Claims Canada August September 2012

www.claimscanada.ca

August/September 2012

Official Journal of the Canadian Indeépendent Adjusters’ Association

THE BIG SQUEEZE

Insurer Consolidation and Consequences for Adjusters

A BUSINESS INFORMATION GROUP PUBLICATION Publications Mail Sales Agreement #40069240

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Contents AUGUST / SEPTEMBER 2012 • VOLUME 6 • NUMBER

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Cover Feature 12 The Big Squeeze Consolidation in the property and casualty insurance industry has had a massive impact on independent adjusters – we look at how they are adapting with a combination of new and proven strategies.

BY CRAIG HARRIS

Spotlight 22 Duty to Serve Incoming CIAA president John Seyler feels now is the time to give something back to the independent adjusting profession.

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BY CRAIG HARRIS

Education Forum 46 A Primer on Cybercrime Insurance adjusting firms, like all businesses, need to establish procedures to ensure that information is protected from cybercrime.

News Features 26 Ontario Moves Closer to Cat Definition A long-awaited report on catastrophic injury definition holds that physical impairments should not be combined with psychiatric impairments for the purpose of determining a catastrophic injury.

BY CRAIG HARRIS

28 A “Twist” To Allocation of Defence Costs A recent Ontario Court of Appeal decision could inject uncertainty into how defence costs should be allocated before an action has been concluded.

38 Material Contribution – The Unicorn of Canadian Law? The Supreme Court of Canada’s recent decision in Clements v. Clements highlights the rarity of the material contribution test in cases involving negligence.

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BY RYAN KRUSHELNITZKY AND PETER GIBSON

40 Clinical Perspectives on the MIG A health care expert explores quandaries and limitations within Ontario’s Minor Injury Guideline.

BY DENNIS GIESBRECHT

BY MICHAEL TEITELBAUM

42 Social Surveillance

32 Are Pedestrians and Cyclists Covered?

The social media world is an oyster for insurers and adjusters looking to find out information about claimants.

With the number of accidents involving bicycles and pedestrians on the rise, we look into what coverage exists if there is no actual impact with a vehicle.

BY DANIEL STRIGBERGER

Departments 4 First Notice 48 On The Scene

Columns 10 President’s Message 46 Education Forum

BY LEONARD KUNKA AND CARR HATCH

34 Driven to Distraction How can the insurance industry help people pay more attention on the roads?

BY JAMES GEUZEBROEK

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• first notice FN Thunder Bay, Montreal floods cause $200 million in damage Insurance Bureau of Canada (IBC), citing data from Property Claim Services Canada (PCS-Canada), reports that the estimated insured damage caused by the recent wind and thunderstorm event that hit Ontario and Quebec amounts to more than $200 million.

PCS-Canada tracks insured losses arising from catastrophic events in Canada. Data confirm thousands of claims have been filed for damage to homes, cars and businesses in the wake of a storm system that hit Thunder Bay and Montreal over a span of four days (May 26-29, 2012).

The storm unleashed torrents of water that overwhelmed sewer systems and caused widespread flooding of streets, homes and buildings.

There have been reports of flooded basements, flooded businesses and cars submerged under water.

Thunder Bay, Ontario declared a state of emergency after the rainstorm unleashed 91 millimeters on the city over a span of about 18 hours. At one point, 71 mm fell in the city in less than six hours. In Quebec, in a period of a couple of hours on May 29, the greater Montreal area received between 40 mm and 80 mm of rain. ●

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New Brunswick wants cap moved to $7,500 New Brunswick is proposing to increase its $2,500 cap on minor auto injuries up to $7,500 and develop a new definition for minor injuries that would see fewer people come under the cap.

The government tabled its report in late June to the Auto Insurance Working Group with the legislative assembly and is currently seeking public input on its proposal.

“The new [minor injury] definition would mean that fewer New Brunswickers would be limited by the cap,” said New Brunswick Justice Minister and Attorney General Marie-Claude Blais. “Our recommendation of a $7,500 cap exceeds the working group’s suggested cap.”

The government’s response says actuaries have calculated that 71% would come under the proposed definition of minor injury as opposed to 81% under the current definition.

New Brunswick’s Auto Insurance Working Group recommended in November 2011 that the government in-

crease its minor injury auto cap to between $4,000 and $6,000, and index the cap annually to the Consumer Price Index (CPI).

Blais said the recommended new cap amount of $7,500 would match the limit currently in place in Nova Scotia.

Other recommendations include: • the province’s Office of the Consumer Advocate be requested to coordinate the development of an information/education package to highlight the rights of individuals involved in a motor vehicle accident; • the Department of Justice and Attorney General examine early-care programs in place in Alberta and Nova Scotia to determine whether such a program would be appropriate for New Brunswick; and • the Department of Justice and Attorney General develop a process that provides for the regular review of the minor injury regime and which allows for input from all stakeholders. l

Quebec insurer to pay for claim involving tree falling on car A Quebec man killed when a tree fell on the vehicle he was driving in the City of Westmount must turn to the province’s auto insurer for compensation, the Supreme Court of Canada recently ruled, rejecting the man’s civil lawsuit against the city.

In August 2006, a tree in the City of Westmount fell on a vehicle occupied by Gabriel Anthony Rossy, killing him. His family sued the city for damages, alleging that the city, as the owner of the tree, had failed to properly maintain it.

The city sought to dismiss the lawsuit, arguing that the injury resulted from an accident caused by an automobile. Therefore, any compensation should come from the nofault benefits scheme administered by the Société de l’assurance automobile du Québec under the province’s Insurance Act. The province’s no-fault insurance scheme applies to any accidents in which injury or damage was “caused by an automobile, by the use thereof or

August/September 2012

by the load carried in or on an automobile.”

The Supreme Court agreed with the city’s position.

“Although the vehicle may have been stationary or moving through an intersection, the evidence on the record is that [Rossy] was using the vehicle as a means of transportation when the accident occurred,” the Supreme Court ruled, thus overturning the outcome in the Quebec Court of Appeal. “This is enough to find that the damage arose as a result of an ‘accident’ within the meaning of the act and that the no-fault benefits of the scheme are triggered. Therefore, the civil claim is barred and [Rossy’s] parents and brothers must turn instead to the Société de l’assurance automobile du Québec for compensation.”

Elsewhere, the court wrote: “The vehicle’s role in the accident need not be an active one. The mere use or operation of the vehicle, as a vehicle, will be sufficient for the act to apply.” l

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• first notice FN Consumers reduce reliance on insurance in harsh economy Faced with the prospect of rocky economic times, Canadians are cutting back on the insurance they are buying, a 2012 survey commissioned for TD Insurance states.

The Environics Research Group survey conducted for TD found that 42% of Canadians are less likely to purchase a new policy or buy enough insurance because of the current economic environment. The second annual TD Insurance State of Insurance Report is intended to help understand Canadians’ habits, attitudes and knowledge about insurance.

The second annual report found some Canadians have decided not to make claims in order to keep their premiums low (33%) or to avoid a high deductible (29%). Twenty-one per cent of Canadians have cancelled or forgone insurance altogether in an effort to save money.

As a result, one in five Canadians now admit they don’t think they have enough insurance (19% versus 9% in 2011).

“If you want to save money and preserve your personal finances, the last thing you should be doing is curbing your insurance coverage,” says Dave Minor, vice president of TD Insurance. “Especially in an uncertain economy, insurance is an important part of financial planning.

For working families, it’s one of the best ways to ensure your assets and income remain intact in the event that something unexpected happens.”

And as times get tough, the survey found not all respondents are practising honesty as the best policy. Twenty per cent of respondents now admit they have not been completely truthful or omitted information when filling out an insurance application, compared with only 13% who reported this in the 2011 version of the survey. l

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Homeowners in Alberta and B.C. not properly covered: survey Albertan and British Columbian homeowners may not be getting the right home insurance protection, with many being offered named peril and broadform policies in situations in which a comprehensive policy would be more appropriate.

Square One Insurance Services Inc., which specializes in home insurance, talked to 2,800 residents in Alberta and B.C. over the past 10 months and found that a “shocking” 21% of them do not have the right home insurance protection.

“Ironically, those who have been loyal to the same home insurance provider for more than five years are most at risk of being improperly protected,” says Daniel Mirkovic, president and CEO of Square One. In some instances, home insurance providers are offering named perils (fire or lightning, explosion, smoke, vandal-

ism, theft, hail and some types of water damage) and broad-form policies (which offer comprehensive protection on buildings and named perils protection on personal property).

Mirkovic says these options are appropriate only if a person has a higherrisk home that does not qualify for a comprehensive (or all-risk) policy.

Square One recommends a comprehensive policy to avoid being blindsided in the event of a claim. These policies protect against all loss types except those specifically excluded in contract wordings — for example, damage due to wear and tear, snow slide or landslide, acts of terrorism and war.

Square One reports the cost of upgrading from a broad-form policy to a comprehensive policy can be as little as $15 annually for a condo owner or renter, and $35 a year for homeowner. l

Allianz reports space “junk” a growing problem A growing proliferation of “manmade space junk” threatens satellites and space stations, approximately a quarter of which are insured against losses from physical damage and service interruption, states a recent report from Allianz Global Corporate & Specialty (AGCS).

The study, Space Risks: A New Generation of Challenges, notes there are now more than 35 million objects in orbit, ranging from defunct satellites to rocket boosters to broken space exploration equipment.

“The space around our planet is becoming increasingly congested,” said Thierry Colliot, managing director of space insurance at AGCS. “The number of objects is now so high that it won’t decay on its own through atmospheric drag. Instead, it’s actually increasing as objects collide and produce fragments, which in turn collide in a runaway chain reaction.”

August/September 2012

As an example, the report cites the case of a defunct Russian satellite colliding with and destroying a U.S. commercial satellite in 2009. Another case involved the crew of the International Space Station forcing to evacuate on two occasions in 2010 and 2011 when a large piece of space debris came too close.

Colliot identified “space crowding, the extreme and stringent conditions of the environment, the difficulties surrounding work on spacecrafts in orbit and the impact of space debris falling to Earth” as among the challenges in the space insurance industry.

AGCS notes that insurance premiums for space risks reached almost $800 million in 2011, with losses totalling approximately $600 million. Rising launch values, a decreasing premium pool and increasing risk exposures are major issues facing aerospace insurance, the report adds. l

www.claimscanada.ca

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• first notice FN B.C. supreme court rules fraudsters should pay punitive damages The Supreme Court of British Columbia has ordered defendants in a vehicle fraud scheme to pay damages, including punitive damages, to the Insurance Corporation of British Columbia (ICBC).

The court reportedly ordered 11 or so defendants to pay a total of about $850,000 in damages in connection with a vehicle fraud scheme that operated throughout 2002 and 2003.

As plaintiff, ICBC sought judgment for conspiracy and/or conversion against a number of defendants in connection to vehicles that had been wrongfully acquired and resold after insurance money had been paid out, Justice Austin Cullen, associate chief justice for the court, writes in Insurance Corporation of British Columbia v. Awla, released on July 9.

ICBC alleged dozens of vehicles were disguised, “resulting in a total of approximately $2 million in insurance claims that were honoured by ICBC.” This action, one of several brought by ICBC, involves seven vehicles wrongfully acquired between Feb. 17 and June 2, 2002. Overall, a dozen vehicles were at issue, some of which were subjected to more than one theft or extensible theft.

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Subscription inquiries (416) 442-5600 • 1-800-668-2374 Fax: (416)Indeépendent 442-2191 Official Journal of the Canadian Adjusters’ Association

www.claimscanada.ca Produced by the publishers of Canadian Underwriter magazine

A bi-monthly magazine (6x per year), Claims Canada is published by BIG Magazines LP, a div. of Glacier BIG Holdings Company Ltd. Business Information Group is located at: 80 Valleybrook Drive, Toronto, ON, M3B 2S9.

