency.
No controls – No success Many insurance companies are hesitant to use additional living expenses (ALE) to provide a stable environment for the restorer. In the past the priority for ALE was if the kitchen was unusable, the bathroom blocked or the living space was substantially affected. It is almost like the claims departments are punished for thinking of using ALE to control the jobsite. Financially you can track the cost of using ALE and you can track the savings year over year of reducing the use of it. Unfortunately for your escalating claims costs most bean counters do not have a way to quantify the returns of using ALE. If you provide the restorer with complete control of the structure for four to seven days you are allowing the optimal conditions to take place to dry that structure.
Do you remember those flooded training houses that were vacant, controlled environments, with proper power, no opening and closing of doors and nobody tampering with equipment? You cannot expect success when you do not provide optimal conditions. I was going to say, “When I was an adjuster”, but let’s be honest: I spent less time behind the desk than that statement is worth. Overall I had two impressive bosses who preached adjusting the claim in an old-school method. Without that adjusting training, I would not be looking at the restoration perspective with the same clarity that I do today. So, "when I was an adjuster", the conversations regarding ALE were always about the inconvenience to the insured and never about creating efficiency in the process. Have you ever walked onto a restorative drying job with the proper placement of equipment? Temperatures reach 80 to 100 degrees Fahrenheit, but 70 to 75 F is deemed comfortable. The decibel level of most jobs is between 75 and 90 db (lawn mower) and the noise is a very loud white noise that can cause many insureds to complain of headaches and migraines. The normal db level of a house is 55 or less and the db level that ear protection is required is 85 db for eight hours according to occupational health and safety. The moisture is being pulled from the air at an astonishing rate and their skin will not only be dry, but the mucus membranes in their nose, eyes and throat will also be very dry. Depending on the job, it might even be dangerous. • In the next issue we are going to outline the use of air-movers calculations and how restorers can work with you to achieve better results. We are building the foundation for the discussion about liability reduction and increased profitability not only for you but also for your contractors. This win-win translates into happy customers and long-term relationships. Kris Rzesnoski is vice-president business development with Encircle. May-June 2018
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• on the scene OTS Martin Grech has joined Pario Engineering & Environmental Sciences LP, as senior vice-president, operations. Martin brings 10 years of senior executive leadership in operations and strategic planning to his new role. As a leader of the Pario executive team, he will use his background in both engineerMartin Grech ing and accounting to support the growth of the organization. Before joining Pario, Martin was a consulting manager in the Human Capital practice at an international financial services firm where he oversaw large scale business transformations for clients. “We are delighted to have Martin join the Pario team,” said Len Copp, Pario’s president. “His engineering and finance background, combined with his strong strategic acumen, will be a tremendous addition to an already strong and growing group of professionals that are focused on delivering for our clients.” ●
SPECS Limited has opened a new office in Newfoundland. The office will be managed by Barry Whittle, a seasoned construction and restoration professional. Located on the Avalon Peninsula, in Conception Bay, this new branch office is well positioned to service both Newfoundland and Barry Whittle Labrador. Barry has worked on the island in the field of construction and restoration for over 20 years. For many years Barry and his family have successfully owned and operated a full-service construction and renovation company. He knows the region and has developed strong relationships that will serve him well as he builds his team at this new branch location. ●
Natasha Pinto has joined DKI Canada as national director of corporate accounts. She will be responsible for the enhancement of innovative client solutions and national operational performance. Natasha will report directly to Lory Perizzolo, senior viceNatasha Pinto president, DKI Canada. She brings a wealth of knowledge and experience with over 14 years of experience in the insurance industry, most recently as director, insurer management services at one of the largest independent adjusting companies in Canada. Natasha holds a Bachelor of Commerce, Honours from Queens University and is working towards her CIP designation. ● 26 Claims Canada