Claims Canada magazine is the Official Publication of the Canadian Independent Adjusters’ Association [CIAA] and through its editorial content and circulation brings together the ‘entire property & casualty insurance claims market nationally’ with information and insight into the profession, business and people of insurance claims and loss adjusting.

All key claims process stakeholders are reached as part of our readership community – including: both CIAA member and non-member independent claims adjusting firms; insurance and reinsurance company executive, claims management

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“The conspiracy defendants whom I have found liable, were involved to some degree or another in a well-organized and executed criminal enterprise to defraud the plaintiff of a significant amount of money,” Justice Cullen writes. “The cost to the plaintiff is, of course, the cost to the motoring public.”

With regard to special damages, the ruling cites approximate totals of $182,497 for Harpreet Awla; $127,342 for Cheri Kostynick; $102,816 for Vikram Atwal; $95,752 for Sandeep Rai; and $58,228 for Jason Smith.

“I am satisfied that the special damages ordered, while reflective of the direct costs consequent on the actions of the defendants relative to the individual vehicles, does not fully address the need to accomplish the objectives of retribution, deterrence and denunciation for which punitive damages are awarded, given that the defendants face no criminal sanction for their conduct,” the court decision states.

For punitive damages, the largest amounts for defendants are $100,000 for Vikram Atwal; $60,000 for Harpreet Awla; and $20,000 for Gurpreet Awla. l

Claims Canada

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August/September 2012

Gary White Production Manager (416) 510-6760

and claims adjusting personnel; corporate risk managers and loss control professionals; insurance brokers; insurance law firms; forensic engineers and accountants; appraisal, restoration, rehabilitation and collision repair professionals; Insurance Institute chapters; insurance associations, regulators and related claims market recipients.

The contents of this publication may not be reproduced or transmitted in any form, either in part or in full, without the written consent of the copyright owner. Nor may any part of this publication be stored in a retrieval system of any nature without prior written consent.

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Message from the President La Plume du Président GREG MERRITHEW

Wow! What a year. The opportunity to meet so many of our members across Canada and represent CIAA in many venues has been a real pleasure for me, and a very positive, uplifting experience. The chance to meet so many like-minded people in a profession that attracts highly motivated and hardworking individuals is a real treat.

We operate in a challenging business climate in a time of change. Not only is the framework of the insurance industry in continuous flux, but the technical aspects of our business continue to change on a daily basis. It certainly is not a boring industry that we find ourselves in.

That being said, there is a real need for our membership in the ranks of independent adjusters across Canada to continue learning and educating ourselves throughout our career. No longer can we say “that’s the way we’ve always done it.” No longer can we take the position that the old tried and true methods of dealing with issues have the same merits today as they did in the past.

Maintaining relevance as a profession will require all of us to bring our “A-game” to the forefront. Most of us do. Those who don’t will be left behind. The industry and society are demanding higher service standards and more seamless access to the service providers in the event of a claim. What this means to independent adjusters is that to succeed in our profession, we must ensure that our systems in place are effective and relevant.

Our association represents members national in scope, with coast to coast coverage, regionally focused members, as well as sole proprietor members providing localized claims adjustment services and, in some cases, very specialized services. Going forward as an association, we must be able to provide beneficial services to all our members.

In the last year, we have brought forward cost effective professional liability insurance coverage available to both the sole proprietor and regional sized firms. For our national members, we have championed lobby efforts on cross-border licensing issues as well as workplace safety issues. For all our members, we have launched our web-based educational program 10 Claims Canada

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Wow! Quelle année fantastique. J’ai eu beaucoup de plaisir à rencontrer plusieurs de nos membres dans tout le Canada et à représenter la CIAA à de nombreuses occasions; ce fut pour moi une expérience très positive, inspirante même. Le fait de pouvoir rencontrer un si grand nombre de personnes qui pensent de la même façon, qui œuvrent dans une profession qui attire tellement de gens très motivés et travaillant a été une magnifique occasion pour moi.

Nous travaillons dans un contexte économique exigeant empreint de changements. Non seulement le cadre de l’industrie de l’assurance est en constante fluctuation, mais l’aspect technique de notre profession change pratiquement de manière quotidienne. Notre industrie est tout, sauf ennuyeuse!

Ceci dit, il ne fait aucun doute qu’à titre d’experts en sinistres indépendants du Canada, nous devons tous continuer d’apprendre et de nous perfectionner tout au long de notre carrière. Nous ne pouvons plus dire « c’est ainsi que nous l’avons toujours fait ». Nous ne pouvons plus affirmer que les anciennes méthodes éprouvées de régler les problèmes sont encore aussi bonnes aujourd’hui qu’elles l’étaient dans le passé.

Pour que notre profession demeure pertinente, nous devons nous surpasser tous les jours et mettre de l’avant ce que nous avons de meilleur. La plupart d’entre nous le font. Ceux qui ne le font pas, ne dureront pas. L’industrie et la société imposent une norme de qualité de service plus rigoureuse et un accès plus transparent aux prestataires de service dans le cas d’un sinistre. En tant qu’experts en sinistres indépendants, cela signifie que pour prospérer, nous devons nous assurer que notre système en place est efficace et pertinent.

Notre association représente des membres à l’échelle nationale, offre une couverture d’un océan à l’autre, grâce à des membres qui travaillent à l’échelle régionale, ainsi qu’à des membres autonomes qui offrent des services d’experts en sinistre localement et, dans certains cas, des services très spécialisés. Pour progresser à titre d’association, nous devons offrir des services qui bénéficient à tous nos membres. Au cours de la dernière année, nous avons offert tant aux experts autonomes qu’aux entreprises de tailles régionales une assurance responsabilité professionnelle rentable. Pour nos membres nationaux, www.claimscanada.ca

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that members can access for further education. These courses comply with continuing education credit requirements in those jurisdictions where required. Our Chartered Loss Adjuster designation (CLA) continues to move forward and should be ready for early 2013.

Our members who are active at the national level are among the best volunteers I have ever had the opportunity to work with. Each of our board members, directors and committee chairs put a lot of time and effort into what they do with no compensation and very little personal benefit. They do a great job and for that I thank them.

Our national office staffed by Pat Battle and Mina Cerulli keep us on track. They are dedicated, and have their heart and soul invested in the CIAA. For that, I also thank them.

It has been a real pleasure being the president of CIAA for 2011/2012. I wish John Seyler, our 2012/2013 president, all the best and pledge my support to him and CIAA in the coming years. n

nous avons effectué du lobbying concernant les problèmes de licences internationales, ainsi que les problèmes de sécurité en milieu de travail. Pour tous nos membres, nous avons lancé notre programme de formation Web, permettant à nos membres de parfaire leur formation en accédant à notre site Web. Les cours offerts sont conformes aux exigences d’obtention de crédit de formation continue dans les juridictions qui les exigent. Notre attestation d’expert en sinistres agréé (ESA) continue de progresser; elle devrait être prête au début de l’année 2013.

Nos membres actifs à l’échelle nationale constituent certains des meilleurs bénévoles avec qui j’ai eu le plaisir de travailler. Chacun des membres de notre conseil d’administration, des directeurs et des présidents de comité consacrent beaucoup de temps et d’efforts dans leur rôle, sans rémunération et avec bien peu d’avantages personnels. Malgré cela, ils font un travail extraordinaire et je tiens à les en remercier.

Notre bureau national, entre les mains de Pat Battle et Mina Cerulli, nous aide à garder le cap. Ce sont des personnes dévouées, qui consacrent leur cœur et leur âme à la CIAA. Pour cela, je les en remercie.

J’ai eu beaucoup de plaisir à occuper la présidence de la CIAA en 2011/2012. Je souhaite à John Seyler, notre président pour 2012/2013, tout le succès qu’il mérite et je lui réitère mon soutien, à lui et à la CIAA, pour les années à venir. n

NATIONAL EXECUTIVE 2011-2012 2011-2011 PRESIDENT Greg G. Merrithew, CIP, FIFAA Arctic West Adjusters Ltd. 201 – 5204 – 50 Ave. Yellowknife, NT X1A 1E2 Phone: (867) 920-2212 Fax: (867) 873-2244 E-mail: gregm@arcticwest.ca 1ST VICE-PRESIDENT John D. Seyler, AIIC ProFormance Group Inc. 5080 Timberlea Blvd., Suite 214 Mississauga, ON L4W 4M2 Phone: (905) 238-4985 Fax: (905) 238-2735 E-mail: jseyler@prospecialty.ca SECRETARY Marie C. Gallagher, FCIP, CRM Granite Claims Solutions 71 King Street, Suite 204 St. Catharines, ON L2R 3H7 Phone: (905) 984-8282 Fax: (905) 984-8290 E-mail: marie.gallagher@graniteclaims.com

www.claimscanada.ca

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DIRECTOR James B. Eso, BA, CIP Crawford & Company (Canada) Inc. 539 Riverbend Drive Kitchener, ON N2K 3S3 Phone: (519) 578-5540 Fax: (519) 578-2868 E-mail: Jim.Eso@crawco.ca

TREASURER Randy P. LaBrash, CIP, CFE, CFEI Crawford & Company (Canada) Inc. 300 – 191 Lombard Avenue Winnipeg, MB R3B 0X1 Phone: (204) 947-2340 Fax: (204) 943-9168 E-mail: Randy.Labrash@crawco.ca PAST-PRESIDENT Mary Charman, CIP Crawford & Company (Canada) Inc. 1 – 120 Mulock Drive Newmarket, ON L3Y 7C5 Phone: (905) 898-0008 Fax: (905) 898-1705 E-mail: Mary.Charman@crawco.ca EXECUTIVE DIRECTOR Patricia M. Battle Canadian Independent Adjusters’ Association/ L’Association Canadienne des Experts Indépendants Centennial Centre, 5401 Eglinton Avenue West, Suite 100 Etobicoke, ON M9C 5K6 Phone: (416) 621-6222 Toll Free: 1-877-255-5589 Fax: (416) 621-7776 E-mail: pbattle@ciaa-adjusters.ca

DIRECTOR John Jones, BA Granite Claims Solutions Suite 300, 5915 Airport Road Mississauga, ON L4V 1T1 Phone: (905) 671-3164 Fax: (905) 671-1889 E-mail: john.jones@graniteclaims.com DIRECTOR Craig J. Walker, CIP, FCIAA, FIFAA Maltman Group International 3550 Victoria Park Ave., Suite 301 Toronto, ON M2H 2N5 Phone: (416) 492-4411 Fax: (416) 492-5657 E-mail: cwalker@maltmans.com

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• cover story

THE BIG SQUEEZE 12 Claims Canada

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August/September 2012

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onsolidation in the property and casualty insurance industry has had a massive impact on independent adjusters in several ways – claims volume, pricing, national contracts and procurement models. Firms ranging from small shops to regional players to national (or multinational) companies are adapting quickly with a combination of new and proven strategies.

BY CRAIG HARRIS

“Fragmented” is a term commonly cited to describe the Canadian p&c insurance industry – typically in the context of the onward march of merger and acquisition (M&A) activity among carriers. Compared to other segments of the financial services industry, such as banks and life insurers, the p&c industry is still loosely concentrated.

The top five carriers represent just 43% of the market, versus the bank and life company markets, which are closer to 65-75%.

Several insurers have publicly stated that the door is open for increased acquisition activity in Canada. There were 29 announced deals in 2011, compared to 21 in 2010 and 12 in 2009, according to PwC’s national insurance consulting practice.

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“Most of the activity in the sector is coming from strategic insurance companies that are turning to M&A as a way to scale up and gain efficiencies, specialty services, and/or lock up distribution channels,” says Allan Buitendag, leader of PwC’s national insurance consulting practice, in a report published this year.

Already this year, Intact Financial made a strategic acquisition of JEVCO Insurance Corporation for $530 million to cement its position as the largest p&c insurer in Canada. The purchase, announced in May, took place roughly a year after Intact Financial bought AXA Canada for $2.6 billion in a deal that has now closed – and caused serious ripples in the adjusting profession.

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In June, RSA Canada announced its intention to acquire L’Union Canadienne from parent company Cooperators General Insurance Company for $150 million. Coupled with last year’s $420 million buy-out of GCAN, RSA Canada is now the country’s third largest insurer.

Landscape changing quickly “We believe the public insurers are in a unique situation to acquire struggling operations and consolidate the Canadian p&c market,” notes GMP Securities analyst Stephen Boland in a report released last October. “Our analysis reveals the Canadian industry remains very fragmented.”

Boland also targets demutualization as a trend that may spur further consolidation in the industry. “We anticipate that the larger, mutual insurers will continue to work with the Department of Finance to demutualize in order to compete more effectively with the large stock P&C companies,” Boland states. “We believe that other

mutual insurers could demutualize which in turn may lead to a period of consolidation, similar to what occurred in the life insurance industry over a decade ago.”

“The landscape is changing quickly and those companies caught in the middle—too large to be niche players but too small to reap economies of scale—will have to rethink their strategies,” adds Buitendag.

Independent adjusters have had a front row seat to this consolidation in their daily business lives. If you replace the word “companies” with “adjusters” in the previous quote, the same scenario applies. In many cases, regional firms with limited markets have seen their contracts with insurers sliced in half, along with a substantial reduction in claims volumes. The unpredictability of the situation can lead to some frayed nerves for adjusters contemplating their business plans.

“If you look at larger insurance carriers, they have acquired all these regional companies to become essentially one client for adjusters,” says Patti Kernagahan, president of national adjusting firm Kernaghan Adjusters. “That does become a little unnerving.”

A large loss

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r

s

“When insurers get larger, they carry a bigger stick and it can hurt you more when they hit you with it,” adds Fred Plant, president of Plant Hope Adjusters.

“I think it’s the unknown of ‘what’s next’ that makes people nervous,” notes John Seyler, president of ProFormance Specialty Claims. “The whole backdrop of your business can change in a hurry.”

This change affects various sizes and types of adjusting firms across the country in different ways. There are those who benefit and those who struggle, with some picking up substantial business and others forced to scramble for alternative strategies.

One of the key consequences of consolidation for adjusters is that larger insurers tend to retain more claims in-house for their own staff adjusters.

Internalized claims handling “If an insurer has a critical mass of claims in a certain region, it may

Already this year, Intact Financial made a strategic acquisition of JEVCO Insurance Corporation for $530 million to cement its position as the largest p&c insurer in Canada.

staff up to internalize all the claims handling,” Plant says. “If you are a regional adjusting firm, that could represent a huge chunk of lost business.

You could be the best adjuster in town

but if you aren’t on ‘the list,’ you won’t get the call.”

“I think the base of business has really shrunk for many small and regional adjusting firms,” notes Greg Merrithew, president of Arctic West Adjusters. “For example, if I look at our receivables list, 60-70% of our accounts are new – our volume hasn’t really dropped, but our client base has changed. The eggs in the basket are smaller.”

“While there are signs of the insurers keeping more files in-house as of late, we have not been exposed to dramatic change,” says Michael Holden, president and CEO, Granite Claims Solutions. “Industry consolidation is occurring along side a number of other current events, in particular the mild winter, spring and changing Ontario auto legislation, which makes it a little more sensitive to gauge impact.”

Moving files in-house is part of a broader strategy for insurance company consolidators to gain greater

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economies of scale by focusing on efficiency, size and standardization.

Another key aspect of this trend is the move to national contracts with one or two adjusting firms.

For larger adjusters, this has proved a distinct advantage.

“The impact on Crawford of significant consolidation is generally positive,” says John Sharoun, president and CEO, Crawford & Company (Canada) Inc. “The increased sophistication of the procurement process that tends to result when an insurer attains larger market share and influence favors larger adjusting firms with national reach.”

Sharoun explains that the process of insurer M&A activity can “trigger uncertainty” in the short-term at a company, leading to delays in decision-making and strategic planning around claims management.

“Once the company is through the integration process, the impact is generally positive as there is usually a reinvigorated claims team in place 16 Claims Canada

p12-21 COVER STORY.indd 16

“Mergers and acquisitions provide a great opportunity to re-establish these needs with our clients and better understand their strategies and requirements, as they adjust to their extended environments.” that is well aware of and aligned with the organization’s strategy – this clarity helps firms like Crawford develop and deliver services and solutions that are tailored to support that strategy,” he notes. “The strong alignment between the enterprise, its claims department and partners like Crawford delivers powerful results.”

August/September 2012

Trigger uncertainty Granite’s Holden echoes the positive impact of insurer consolidation on larger adjusting firms. “We spend a lot of time developing our Quality Initiative Program around the specific needs of our clients,” he says.

“Mergers and acquisitions provide a great opportunity to re-establish these needs with our clients and better understand their strategies and requirements, as they adjust to their extended environments.”

Some adjusters, however, question the ability of national contracts to truly service the diverse needs of insurance carriers. Patti Kernaghan says she has seen trends come and go in more than 20 years of experience in the industry.

“I think over the past couple of years we have seen see a reconsideration of these national contracts,” notes Kernaghan. “Insurance companies are looking carefully at service levels and expertise. For example, I look at what we offer in terms of www.claimscanada.ca

12-08-21 1:54 PM

.” best y r e he v ed SI US nd t referr l to A D J E RT S E N e s P o n t el EX ga ough ark slo ust as w r. n e ste care allm ply j you assic H ould ap ent adju n e is l “Wh e that c rds, it c depend ld th : i u b l n a e to llars Whi eting c of an i ienc three pi ed, e n r r e o g i p t to ec nd on r ex r sel thei ended was fou d you e l p y poo s de pan ope, adjuster ur com H r er o les. nce rego e in acG s insura years aft princip M ienc issues, . r l a e 0 D a t 8 s p tal f ex cces , and men han th o ronmen lds. lant their su more t e funda p P e d d i , v e t y fie re ovid es to en ialized G. F ood tha ty. Toda hose sam r , p r e t i t h loss . We spec the tegr ders g to y fat ately mobile y other s in is. r n m they un , and in dherin m e e i d t h , an W ce d by a ris hol auto a in ervi pany nad lty and y and m hare mes of c s a s C com ledge, s succee ce, g A i a t o tic to w ellen 4/7. vice in c tlan rty, casu technol 2 x A , e kno ntinue d f ser un now ter o ope rd o e gro , caring rts k neral pr , compu we c nda e h a t t p s e x n l e the ed e le, o ying nsib mg be e set train ing fro e surve ailab d, respo w v wi l l r , a u s d n g e r i i O n r e n r p a t a br ma s ra aff f ra djus al st tance o your field culture, ce a n t n a o a i h r r s t ce nsu ofes aqua mpo uran ent i t. d, pr w the i s d s e t n a a e s l o c l co dep ona y kn dedi st in ditiona pers eeds. o y Our any, the m m d p fore rs’ n ave no a com ou h custome ada’s alue at Y n . a s r ter or v rn C djus hat you aste superi A e s e w p g A r erin t Ho atter es o Plan d, no m m deliv i t n , i i t Mar 53.8507 trus resente e r h u t .8 ep yo ut Put ccably r gho ct at 506 u o e r p e h im you. e dir ide t S TER

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transportation, which is a specialized ize on its market size,” notes Sharoun. field. I would challenge any other firm “These companies require more comin the country to match our level of explex and sophisticated service conpertise here.” tracts from any company wanting to “Larger insurers For smaller adjusters, the trend of do business with them.” national adjusting contracts can leave can use their size to Procurement process them feeling out of the loop. “Most leverage pricing.

Kernaghan says she has noticed small owner-operators may have 5-10 a few new wrinkles in procurement markets, and they have to carefully Over time, they can and RFPs. “What has happened lately build and strengthen the relationship drive the cost down for is that insurance companies have bewith those markets, “ notes Merrithew. come more creative in what they are adjuster services.

“The fact is that these contracts are looking for,” she observes, adding that still out of the control of the adjuster.

That doesn’t mean data is increasingly required on onYou could be doing a great job, but the the work we do is less line web forms. “They have developed decision is made elsewhere.” more criteria required in an RFP.” or different; In addition to national contracts, This formalized process is an larger insurers have been increasingly it’s just that we emerging reality for many adjusters using procurement managers to overget paid less for accustomed to building personal relasee all supplier contracts, including tionships with regional claims managadjusters. This represents a more forour services.” ers. malized process involving RFPs, de“Procurement managers generally tailed adjusting firm information and don’t want to see or meet with indeperformance measurement criteria. pendent adjusting firms, which they “The increased sophistication of tend to see similar to other suppliers,” says Merrithew. the procurement process. . . when an insurer attains larger “They require a response to an RFP and then make decimarket share and influence tends to favor larger adjusting sions based on certain criteria.

It used to be that you dealt firms with national reach as the insurer seeks to capitalwith regional claims managers and they negotiated and discussed relationships with adjusters. That is not the case anymore.”

A key offshoot of the procurement model is a stricter emphasis on pricing, according to Plant. “Larger insur“Your Northern Resource!” ers can use their size to leverage pricing. Over time, they can drive the cost down for adjuster services. That doesn’t mean the work we do is less or different; it’s just that we get paid less for our services,” he notes.

Arctic West Adjusters provides all claims adjusting “The pricing issue applies to contractors, third party services to the Northwest Territories, Nunavut vendors and everyone in the supply chain, not just the inTerritory and, Yukon Territory. dependent adjuster,” Plant adds. “The bigger they are, the more they can squeeze.”

With over 30 years northern focus, Greg Merrithew and Faced with the daunting set of challenges that comes his team of experienced adjusters provide Insurers quality with insurer consolidation, adjusters are quick to discuss service in a timely fashion with Northern expertise. adaptive strategies.

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18 Claims Canada

p12-21 COVER STORY.indd 18

August/September 2012

Adaptive strategies “We need to recognize that our business has changed fundamentally and will never go back to the way it used to be,” Sharoun comments. “The consolidation of insurance carriers reflects the larger trends we are seeing in the global business community. Successful firms in any industry need to have a laser sharp strategic focus with the scale and flexibility to execute it properly. The insurers are pursuing these three objectives aggressively. As independent adjusters we need to find unique and creative ways to support them and help them achieve their objectives.”

This altered competitive landscape will contain some key features, according to Sharoun: • Business rules are changing and more sophisticated cuswww.claimscanada.ca

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tomers will become the norm; • Insurers will require a fundamental shift away from adjuster’s traditional file-by-file solutions; • Larger insurers will need a more diverse product offering from adjusters; and • Flexible pricing and service agreements will become entrenched.

Innovation is commonly cited as a crucial strategy for adjusters to succeed in this changing marketplace.

But what specifically does that mean?

“To me, innovation means having experienced, competent, well-trained loss adjusters who can handle a claim from beginning to end,” says Plant.

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August/September 2012

to close the file. If we go down that route, we are just claims administrators – that is not sustainable.”

Plant notes that he has been “preaching this message” to insurance companies that the adjuster is a crucial extension of the carrier’s claims service commitment to the policyholder.

“Some companies get it, but I would say they are the exception,” he points out. “As an adjusting firm, we are committed to bringing people on board and providing them with the right kind of training and continuing education. That is expensive, but I don’t charge more for that. How can independents retain the quality of service if they can’t charge properly for what that costs?”

Other adjusters say that proven strategies are still relevant in today’s p&c insurance industry.

“This may sound mundane but the best way for adjusters to adapt to this new reality is to focus on service with their clients,” notes Kernaghan.

“There has to be a high level of communication between the adjuster and insurance company client. We need to be problem solvers for the client and we need to collaborate with examiners to get the claim handled properly and the file closed. That is the expectation today of the adjuster.”

Balance of quality and service Kernaghan adds that the ability to see the claim from the insurer side of the equation is an invaluable skill for adjusters. “We need to understand that the company claims examiner is being monitored and evaluated on the level of claims efficiency,” she says.

“If we are not communicating or collaborating with the client, it slows the process, it lowers efficiency. As adjusters, we need to get to the point, communicate effectively and focus on service.”