Students of the British Columbia Institute of Technology (BCIT) General Insurance and Risk Management program made the finals of the Spencer Risk Management Challenge for two years in a row. Last year, BCIT students were the first post-secondary Canadian team to make it to the finals. The team of Makayla Robertson, Anthony Nguyen, Annie Nim and Bianca Neves were headed to San Antonio, Texas to attend the Risk Management Conference in April and compete against international teams in the Spencer Risk Management Challenge. The BCIT team was one of eight teams from 28 international competitors to ‘take it to the next level’ and compete in San Antonio. “We would like to thank the Spencer Foundation and the Risk and Insurance Management Society for making this possible,” said Shaun Sinclair, program head, General Insurance and Risk Management, British Columbia Institute of Technology. “My personal congratulations to the students who worked very hard to make this happen. I know there were many late nights spent working on this project while keeping up with the intense amount so school work our program requires. ●
(From left) Makayla Robertson, Anthony Nguyen, Annie Nim and Bianca Neves
ClaimsPro has appointed two new division leaders for its marine services unit: John Hosty as national director, marine services and Patricia Foster as director, marine accounts. John is a qualified Master Mariner and has sailed in all ranks up to Captain on a wide variety of merchant vessels. Most recently he was CEO of a North American marine surveying and consulting company. Before that he was director marine programs for an international independent adjusting firm. John is a senior marine surveyor, with a broad experience including general claims, pleasure craft, project cargo and risk control. He has significant technical expertise in the hazardous materials and environmental response sectors. In his new role, John will oversee ClaimsPro’s national team of marine surveyors and adjusters. Patricia is a Registered Nurse (RN), holds an MBA from Liverpool University and is a designated Chartered Professional Accountant (CPA, CMA). She was most recently CFO and general manager of a Canadian marine surveying and consulting company. Patricia brings a wealth of senior corporate financial leadership and operations management within the areas of risk control, project cargo, procure-to-pay supply chain, logistics, hazardous materials management, and healthcare, and she has extensive experience in managing marine claims including large volumes of pleasure craft accounts. In her new role she will oversee ClaimsPro’s marine service business unit. ● www.claimscanada.ca
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• on the scene OTS On Side Restoration Services Ltd. is opening a new Hamilton branch led by Brandon Boyd, branch manager. The Hamilton Branch will serve the Greater Hamilton Region, Brantford, Burlington and St. Catharines/Niagara. Brandon started out as a water and Brandon Boyd environmental technician and naturally evolved into project management roles, adding more complexity as he built his career. He holds numerous certificates including: Type 3 Asbestos Remediation Technician, Level 3 Applied Microbial Remediation Technician, Water Restoration Technician as well as Health and Safety Technician. ●
Solera Canada (Audatex) has acquired Montreal-based Fluttrbox, an emerging provider of on-demand aerial property inspections. Fluttrbox’s software, in conjunction with drone and other aerial technology, along with in-depth, high quality reporting, allows insurance companies to accurately inspect properties without the wait. Traditional property inspections can take several weeks to carry out, but Fluttrbox does the job in only days, allowing for quicker decisions, and significantly reduced cycle times. For the Canadian market, the technology offers opportunities not only on the property side but also with automotive, the company says. For example, during CATs, drones and other aerial tools can be used to quickly assess damaged vehicles that may not be accessible on foot. ●
Laura Emmett has joined Strigberger Brown Armstrong LLP’s litigation practice. “Laura is an outstanding advocate and a true leader,” said Lisa Armstrong, managing partner. “We are thrilled to have someone as dedicated to the industry as she is join our Laura Emmett team.” Laura will be primarily working out of the firm’s Waterloo office. Her practice includes all aspects of general insurance litigation with a particular interest in cyber insurance, bodily injury, and drone regulation. She is the current vice-president and incoming president of the Canadian Defence Lawyers Association, co-author of the Annotated Statutory Accident Benefits textbook, and an adjunct professor at the University of Western Ontario law school. Previously, Laura worked for a respected regional defence firm in London, Ontario. ● www.claimscanada.ca