Merrithew echoes the importance of adjusters seeking to achieve the right balance of quality and service within their chosen client segments.

“I think the best way to compete is with quality and service,” he says.

“The quality is that you have properly trained and educated adjusters who www.claimscanada.ca

12-08-21 1:55 PM

can investigate, do a thorough coveropportunities exist. This could be in age assessment and manage the claim specialized business areas, servicing from beginning to end. I think the foSIR clients, geographic niches.” cus on quality and service will make the Sharoun reinforces this emphasis adjuster stand apart. That is the differon adjusters paying attention to the Another tactic is to ence between a claims adjuster versus a bigger picture and tapping into reclaims administrator. “ sources currently available to them. seize on opportunities Merrithew notes that firms of vary“As the national trade association for for business that have ing sizes have to seek their own balance adjusters, CIAA gives adjusting firms opened up elsewhere in terms of resources, quality and seraccess to training, legislative and vice. “As national companies get a price compliance advice and a national in the marketplace, edge, they face more of a challenge getsupport network of peers to assist in such as providing ting revenues,” he adds. “They have to the transition of our business modclaims services to pay salary and benefits, obviously the el,” he notes. size/overhead of their operation is bigThat business model definitely clients with higher ger. The question again comes back to will be in transition mode in the self-insured how they can maintain quality and seryears ahead for adjusting firms of all vice?” sizes across Canada. And the empharetentions (SIR).

For smaller firms, the decisions and sis will be on service and accounttactics may be different. Merrithew says ability. he has observed a pattern of adjusters “Adjusters should constantly finding business niches or specialized challenge themselves to demonstrate service offerings in geographic regions. their contribution to achieving the “One route for smaller firms to go is to become special- insurance carrier’s objectives,” Sharoun concludes. “If you ized, whether that is in something like bonds or liability,” can’t measure your tangible contributions to the bottom he notes. “This attracts the more complex, larger types of line, there is no way your customer can either – and that assignments. I think there is a trend of smaller adjusters makes you vulnerable.”  becoming boutique businesses across Canada.”

Another tactic is to seize on opportunities for business that have opened up elsewhere in the marketplace, such as providing claims services to clients with higher selfinsured retentions (SIR).

“A trucking company, for example, may go to a broker, set an SIR of $500,000 and it will handle any claims below that,” Merrithew explains. “But they are often too small to have a claims staff or risk manager; they look outside for claims services. We have four SIR accounts and have been able to offset losses from traditional clients. I think this is an opportunity for independent adjusters to acquire business that historically has not been there.”

Meeting the challenge Kernaghan concurs that when one door closes, another one often opens. “Some merger activity, such as those at the MGA-broker level, may lead to more opportunities for adjusters,” say Kernaghan, who adds that her firm has grown by 54% in the last two years. “There are also private companies doing their own claims through higher SIRs or captives, but I wouldn’t say this is a huge trend. There are, however, definitely some options for adjusters to pick up lost business.”

For Merrithew, the adaptability of the independent adjuster will be tested in a time of insurance company consolidation. He is confident that adjusters of all sizes will meet the challenge.

“My perspective is that when there is change, an opportunity opens up,” he says. “Insurance adjusters have to pay attention to the national picture and see where these www.claimscanada.ca

p12-21 COVER STORY.indd 21

August/September 2012

Claims Canada 21

12-08-21 1:55 PM

• spotlight S

DutytoServe Incoming CIAA president John Seyler feels a strong sense of giving back to the independent adjusting profession.

BY CRAIG HARRIS

A

not-so-widely known fact about John Seyler’s early career is that he served three years in the Canadian military in an infantry unit, based in Europe. He draws a parallel between that experience and his role as incoming president of the Canadian Independent Adjusters Association (CIAA).

“It’s not like I was conscripted into the CIAA or anything,” he says with a laugh. “But I see a similarity with the idea of giving service. That’s really what it’s all about. I felt then that Canada had served me well: it was time to give something back. And that is exactly how I feel about the adjusting profession right now.”

Seyler will have an immense opportunity to give something back to an association that has experienced its share of turbulence in the last few years. Issues ranging from industry consolidation to cutbacks to competition have made independent adjusters leaner, but also more resourceful in their approach to business.

“I think adjusters have to understand what their forte is,” he observes.

“Perhaps ten or 15 years ago, you could take whatever claims came through the door. Today, however, it is much harder to make a living from that commodity-based work.”

22 Claims Canada

p22-24 SPOTLIGHT.indd 22

Seyler notes that specialization and knowledge will become the mantra of the modern adjuster. “I think we have to change the way we do things to accommodate developments in the insurance industry,” he says. “That means we have to be agile and adapt to new opportunities.”

He has first-hand experience of this adaptability. One year ago, Seyler partnered with Tammie Norn to create a new adjusting firm, ProFormance Specialty Claims Inc. ProFormance Specialty Claims Inc. and its sister company ProFormance Adjusting Solutions operate as independent companies under the ProFormance Group.

The company has grown rapidly and the group has three offices in Ontario with 25 employees combined.

Seyler heads ProFormance Specialty Claims Inc., which specializes in transportation, commercial auto, casualty, E&O and D&O claims. Norn is in charge of ProFormance Adjusting Solutions and oversees the handling of accident benefits, mediations, training and bodily injury claims.

The mission of ProFormance Group Inc. is to become a leader in specialty claim handling by providing innovative strategies and alternative solutions to the traditional methods of managing claims. “I definitely think

August/September 2012

one of our strengths is our agility – if we see an opportunity, we take advantage of it,” Seyler adds.

He says the company is looking at adding new ventures for different markets, such as commercial property and risk assessment.

Before ProFormance, Seyler worked for 22 years with a large national adjusting firm. Here, he learned the ropes of the profession and honed his skills as an independent adjuster. “It was a really good opportunity to work and learn. I started in Toronto and then moved to Vancouver, Woodstock, Ontario,and London, Ontario getting a chance to meet a lot of very different, interesting people.”

Adjusting, to Seyler is a profession that provides a good fit for his interests and skills. “I like dealing with people and I am curious by nature. Adjusting is one of those professions very well suited to my character.”

Far from being stodgy, he sees property and casualty insurance as a thriving industry with distinct pressures, challenging situations and enormous opportunities to help out people in a time of need.

“I often get the usual reaction when I mention I work in insurance, which is a blank or mundane look,” Seyler says.

“But once I get talking, people realize www.claimscanada.ca

12-08-21 2:01 PM

a profession like independent adjusting is much more involved. I could be at a big fire or an accident scene, and people start to realize exactly what it is that I do. Then the tone changes.”

His years of experience have given him the foundation, expertise and skills to navigate his term as president of CIAA. In terms of his plans for the association, Seyler says he has three main priorities for the upcoming year – continuing education, member accessibility and relevance, and strong relationships with sister associations.

Top of mind for Seyler is the new web-based continuing education program launched by the CIAA. “This is a terrific tool not just for companies in those provinces that require mandatory continuing education for adjusters, but for all firms,” he says.” We are very excited about it for the coming year.”

Members can take advantage of a modular online program offering individual courses they can select and take at their own pace.

“For example, we have an AB/BI adjuster on our staff, but we want to move him into casualty,” Seyler explains. “This kind of continuing education will help him develop those skill sets.”

Another priority for Seyler is making the CIAA more accessible to all its members, regardless of company size. “It’s no secret that adjusting firms have faced challenges in the last couple of years. We have seen financial constraints, layoffs and cutbacks. I think we at the CIAA have to understand that people are watching their purse strings closely. They want to see the benefits of being a CIAA member and we have to deliver those services and programs that best meet the needs of all members.”

One way to do that is to get input from as many member firms as possible – from different regions and various company sizes, according to Seyler. “I think we need that diversity because it really provides insight into different situations and circumstances. I believe we have to understand and www.claimscanada.ca

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August/September 2012

Claims Canada 23

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respect where all of our members are coming from and encourage them to get involved with the association.”

A third goal for Seyler this year will be strengthening relationships with fellow associations. These include groups such as the Ontario Insurance Adjusters Association, Canadian

24 Claims Canada

p22-24 SPOTLIGHT.indd 24

Insurance Claims Managers Association and Insurance Bureau of Canada, among others.

“We really need to play off our relationships with these organizations and enhance our already strong partnerships,” he says.

While CIAA has solid relationships

August/September 2012

with OIAA and CICMA, Seyler thinks there is also an opportunity to work with IBC on issues such as portability of licensing and mobility of adjusters across Canada.

“This issue has really plagued us for some time,” he observes. “We have been lobbying provinces to put in place portability measures but everyone seems to want to protect their piece of the pie. I think we have a great opportunity to work with IBC and push for change.”

Seyler notes that extreme claim events, such as flooding or wildfires, tax the ability of insurance companies to handle losses. A system that encourages mobility and accepted standards of adjuster licensing will take this pressure off, allow adjusters do their jobs – and, most importantly, meet the needs of policyholders.

“I think we are starting to see some movement from politicians on this issue,” he says. “Policyholders at a time of need are their constituents, as well.

If we can get fire fighters from Ontario to help out on a blaze in B.C., why can’t we do the same with adjusters? I think that message is getting through.”

The above priorities may seem like a long laundry list of challenges, but Seyler is optimistic that these can be achieved with a solid team behind him. “I feel very fortunate to have a terrific group with me at the CIAA, in terms of both staff and volunteers on various committees. Anyone who has been in this position before understands that the real work is done by a dedicated team.”

Seyler does not mind bringing a military-like bearing on getting results for the CIAA. His experience as an adjuster and also as an army “grunt” has taught him how to enlist support, encourage camaraderie and work together toward common goals.

“Working with the staff and volunteer members of CIAA is one of the exciting things about giving back to your profession,” Seyler concludes.

“When you have that kind of support, it’s amazing what can get done.”  www.claimscanada.ca

12-08-21 2:01 PM

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12-08-01 9:43 AM

Ontario Moves Closer To CAT Injury Definition

BY CRAIG HARRIS

O

ntario’s insurance regulator recently released its long-awaited report on catastrophic injury definition, holding that physical impairments should not be combined with psychiatric or mental/behavioural impairments for the purpose of determining a catastrophic injury.

The Financial Services Commission of Ontario’s (FSCO) review of catastrophic impairment, submitted to the Finance Minister in June, was part of the government’s auto insurance reform package implemented in 2010. In its recommendations, FSCO generally agreed with the suggestions of an expert panel struck by the commission to examine the definition of catastrophic injury.

The superintendent recommended that a combination of requirements should be used to determine a psychiatric catastrophic impairment. However, psychiatric and physical impairments should not be combined for the purpose of determining a catastrophic impairment of the whole person, according to the Superintendent’s Report on the Definition of Catastrophic Impairment in the Statutory Accident Benefits Schedule.

“The panel had trouble understanding how combinations of physical and psychiatric conditions that independently do not meet the criteria for catastrophic impairment could be equated to a severe injury to the brain or spinal cord or to blindness,” the superintendent wrote. “I agree with the expert panel’s position that arriving at a designation of catastrophic impairment is not a simple additive process. I therefore accept the expert panel’s recommendation that the combining of physical and psychiatric impairments not be permitted.”

The superintendent also found that the catastrophic impairment definition should not allow pain to be quantified as a separate impairment.

“If the panel recommendations are implemented as stated in its report, psychological and behavioural impairments would no longer be included in the definition of catastrophic impairment,” the report notes. “These conditions include chronic pain and fibromyalgia. However, a claimant with one of these conditions may be able to meet the criteria for catastrophic impairment on psychiatric grounds.”

While restricting some parts of the definition of a catastrophic impairment, FSCO’s superintendent is also calling for automatic designation of catastrophic impairment for children (claimants under 18) and interim benefits for claimants “who unequivocally require intensive and prolonged rehabilitation.”

26 Claims Canada

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August/September 2012

Interim benefits should be capped at $50,000, the superintendent recommends.

“A final determination of catastrophic impairment would be deferred until the natural course of the condition has unfolded,” the report says. “For example, an adult who sustains a very severe brain injury would be able to access interim benefits for six months, at which point an assessment would be conducted to make a final determination.”

The panel has also called for the following clinical tools to be used in determining a catastrophic impairment: • American Spinal Injury Association (ASIA) classification for spinal cord injury.

• Extended Glasgow Outcome Scale (GOS-E) for traumatic brain injury in adults.

• Spinal Cord Independence Measure for severe difficulty with walking.

• Global Assessment of Function (GAF) for psychiatric disorders.

The ASIA classification for a spinal cord injury is a new addition to the definition of catastrophic impairment. The panel qualified the use of the ASIA scale, however, so that “participation in, or completion of, an in-patient spinal cord injury rehabilitation in a public rehabilitation hospital is not necessary in addition to the other requirements.”

The recommended definition of a catastrophic impairment replaces the Glasgow Coma Scale, which, the panel notes, “has proven a poor tool for predicting the longterm outcomes of traumatic brain injury,” and replaces it GOS-E. It is now up to the Ontario government whether or not to adopt FSCO’s recommendations on catastrophic injury.

The Ontario Trial Lawyers Association (OTLA) and Alliance of Community Medical and Rehabilitation Providers quickly launched a media campaign against proposed changes to the definition of a catastrophic impairment for victims injured in car accidents. It featured full-page ads in daily newspapers featuring victims severely injured in auto accidents.

Currently, accident victims who are deemed to have suffered a catastrophic (CAT) injury are eligible for basic medical and rehabilitation benefits of up to $1 million. But the OTLA and rehab alliance group argue that if the province accepts the recommendations of the expert panel, the CAT threshold will be raised significantly.

“We estimate that the number of cases deemed catastrophic will be reduced by half if these changes are implemented,” says OTLA president Andrew Murray. www.claimscanada.ca

12-08-21 2:03 PM

“If the government goes ahead with this, it will hurt a tween 2004 and 2010, the number of no-fault injury claims lot of very vulnerable people,” says Nick Gurevich, president rose 28%, while the count for large claims has more than of the Alliance of Community Medical and Rehabilitation doubled. Hospitalizations from motor vehicle accidents are down 12%, yet auto insurers are being presented with many Providers.

Insurance Bureau of Canada (IBC) accused critics of the more catastrophic injury claims, according to IBC figures.

An expert panel commissioned by the Financial Services proposed catastrophic injury definition of “fear-mongering.”

“This is false, misleading, singularly irresponsible and is Commission of Ontario (SCO) issued its report on catanothing more than self-serving fear-mongering,” IBC’s vice strophic impairment definition in April 2011. That report made several recommendations, including not combining president for Ontario, Ralph Palumbo, responded.

“It is part of a campaign by people who make money physical and psychological injuries in determining catafrom auto collisions and want to maintain the status quo. strophic impairment, requiring medical doctors or qualified They’re worried that more money will go to treatment in- neuropsychologists to be the lead evaluators in catastrophic stead of their legal fees. Ontarians should listen to the advice injury assessment and establishing an interim status for people with traumatic brain injuries and major physical imof the medical experts and not lawyers.”

IBC adds that the superintendent’s recommendations pairments to get quick access to rehabilitation services.

Lawyers continue to disagree with proposed recommenfollowed on the advice of an expert medical panel established by FSCO. In addition, the government has promised dations to change the definition of catastrophic injury for accident victims. a public consultation in the 2012 budget.

A group of prominent personal injury lawyers, who in“The panel of experts was of the view that the current system leads to inconsistent catastrophic impairment de- clude Richard Halpern, partner at Thomson Rogers, Roger terminations and frequently gets the diagnosis wrong,” IBC Oatley of Oatley Vigmond Personal Injury Lawyers LLP, Ninotes. “The proposed changes would make the process more gel Gilby, partner at Lerners LLP and Stephen Firestone of accurate, consistent and objective and would incorporate Lackman Firestone, resigned from an informal FSCO legal leading edge science-based evidence into CAT determina- committee because their recommendations on catastrophic impairment were ignored.  tions.”

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A “Twist” to Allocation of Defence Costs

BY MICHAEL TEITELBAUM

A recent Ontario Court of Appeal decision, Tedford v. TD Insurance Meloche Monnex (2012), potentially injects uncertainty into how defence costs can or should be allocated before an action has been concluded. We believe the decision is helpful to insurers, as it may raise more questions than it answers. This could result in more litigation seeking guidance in respect of these unanswered questions.

The Tedford case addressed circumstances that did not arise in a previous case on the subject, Hanis v.

Teevan, [2008]. In that case, the court ruled that allocation of defence costs will likely have to be determined at the end of the underlying action after an insurer provides a full defence if one or more of the claims are covered under a liability policy.

In Tedford, the primary differences were that (1) the insured was seeking a defence at the outset, while in Hanis defence costs were addressed after the matter was completed, and (2) in Teevan, “the covered claims represent a small portion of the total damages claimed.”

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It remains to be seen which of the court’s rulings, whether in Tedford or Hanis, will be the proper determination for allocation of defence costs.

Facts and Motion Judge’s Decision In the underlying action, it was alleged that the insured, Damon Tedford, made negligent misrepresentations in the Seller Property Information Statement completed in connection with the sale of his home. In that action, the plaintiff purchaser pleaded that as a result of the misrepresentations she incurred and will continue to incur repair costs, and has suffered anxiety, sleep disturbances, fatigue, stress, headaches and symptoms of depression, (the “Health Consequences”).

Tedford held a homeowner’s policy which provided coverage for damages due to “Bodily Injury” or “Property Damage.” The application judge concluded that as the Health Consequences amounted to Bodily Injury, a duty to defend therefore arose, and that duty extended to the entire action.

It was common ground that the damages the insured may have to pay with respect to the repair costs did not constitute property damage under the

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policy. Accordingly, but for the alleged bodily injury, a duty to defend would not have arisen.

The Court of Appeal’s Reasons The Court of Appeal upheld the application judge’s finding that there was a duty to defend the misrepresentations under the Bodily Injury coverage. The Court found that the claim for alleged Health Consequences arising from the misrepresentations were not “derivative”, as submitted by the insurer, which argued that the true nature of the Plaintiff’s claim was one for economic loss arising out of a commercial transaction and the claim for Health Consequences was derivative of that loss. The Court disagreed, noting that only one cause of action was being advanced, that of negligent misrepresentation, and this is not a derivative claim as contemplated by the Supreme Court of Canada’s decision in Non-Marine Underwriters, Lloyd’s of London v. Scalera, [2000].

In respect of the allocation of defence costs issue, the Court noted that the policy did not provide for “allocation of defence costs where an insured is subject to both covered and uncovered claims and the same costs are inwww.claimscanada.ca

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curred in the defence of both covered and uncovered claims”.

It found that the application judge erred in requiring the insurer to defend the entire action without making provision for apportionment of the defence costs.

Justice Hoy, speaking on behalf of a three-member panel which included Lang and Epstein JJ.A., noted that in Hanis Justice Doherty held that “where there is an unqualified obligation to pay for the defence of claims covered by the policy…the insurer is required to pay all reasonable costs associated with the defence of those claims even if those costs furthered the defence of uncovered claims. The insurer is not obligated to pay costs related solely to the defence of uncovered claims.”

Her Honour also noted that the apportionment of defence costs was determined following the underlying trial in Hanis. In the case at hand, the insured is seeking to have the insurer “assume the conduct of the defence, and the covered claims represent a small portion of the total damages claimed”, so “considerations not addressed in Hanis arise”.

Her Honour also noted that the insurer argued it would be unfair for it to have to defend the entire action because “of the plaintiff’s $185,000 damages claim, at least $150,000 relate to repair costs, and [t]he plaintiff seeks damages of approximately $25,000 for Health Consequences.”

Her Honour found that a decision relied upon by the insured, Riocan Real Estate Investment Trust v. Lombard General Insurance (2008), where the insurer was ordered to defend the entire action, even though not all the claims were covered by the policy, and no order was made with respect to the allocation of costs, was not of assistance because it was decided before Hanis. Moreover, the facts in Riocan are different because multiple theories of liability were advanced to support a claim for the same damages. The potential liability in respect of the covered claim was the same as that in respect of the uncovered claims.

The Court held that, unless the parties otherwise agree, insurers’ counsel 30 Claims Canada

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“should be instructed to defend both the covered and the uncovered claims, in a manner commensurate with the aggregate amount claimed, and that the insureds [should] bear the costs of the defence, to the extent they exceed the reasonable costs associated with the defence of the covered claims. In determining the reasonable costs asso-

It appears that the Court is laudably attempting to pursue fairness for both insureds and insurers through this judgment by noting that an insurer should not have to pay defence costs that are “disproportionate to the extent of its potential liability for the covered claim.”

ciated with the defence of the covered claims, it is appropriate to consider the quantum of the covered claims. It would be unfair to the insured to fix it with defence costs that are disproportionate to the extent of its potential liability for the covered claim.” The Court went on to say that if the parties are unable to agree on an allocation of the costs, the insurer will be entitled to

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apply to the Superior Court of Justice for a determination of the allocation, in accordance with Hanis, after the matter is concluded or at such other time as the parties agree.

Comment While, as indicated, this formulation is helpful to insurers, it also introduces some potential uncertainty into how defence costs can or should be allocated before an action has been concluded. It leaves a number of unanswered questions, some of which are as follows: 1. Is the court’s intention, as appears to be the case, to provide that when damages are either covered or uncovered under a liability policy, this is when allocation is appropriate, as opposed to when there are multiple theories of liability that will require a defence to be provided with respect to one or more of them that will overlap to some extent? As we had understood the Hanis decision, it was not a matter of whether mixed claims, i.e., covered and uncovered claims, are so intermingled or intertwined that creates the defence obligation; rather, it is the obligation to defend the covered claims that also incidentally encompasses the uncovered claims, unless it can be shown the defence costs relate exclusively to uncovered claims. Otherwise, it would be difficult if not impossible to determine what costs were solely attributable to uncovered claims insofar as a liability defence is concerned.

Arguably, the court in Tedford appears to be saying this is less of an issue insofar as covered or uncovered damages are concerned, if it is an issue at all.

In terms of the liability defence in Tedford, the Hanis considerations do not arise since the court finds only one covered cause of action is being asserted. The question is whether, applying Hanis to a covered versus uncovered damages analysis, the court is implicitly saying that if the damages are not covered, and there are identifiable costs associated with their defence, then those are the costs the insured must www.claimscanada.ca

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bear? That query posed, this does not appear to fully be the case because the court has suggested it is appropriate to consider the quantum of the covered versus uncovered claims in determining what the reasonable costs are for defending the covered claims.

2. How often can it be determined, with any certainty, what the breakdown is between the damages that are said to be covered as opposed to uncovered? For example, unless it is specifically pleaded that uncovered repair costs are a certain amount while covered damage claims are another specific amount, are the parties to simply rely upon the amounts claimed in the statement of claim? And, if those amounts are equivalent, share defence costs equally? Or, does this mean that allocation is not truly possible at the pleadings stage, but that once discoveries are held where damages may be more specifically determined, then this would be the appropriate time to determine allocation? If so, would that allocation then be applied retrospectively?

3. If the insured refuses to be reasonable, and does not agree to allocation at the outset of the matter in circumstances such as these, will a court when deciding the point after the fact penalize the insured in some fashion?

4. If the parties will not agree to a determination of allocation, is the Court saying that there is a continuing obligation on the part of the insurer to fully defend and seek reimbursement at a later date? It appears this is the case when it says that “appellant’s counsel,” whom we take to mean defence counsel, is to be instructed to defend both the covered and uncovered claims, “in a manner commensurate with the aggregate amount claimed.” However, it would have been helpful to have received more elaboration and guidance in this respect.