Barbara Haynes, founding CEO of DAS Canada, will be retiring from DAS at the end of August this year. “I’ve met some wonderful people throughout my career in Canada and the industry has been very good to me. I’m especially honoured to have had the opportunity to do something not many people get to do – start a new insurance company, an exciting and rewarding experience. The DAS Canada team has done a fantastic job in creating awareness and building the legal expense market, and I wish them all the very best as they continue to build on the early success of the company,” she said. Lars von Lackum, chair of DAS Canada and global head of ERGO’s Legal Protection business, said, “Barbara’s drive and passion for the business, and ability to build an engaging culture have resulted in DAS having a strong brand and market leader position for legal expense insurance in Canada. We would like to thank her, and wish her and her family all the very best in this next phase of her life.” ●
Kernaghan Adjusters has relocated its Whistler, British Columbia, operation and welcomes Michael (Mike) Unger, CPCU, MMS, MAS, as sea to sky corridor manager, executive adjuster, and David Johnston, BA, CPCU, FCIP, CRM, as senior adjuster. Mike brings a wealth of insurance industry Michael Unger knowledge and expertise to his new role. He has over 17 years of experience in various markets including the U.S., Canada and London. Mike specializes in major commercial property losses and is well versed in catastrophe claims. He is accustomed to handling a large volume and is known in the industry for his David Johnston diverse and dynamic skill set. David joins the Whistler team with 28 years of industry experience. He has worked in various areas of the insurance industry including: claims adjusting, underwriting, product development, project leadership and broker management. Both Mike and David are long-time residents of the Sea to Sky Corridor, which gives them an in-depth understanding of the community and the surrounding environment. ●
CIAA New Members — March 22, 2018 INDIVIDUAL MEMBERSHIP
Crawford & Company (Canada) Inc. Paul Jeremy Dewar Charlottetown, PEI Level 1
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• on the scene OTS GO BIG! was the fitting tagline of the 2018 RIMS conference, held in the great state of Texas from April 15 to 19. San Antonio – now in its tricentennial year – hosted the proceedings, which included a massive tradeshow, keynotes and seminars, and numerous social events run by the Risk Management Society or conference sponsors. Canadian Underwriter’s busy afterhours schedule included functions held by AIG, Crawford & Company, Sedgwick and XL Catlin, plus the ever popular RIMS Canada Night, sponsored this year by AIG, Aviva, Canadian Litigation Counsel, XL Catlin and Zurich. Thank you all!
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â€¢ on the scene OTS
Claims Canada 29
• on the scene OTS This year’s edition of The Big Mingle lived up to its name. The highly anticipated annual event attracted several hundred partygoers to The Rec Room in Toronto’s John Street Roundhouse for networking over drinks, hors d’oeuvres and a poutine-powered buffet. Once again, Blouin Dunn LLP and -30- Forensic Engineering co-hosted the get-together, which coincided with the end of the annual Ontario joint conference of the CICMA and CIAA.
30 Claims Canada
Cancer Changes Everything. So Can You. Join WICC Ontario at Relay For Life
Proud partners since 1996
WHAT IT’S ABOUT:
HOW YOU SIGN UP:
What: Canadian Cancer Society’s Relay For Life – and WICC’s 10 year anniversary supporting the fundraising event
• Build your team: Friends, family, colleagues and clients
Why: To celebrate cancer survivors, commemorate those we’ve lost and raise money for life-saving research
• Choose: Relay For Life at Downsview Park in partnership with WICC
Where: Downsview Park, 35 Carl Hall Rd, Toronto
• Pick WICC: Select WICC under “Team Company” to ensure your funds go towards the industry campaign
When: Friday, June 15, 2018 6:00pm – midnight Who: Be a captain and sign up your team today!
• Register: Online at www.relayforlife.ca/wicc
Questions? Go to www.wicc.ca or contact email@example.com
Design compliments of
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3/2/18 11:59 AM
With over 40 offices on 5 continents, over 30
language fluencies, 18 distinct professional
designations and a work history that spans more
than 130 countries and 800 industries, we are truly
world-class experts with a global reach.
To work with a member of our respected team
contact any one of our Canadian offices or visit us