It appears that the Court is laudably attempting to pursue fairness for both insureds and insurers through this judgment by noting that an insurer should not have to pay defence www.claimscanada.ca

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costs that are “disproportionate to the extent of its potential liability for the covered claim.” This is a welcome development. That said, the mechanics and procedure for achieving this were not specifically addressed and we anticipate this may become necessary in future decisions.

Thus, at the moment, unless insureds and insurers take a reasonable approach to situations like that spelled

out in Tedford, all parties are ultimately left with what we perceive to be the current status quo – the insurer will be obliged to fully defend, but can seek reimbursement after the action is concluded.  Michael S. Teitelbaum is a partner with Hughes Amys LLP. Hughes Amys is a member firm of The Arc Group Canada.

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Are Pedestrians and Cyclists Covered Under Auto Insurance?

BY LEONARD KUNKA AND CARR HATCH

With the near tropical winter most Ontarians experienced this year, the number of cyclists on our roads in January and February was higher than ever.

This naturally led to a rise in the number of accidents involving bicycles and motor vehicles.

Despite the obvious coverage available to an injured pedestrian or cyclist who has been struck by a motor vehicle, the question emerges as to what recourse is available for a pedestrian or cyclist who is injured when there is no actual impact or physical contact with the motor vehicle alleged to have contributed to the incident. A common example of such a situation is a cyclist who crashes and sustains injuries while swerving to avoid being struck by a motor vehicle.

The case law has developed around this question significantly with respect to Statutory Accident Benefits coverage.

Despite the development of the law, an injured party in the situation described above can still expect the responding accident benefit insurer to initially deny that their injuries were caused by an “accident,” as defined in section 3(1) of the Statutory Accident Benefits Schedule (SABS). The Schedule states: 32 Claims Canada

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“ ‘Accident’ means an incident in which the use or operation of an automobile directly causes an impairment or directly causes damage to any prescription eyewear, denture, hearing aid, prosthesis or other medical or dental device.”

Injuries involving pedestrians or cyclists and motor vehicles are often considered “catastrophic,” which enable the injured party to receive enhanced benefits under the Schedule. With potentially enhanced benefits available, the determination of whether the claimant was injured as a result of an “accident” often becomes a high-stakes debate.

The case of Seale v. Belair Insurance Co. a 2003 decision from the Financial Services Commission of Ontario (FSCO) sheds light on this issue. In Seale, the claimant’s vehicle had lost traction and became stuck in an icy intersection. The claimant shut off her engine and exited her vehicle with the intention of trying to push the vehicle.

Before the claimant started to push her vehicle, it began to slide on the road and eventually came to rest in a snow bank.

After thirty seconds elapsed, the claimant then walked toward her vehicle and slipped and fell on the icy road, sustaining injuries. The Arbitrator concluded that the injury was sustained while the van was being “used” or “op-

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erated.” The Arbitrator concluded that a determination of whether “use or operation” of the vehicle directly caused the injuries involved a consideration of intervening acts or forces, and whether the loss was a normal and reasonable risk of motoring. Importantly, the Arbitrator stated that the definition of “accident” does not require the injury to occur because the insured has physical contact with the vehicle.

The FSCO decision of Petrosoniak v.

Security National Insurance Co., is also helpful. In Petrosoniak, a cyclist was injured when his bicycle crashed on the pavement after it had driven over a patch of hydraulic oil spilled by a motor vehicle on the road. In assessing the word “direct” in the definition of “accident,” the Arbitrator referred to the term “direct cause” which he defined as “the active, efficient cause that sets in motion a train of events which brings about a result without the intervention of any force started and working actively from a new and independent source.” The Arbitrator found that the cyclist was indeed injured in an “accident” and entitled to accident benefits.

The Insurer conceded that the definition of “accident” does not go as far as to require the injured party to come into direct contact with a vehicle. The Arbitrator stated: “In the instant case, the [cyclist] was injured as a direct result of coming www.claimscanada.ca

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into contact with a wet patch of pavement. I have found that the fluid on the pavement was released by a motor vehicle. While the fact that the fluid fell onto the roadway, as opposed to falling directly onto Mr. Petrosoniak, may have constituted an intermediate step in the process which ultimately led to his injuries, it does not, in my view, constitute an intervening act or a force ‘working actively from a new and independent source.”

Importantly, the Petrosoniak definition of “direct cause” has been applied by the Ontario Court of Appeal in the 2002 decision of Chisholm v. Liberty Mutual Group.

A review of the relevant FSCO decisions reveals the following propositions that have been used in determining what constitutes an “accident” pursuant to section 3(1) of the Schedule.

These propositions include: 1. The use or operation of a motor vehicle must directly cause the impairment.

2. A direct cause is a cause that sets in motion a train of events leading to a result without any later intervening act.

3. Direct cause does not mean the only cause or the most immediate cause.

There can be more than one direct cause of a victim’s injuries, and one of the direct causes is the use or operation of a motor vehicle.

4. The motor vehicle need not come into direct physical contact with the victim.

5. The role played by the motor vehicle must be more than just the location, opportunity or motive of the incident.

6. The motor vehicle must be a dominant feature in the incident and not ancillary to it.

These cases demonstrate that a cyclist or pedestrian who is injured, but who was not in physical contact with a motor vehicle, will still be entitled to Statutory Accident Benefits, if the facts and circumstances of their case qualify under the “direct cause” or “dominant feature” propositions contained in these decisions.

It is therefore critical for pedestrians and cyclists who have been injured in www.claimscanada.ca

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an “accident” to act quickly to retain counsel, as the initial investigation into the accident (particularly where there is no impact or contact with a motor vehicle) will largely determine whether they will later be entitled to accident benefits.

A flawed motor vehicle accident report, the failure of counsel to obtain immediate witness statements or to conduct a proper investigation, or the general delay of the injured party in

obtaining counsel can all have a deleterious impact on a claimant’s likelihood of having their incident considered an “accident” within the meaning of the Schedule.  Leonard H. Kunka is a partner with Thomson Rogers and a leading practitioner in personal injury litigation. Carr Hatch is an associate with Thomson Rogers.

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DRIVEN TO DISTRACTION

How can the insurance industry help people pay more attention on the roads?

BY JAMES GEUZEBROEK

A single mother was driving with her young son north of Toronto on Canal Road in the Holland Marsh one night a few years back. It was a cloudy and starless sky. She was on the phone. In a matter of seconds she lost control, went into the canal flowing through the marsh, and she and her son both drowned. It didn’t have to happen.

Tragic personal stories like this illuminate faceless but impressive statistics. In its 2009 Ontario Road Safety Annual Report (latest available),the Ontario Ministry of Transportation reported 79 people died in collisions caused by driver inattention in that year. There were 11,771 personal injuries and more than 25,000 collisions involving property damage.

Cell phone use is, of course, only one distraction, and, some have recently argued, one of the lesser ones in terms of

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frequency. But in the case of the woman and her son in the Holland Marsh, it was the fatal one.

Perceptions of Distracted Driving According to a CAA study, distracted driving in Canada recently surpassed impaired driving as the number one road safety concern among Canadians.

Consider these facts.

• Nearly 80% of collisions and 65% of near-collisions involved some form of driver inattention up to three seconds prior to the event. (National Highway Traffic Safety Administration, 2010) • A driver is 23 times more likely to be involved in a collision if texting while driving and 4 times more likely to be involved in a collision if talking on a cell phone (handheld or hands-free) while driving. (U.S. Department of Transportation, 2009) www.claimscanada.ca

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• When distracted while driving, you may fail to see up to 50% of the available information in your driving environment. You may look but not actually “see” what is happening (Strayer, 2007) But despite the dangers, there continues to be considerable non-compliance with bans on cell phone and texting while driving.

The OPP and other police authorities across Canada conduct blitzes regularly and a standard theme in feedback from them and author police authorities is that “people

IBC Tips on Avoiding Distracted Driving The ability to multi-task has no place behind the wheel. Here are IBC’s recommendations for drivers before hitting the road: • Ask passengers to keep chatter to a minimum and help you navigate.

• Deal with distractions such as eating, putting on make-up, reading, combing your hair and checking messages before you hit the road.

• Be well rested before getting behind the wheel. If you are out late and too tired to drive home, sleep over or call a taxi.

• Ensure you have clear directions to your destination and check them before you leave. Listen to your GPS device; don’t look at it.

• Adjust the seat, headrest, seatbelt, rear-view mirror, climate control, radio, etc., to your liking before you drive.

• Manage dashboard controls and music preferences ahead of time and only adjust them when the car is stopped.

• Pull over somewhere safe if you need to make a call, check a message, deal with passengers, eat or drink, etc.

• Tell everyone that for safety reasons, you no longer answer calls or respond to messages while driving.

• Don’t answer your cell phone or PDA messages while driving. Better yet, turn these devices off when you get into your car.

• Never text and drive! Texting takes your eyes and mind off the road and your hands off the wheel.

• If you use a navigation system, follow the manufacturer’s installation instructions and attach the device securely where it is easy to see and does not block your view of the road.

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don’t seem to be getting the message.” To drive home just how serious authorities consider distracted driving to be, the OPP has made it the fourth element in their “big four,” which also includes aggressive driving, failure to use restraint devices and driving while impaired.

Distracted driving can also result in a criminal charge under the Criminal Code of Canada (section 249) or under local traffic laws. As well, many employers have policies banning the use of communication devices while driving.

More information on provincial legislation related to distracted driving visit the Transport Canada’s website at www. tc.gc.ca under distracted driving legislation. Keep in mind legislation changes frequently.

IBC’s Position While supporting legislation on distracted driving, IBC believes in long-term public education as the core element necessary to get collisions from distracted driving down.

And so IBC used, in addition to website and brochure materials, the DUMB Car (Distractions Undermining Motorist Behaviour) – a driving simulator that shows in an entertaining way how severely distractions can impair your driving.

The car was part of the Be Smart. Be Safe. Tour, an award-winning community outreach program designed to deliver important messages directly to the public on road safety, injury prevention and more.

The car traveled to various community fairs and festivals across Canada in a large trailer that also housed a number of other interactive safety exhibits.

Introduced in 2007 it taught thousands of people─ in schools, in universities, with service groups and at special events across Canada about the dangers of distracted driving. In 2009, IBC introduced the upgraded DUMB Car 2.0, which addressed a broader range of road safety issues.

The DUMB Car 2.0 tests drivers’ reactions to a variety of scenarios. The simulator features an actual-size driver’s seat, gas pedal and brake, steering wheel, dashboard and wide video screen.

Drivers see how well they can handle the vehicle while: • Driving in adverse weather • Avoiding road hazards • Identifying point-of-no-return at traffic lights • Handling distractions Novice Drivers and Distraction Solid research guides our industry’s road safety initiatives. With that imperative in mind IBC commissioned Human Factors North to conduct a driver distraction study, involving novice and experienced drivers. It was a two-part study, involving a driving simulator in a university lab and on-road courses.

While the study found that cell phone use is a problem for all drivers, the driving of novices was poorer than the driving of experienced drivers. Novices took longer to perceive hazards developing, and did not take the cautious approach of experienced drivers and slow down when they are on the phone. As a proponent of graduated licensing prowww.claimscanada.ca

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of working with provincial governments and safety organizations to make communities safer for everyone.

From seatbelt legislation and anti-drink ing-and-driv ing campaigns to graduated licensing, Canada’s home, auto and business insurers have always been at the forefront of safety.

When it comes to distracted driving, the stick needs to combine with the carrot to achieve sustainable results.

Education needs to help legislation work more effectively.

For more on distracted driving please go to the IBC website (www.ibc.ca) under Novices took longer to perceive car insurance and click on hazards developing, and did not road safety. î —

grams across Canada, IBC believes the study showed support for changes to licensing.

The Bottom Line Distracted driving is a major problem in this country.

Cell phones only constitute one form of distraction. There are MP3 players, GPS systems, radios and CDs. Not to mention eating, putting on makeup and consulting a map. And although banning cell phone use while driving is a fine start, changing societal perceptions is even more critical. Just as the work is continuous to make drinking and driving taboo, it’s now time to make distracted driving, in all its forms, socially unacceptable as well. It is up to everyone to avoid distractions while driving.

IBC and the insurance industry have a long history

take the cautious approach of experienced drivers and slow down when they are on the phone.

James Geuzebroek is vicepresident, communications, Insurance Bureau of Canada.

24HR

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Material Contribution: The “Unicorn” of Canadian Law

BY RYAN KRUSHELNITZKY AND PETER GIBSON

In late June, the Supreme Court of Canada rendered its most recent judgment on causation in Clements v. Clements (2012 SCC 32). The decision of the majority, written by the Chief Justice, will be of interest to lawyers and insurers across the Country, who deal with questions of negligence on a daily basis.

Plaintiffs who are unable to show causation on a “but for” test argue for the less onerous “material contribution” standard, while defendants (and their insurers) argue for a more rigorous and universal application of the “but for” test. This most recent decision adds to a consistent line of line of cases emphasizing that the “but for” test is the standard test in negligence law. The “material contribution” test is only available in the rarest of circumstances.

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While it was hoped that the Court would have used Clements as an opportunity to explain the application of the “material contribution” test, it left that issue for a future case. Instead, the majority of the Court built on the incremental approach in Resurfice Corp v. Hanke (2007 1 S.C.R. 333) and provided further clarification as to when the “material contribution” test might be available (though also noting that it had never b`een applied by the Supreme Court of Canada).

Clements involved a case in which a motorcycle was overloaded, and, unknown to the driver, the rear tire had been punctured by a nail. While the motorcycle was accelerating to pass a car, the nail fell out of the tire, the tire deflated, the bike wobbled, and a crash ensued. A passenger on the motorcycle suffered severe injuries and sued the motorcycle driver in negligence.

The trial judge held that the driver’s negligence contributed to the injuries, but also held that the plaintiff was unable to prove causation on the “but for” standard because of limitations in the

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scientific reconstruction evidence. The trial judge applied the “material contribution” test to find the driver liable.

The Court of Appeal disagreed, and held that the “but for” test ought to have been applied, and that the plaintiff had failed to prove causation.

In Clements, the Court was faced with the issue of whether the “but for” test applied, or whether the “material contribution” test applied. The Chief Justice reaffirmed that the “basic rule” for negligence cases was the “but for” test for causation. She explained that the “but for” test was a “different beast” from the “material contribution” test.

This is because “the material contribution test removes the requirement of ‘but for’ causation and substitutes proof of material contribution to the risk” (Clements at para. 14). The Chief Justice explained that material contribution “imposes liability not because the evidence establishes that the defendant’s act caused the injury, but because the act contributed to the risk that injury would occur” (Clements at para. 15). www.claimscanada.ca

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In Resurfice, the Chief Justice had earlier held that the “material contribution” test can only be properly applied in limited circumstances— i.e. proof of causation using the “but for” test was impossible, and the plaintiff was exposed to an unreasonable risk of an injury that occurred.

In Clements, she clarified when these limited circumstance might arise. She held that the motorcycle accident in Clements was not the kind of case in which the material contribution test would apply. Instead, the Chief Justice found that the “material contribution” test could apply when (Clements at para. 46): “(a) the plaintiff has established that her loss would not have occurred ‘but for’ the negligence of two or more tortfeasors, each possibly in fact responsible for the loss; and (b) the plaintiff, through no fault of her own, is unable to show that any one of the possible tortfeasors in fact was the necessary or “but for” cause of her injury, because each can point to one another as the possible ‘but for’ cause of the injury, defeating a finding of causation on a balance of probabilities against anyone.”

The majority decision was limited to stating that the “material contribution” test might apply in circumstances in which “but for” cannot be proven against a number of multiple defendants, and left the question of whether such a test for causation would be available for circumstances involving a lone defendant (e.g. such as in a mass toxic tort case) for another day.

Notably, after an extensive review of the Supreme Court’s earlier jurisprudence on causation, the Chief Justice observed that “while accepting that it might be appropriate in ‘special circumstances’, the Court has never in fact applied a material contribution to risk test” (Clements at para. 28). The majority concluded that the circumstances at bar did not give rise to a situation in which the “material contribution” test could be applied, and ordered a new trial so that the trial judge could apply the “but for” test.

The decision of the majority, therefore, confirms that while it may be www.claimscanada.ca

possible, in rare circumstances, for the “material contribution” test to apply, the Supreme Court of Canada has, in fact, never applied it.

Accordingly, the specific application of the “material contribution” test is an open issue that has yet to be dealt with conclusively by the Supreme Court of Canada. Just like the unicorn, the “material contribution” test is a rare and “different beast.” Given the right set of circumstances, it might be spotted one day in a Canadian court-

room, but every reported sighting so far has proven to be a hoax.  Ryan Krushelnitzky is an associate at Field LLP. His primary areas of practice are in insurance defence, products liability, construction and civil litigation.

Peter Gibson is a partner with Field LLP. His practice is predominantly in the area of insurance law where he has experience in coverage disputes, defending claims and pursuing subrogated matters.

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Clinical Perspectives on the MIG

BY DENNIS GIESBRECHT

From the clinical perspective, the Minor Injury Guideline (MIG) in Ontario is a rather blunt tool.

While a more precise tool is being prepared for use, it is not available yet, and we are likely to need to deal with the current construct for another year. As of the writing of this article, we still have been provided no guidance from arbitration decisions or other authoritative sources of how this guideline will be interpreted. Insurers do not know the extent of the possible exposure, and clinicians do not know whether their professional opinions will be validated or set aside. This is the nature of a new administrative guideline of this kind.

“The SABS and the MIG are intended to encourage and promote the broadest use of the Guideline, recognizing that the majority of people injured in car accidents in Ontario sustain minor injuries for which the goods and services provided under the MIG are appropriate.” FSCO’s statement sets the stage for Ontario’s attempts to manage costs related to minor injuries.

There are few who dispute this statement, but the effect of this Guideline extends beyond the obvious, so a look at some of the twists and turns experienced with the MIG is in order.

The MIG is more inclusive than prior guidelines such as the Pre-Approved Frameworks. They include a sprain, strain, whiplash associated disorder (WAD), contusion, abrasion, laceration or subluxation and includes any clinically associated sequelae to such an injury. While this appears to be clear and simple, there are some surprising issues that may arise particularly looking at the clinical sequelae to WADs – these can include impairments commonly identified as 40 Claims Canada

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neurological, such as dizziness, tinnitus, headache and memory acuity.

Differentiating whether these are associated with the minor injury or with something else is typically the task of medical professionals.

A cerebral contusion is technically a Mild Traumatic Brain Injury (MTBI), with symptoms described often as postconcussive. A plain and simple reading of the MIG would argue against this ever being captured within the MIG, but our experience is that this may warrant more nuanced consideration. Arguably, MTBI should be demonstrable on imaging as an organic injury and concussion is more of a functional head injury without actual “brain injury”, but experts and organizations seem to disagree on this. Is this a minor injury?

Does it automatically disqualify a person from treatment within the MIG? The role of loss of consciousness is disputed and forms a grey area within expert opinion as well.

Some say that when no treatment is prescribed for this injury, and since time is all that may be needed for resolution, it should not exclude a person from the MIG, provided obvious minor (MSK) injuries predominate (more on this later). While the cognitive sequelae are generally anticipated to resolve spontaneously, there may be long-term implications of pain-related post-concussive symptoms that persist in 10-15% of cases. These would clearly demand removal from the strictures of the MIG, but this may not become evident until later in the case. Moving to secure an earlier expert opinion is recommended when these issues arise, or do not quickly diminish and create exposure.

There is an explicit assumption that “psycho-social” matters will be handled within this Guideline, and according to FSCO (Bulletin No. A-02/11) to be completed within the

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$400 available for supplementary goods and services. There is also an implicit assumption that psychosocial matters for those who suffer minor injuries will also be minor in nature and importance.

Psychology and psychiatry professionals have certainly struggled with the MIG construct. They are asked to make determinations comparing physical issues with psychological issues – there is little guidance in the literature for this activity. In a conference (“Before the MIG hits the Fan” 2011, LifeMark/Centric Medical Assessments) psychiatrist Dr. William Gnam noted that minor accidents are anticipated by many to produce only minor injuries, but unfortunately the literature does not support this assumption – a minority of persons sustaining minor physical injuries will go on to develop mental disorders that will not be adequately addressed by treatment within the MIG, based on current evidencebased treatment guidelines.

For those who do not have a major mental disorder after an accident, their psychosocial needs can likely be addressed fully within the current provisions of the MIG. There is no compelling evidence-based case for prolonged psychosocial treatment if psychiatric symptoms do not attain disorder status. It is a minority of people involved in minor accidents that go on to develop major mental disorders, but these individuals are of significant concern to the industry.

The time courses of PTSD, phobias, and major depression arising from MVAs appear to differ, but risk of chronicity exists for each, and when one sees the possibility of chronicity arising, this is of great concern to insurers and medical professionals alike!

It is in everyone’s interest to avoid chronicity, and the MIG is a relatively focused program with expectations www.claimscanada.ca

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and hopes for quick termination and closing of the file both from the medical and the adjusting point of view.

Lastly among inclusions is the continuing whiplash associated disorders question – it does not seem to have changed substantially from the PAF days. The Guideline defines the MIG to include the traditional WAD I and II definitions but not the WAD III and IV. We still see many OCF-18s referencing WAD III, without identification of the objective, demonstrable, definable and clinically relevant neurological signs to justify this diagnosis. Challenging any unsubstantiated claims and securing an independent diagnosis is a continuing necessity, given the potentially serious nature of this condition.

The exclusions within the MIG are more constrained than previous guidelines. As long as the injuries fall within the definitions of minor, there is only one identified – “if the insured person’s impairment is predominantly (emphasis added) a minor injury but, based on compelling evidence provided by his or her health practitioner, the insured person has a pre-existing (emphasis added) medical condition that will prevent the insured person from achieving maximal recovery from the minor injury if he or she is subject to the $3,500 limit …”.

As a result, there is no allowance for the funding for assessment or treatment outside of the minor injuries that may have arisen from the accident, or other conditions that may come to light after the accident, but within the MIG treatment period. This also seems to exclude all but the most basic of psycho-social interventions, and certainly advanced diagnostics (MRIs or CT scans) to verify conditions such as full ligament tears or TBIs are expensive enough to be practically excluded from the MIG on the treatment side.

This leads to one of the more difficult matters for clinical professionals: how do we consider both physical/medical impairments principally referenced in the MIG with the psychosocial or the mental/behavioural elements? This issue is basically mirrored in the catastrophic injury rating www.claimscanada.ca

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discussions, and is part of the consideration of the “predominantly” minor injury question.

How does one define “predominantly”? Is predominance measured by the number of observed minor injury impairments as a factor of the total number? By the impact on treatment needs and costs? By the impact on function? After all, the MIG is essentially a functional restoration program. Who should evaluate predominance – physical providers or psychiatric providers?

Both together?

With the MIG and a focus on diagnosis and causation of accident-related impairments, there has been a return to use of the more traditional medical assessor. GPs are now more frequently used for this purpose as their scope of practice is extremely broad. However, not all are willing to go out on a limb to comment on mental disorders, and comparison of physical and mental conditions are dealt with in an understandably inconsistent fashion, given the lack of guidance from the literature. Our experience has been that results are most reliable and defensible when both sides are involved together.

This way, the professionals can come to a common understanding of which impairments should be considered to be “predominant.”

On the one hand, the job of a clinical professional is to consider these matters carefully and render a reasoned, evidence-based and understandable judgement – but that judgement is based more on medical considerations than administrative, adjusting or costcontrol considerations. It is the somewhat difficult spot medical professionals find themselves when dealing with administrative guidelines that involve legal or administrative definitions as much as medical ones.

On the other hand, some insurers, without medical input, are making the decisions about whether a case should be handled as MIG – basically a “medical” decision, to some extent anticipated by the Superintendent’s Bulletin A-02/11. The impact of this is not yet clear, but it has some associated risk.

A final issue with the MIG is related to access to Income Replacement ben-

efits. While the previous Pre-Approved Frameworks were linked to limited IRB funds, the MIG is not. This concern was predicted by many when the MIG was implemented. What are we to do when a person has legitimately suffered minor injuries, is provided with excellent care as recommended in the Guideline, but was involved in a heavy duties job to which s/he needs to return at full capacity? The $3500 is (well) spent but this person legitimately still cannot manage the full duties, and needs some work hardening or conditioning. We have seen numerous situations where the insurer is exposed to ongoing IRB payments, and the claimant, whose responsibility is to engage in treatment to mitigate the injuries and maximize progress, is not able to access required funds to do so to complete the process within the MIG. It is a classic catch-22 situation that the medical professionals cannot solve, and it ends up as an adjusting issue.

A contract has recently been awarded to Dr. Pierre Côté for creation of the Minor Injury Treatment Protocol (MITP). According to FSCO, scientists and other experts will contribute to the development of an evidence-based protocol that will form the basis of a new MIG. We hope that this new protocol will meet its objectives and solve some of the issues described above. But we will inevitably be faced with a new construct that will require consideration, thoughtful implementation and a whole new round of interpretive exercises.

Until then, it is clear that individual cases continue to require individual consideration. The majority of MIG cases are easily identified and proceed with little problem, but a minority of cases fall into a grey zone and risk seems impossible to avoid with these cases. As always, a clear diagnosis and medical/psychiatric opinion has its place, as the principal issue in determination of whether a person belongs in the MIG remains a clinical decision.  Dennis Giesbrecht is manager, clinical intake and client services for Centric Health Medical Assessments.

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Social Media

Surveillance

Several personal injury plaintiff lawyers I know often tell me how badly they want to get surveillance on some of their own clients. They want to see whether those clients are as impaired as they allege. Nothing could sting a plaintiff lawyer more than seeing the value of their case tumble because their incapacitated client has been captured on film completing a local triathlon.

There’s a much cheaper way for lawyers (and insurers/adjusters) to get surveillance on their clients. It’s called the World Wide Web. And, much to the plaintiff bar’s chagrin, defence lawyers and their insurer clients are also using the Internet to gain a wealth of information on their claimants.

The insurer’s best friend these days is Facebook. Although plaintiff lawyers are telling their clients to stay off Facebook, many plaintiffs cannot avoid the appeal of sharing their lives with their Facebook “friends.” As I write this article on one of my dual monitors, I am looking on the other monitor at the semi-protected Facebook profiles of one of my claimants.

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Defence lawyers have been trained to ask questions about Facebook profiles at examinations for discovery.

Those who don’t ask the questions are likely doing their clients a disservice.

As a joke I once asked an 86-year-old plaintiff whether she was on Facebook.

Not only did she have a profile, I eventually received photos of her canoeing at a family picnic. Apparently, she was having a “good day.”

The case law on Facebook production is still unsettled, as judges and arbitrators have struggled to deal with issues of relevancy, proportionality and privacy. There are two decisions from the past year that warrant some discussion, as both decisions allowed the defending insurers to access information contained in Facebook profiles.

First, in McDonnell v. Levie, the tort plaintiff alleged that she sustained serious personal injuries as a result of an August 2007 motor vehicle accident. In her Statement of Claim, she alleged serious permanent impairments caused by her injuries. She alleged that the injuries permanently impaired, among other things, her enjoyment of life.

At her examination for discovery, the plaintiff confirmed using Facebook

August/September 2012

and posting pictures of herself on it.

She also testified that various daily activities were affected by her injuries.

The defendants brought a motion seeking an order compelling the plaintiff to “produce pictures of her engaged in activities as documented on her Facebook account.” The motions judge reviewed some of the cases on this issue and held: [W]here the plaintiff puts her social enjoyment of life in issue and alleges various activities that she is unable to do then photographs of her social life and activities, before and after the alleged trauma, which she concedes are on her Facebook account, are produceable as having some semblance of relevance and should be part of her Affidavit of Documents. Whether they are ultimately produceable at trial will be a determination made by the trial judge.

The judge ordered the plaintiff to preserve and print (at the defendant’s expense), photographs of her involved in activities and social events from three years before the accident to date, with dates where possible. She was ordered to provide them with a supplementary Affidavit of Documents. www.claimscanada.ca

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The second case of interest is from the Financial Services Commission of Ontario. In Rakosi v. State Farm, the claimant claimed entitlement to income replacement benefits, attendant care benefits, medical benefits and the cost of various assessments, including a chronic pain assessment recommended at a year and a half post-accident. The application for the assessment claimed that she had experienced no functional improvement in her pain condition.

State Farm managed to obtain copies of various photos from the claimant’s public profile on Facebook and another social networking site named Hi5. Several photographs on the Hi5 site depicted Ms. Rakosi engaged in a variety of activities, including “zip-lining.” State Farm then sought production of her “non-public” photos from Facebook. When the claimant refused, State Farm brought a motion before the pre-hearing arbitrator to compel production.

The arbitrator found that State Farm had established that there was at least a “semblance of relevance” between photographs showing the claimant engaged in various social activities and her claims that she was unable to work or engage in certain self-care activities due, at least in part, to a chronic pain condition. He was also satisfied that the claimant’s Facebook profile likely contained photographs similar to those shown on the Hi5 site. Finally, the arbitrator wrote that although the documentary production might fail to ultimately disclose anything of any import, that risk should not preclude a party from having access to files or classes of documents that have a rational connection to the issues in dispute.

On appeal, the Director’s Delegate disagreed with the arbitrator’s test for productions but held on the facts of the case that the requested photos were producible. He held that production at the Commission must be considered on a case-by-case basis, with a twostage analysis: Firstly, the requested documents must be relevant. Secondly, relevance “is a necessary, but not sufficient requirement.” Notwithstanding relevance having been established, 44 Claims Canada

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The arbitrator found that State Farm had established that there was at least a “semblance of relevance” between photographs showing the claimant engaged in various social activities and her claims that she was unable to work or engage in certain self-care activities due, at least in part, to a chronic pain condition. there is the further question of whether The arbitrator found that State Farm had established that there was at least a “semblance of relevance” between photographs showing the claimant engaged in various social activities and her claims that she was unable to work or engage in certain self-care activities due, at least in part, to a chronic pain condition. production is “reasonably necessary”, which requires weighing the degree of relevance against other pertinent considerations.

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On the facts of this case, he found: The Appellant’s accessed Hi5 account includes pictures showing the Appellant being attached to a zip line. While ziplining may not be an employment or a self-care task, I am not persuaded that there is an error in finding that preparing for an activity that can involve some significant measure of physical action or precaution, presently relevant to the determination of the issues in arbitration. The Responwww.claimscanada.ca

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dent has, at this point, established a reasonable, rational relationship between the Hi5 ziplining pictures and the Appellant’s ability to perform activities relevant to the disputed benefits. I am not persuaded that the absence of such a reasonable, rational relationship to the issues to be determined of each and every photograph in the public access Hi5 account detracts from the relevance of the ziplining pictures.

Insurers and adjusters need to take note of decisions like McDonnell and Rakosi, as they provide excellent reminders that a wealth of information on claimants could be readily available through social media. There is obvious value in obtaining photographs or “wall” posts depicting claimants engaged in activities they allege they cannot do. It could also be demoralizing to compel the claimant to hand over “personal” photographs and “wall” postings to the very party that they claiming damages or benefits against.

I heard of an incident once where the plaintiff was so against producing her Facebook postings to the defendant that she pushed her lawyer into canvassing for a quick (and lower) settlement.

Another interesting feature of a Facebook profile is the “Events” post, which announces that a particular user will be attending a certain event.

I once saw on a claimant’s semi-open profile that she was attending a local concert at an area pub. I then forwarded the information (date, time, place, dress code, etc.) to an investigator, who also attended the event and obtained damaging surveillance of the claimant doing all sorts of activities she allegedly could not do. The investigator also enjoyed the concert.

But insurers and adjusters should not wait until litigation or arbitration to look at a claimant’s Facebook profile. There could be an abundance of information readily available as soon as the notice of a claim is received. There

is also a good chance that a Facebook profile will be “cleaned” before an examination for discovery, so insurers should gather publically available Facebook information early in the claim.

The Internet, and in particular, social media, has changed the way in which personal injury cases can be defended. There is no end in sight to the social media revolution, and the number of venues through which claimants may freely reveal the exaggeration of their injuries is growing daily. Insurers and adjusters need to incorporate social media searches into their claims investigation protocols and take advantage of the blind spot claimants have when it comes to Internet profiles. One quick and simple search can turn the tides of a case and can reduce the insurer’s exposure in an otherwise expensive case.  Daniel Strigberger is a partner in the insurance litigation group in the Waterloo office of Miller Thomson LLP.

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EF

• education forum

A SERIES OF ARTICLES PROVIDED BY THE INSURANCE INSTITUTE OF CANADA

A Primer On Cybercrime The threat of cybercrime is real, and no business is immune. In a competitive environment – and with heightened concerns about the protection of personal information – insurance adjusting firms, like all businesses, need to establish procedures to ensure that information is protected.

Sizing up cybercrime Cybercrime refers to a criminal offence involving a computer either as the object of the crime, as a tool for committing a material component of the crime, or as a storage device to conceal evidence of a crime. The activity dates back to the early days of organizational computing in the 1950s and 1960s.

While most organizations are now aware of the intrinsic risks related to Internet use, many remain unaware of the potential severity of cybercrime and are unprepared to deal with its increasingly sophisticated forms. Cybercrime methods can include the following: • Malware – malicious software that attacks, degrades or impedes use of a network, such as viruses, worms, spyware or Trojan horses • Bot scams, in which viruses are used to take over large numbers of computers • Denial of service (DoS) attacks, in which a firm’s network or e-commerce system is overwhelmed with meaningless service requests 46 Claims Canada

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• Distributed denial of service (DDoS) attacks, in which a DoS attack is launched from multiple intermediaries instead of just one, making it harder to track down and stop Firewalls, intrusion detection systems, authentication devices, antispam software and anti-virus software are among the tools most commonly implemented to protect against cybercrime. But despite these safety measures, vulnerabilities persist. Attacks can result in a range of adverse effects: • Mischief to systems • Attacks on critical infrastructure • Web defacement • URL hijacking • Damage to data integrity (copying, altering, deleting, destroying) • Theft of customer data • Theft of intellectual property • Financial fraud • Extortion • Corporate espionage.

Cybercriminals come in different forms: some may be “professionals” hired for their skills and services, while others may commit their e-crime for personal gain or retribution.

Employees, contractors, cleaning staff and other regular visitors can pose the greatest threat, especially if security policies and implementation are inadequate. Employees working internally may use work-related access or illicitly retrieved passwords to access the personal and financial data of staff, clients and claimants. From the outside, thieves may attempt to impersonate a customer or creditor; or hackers may tap into an organization’s database. “Social engineering” schemes involve both insiders and outsiders: outsiders use skills of influence and persuasion to convince company insiders to allow inappropriate access to company systems or provide proprietary information.

Tools of Cybercrime • Virus: Piece of code that infects or corrupts files on a targeted computer by attaching itself to an existing program • Worm: Self-replicating program that uses a network to send copies of itself to other nodes on the network, consuming bandwidth • Spyware: Software that collects information about users without their informed consent • Trojan horse: A legitimate-looking program that performs hidden and unauthorized functions; used to take control of a victim’s system

August/September 2012

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Counting the costs Cybercrime can result in direct financial loss for a firm (through fraudulent activity), indirect financial loss (such as through business interruption and the costs of restoring data and services), and the loss of intellectual property or other forms of competitive advantage.

Perhaps the biggest potential cost of data loss through cybercrime is the damage to business reputation and loss of customer confidence that can result.

When an organization fails to protect its information intelligence, clients and other key stakeholders lose their trust in the organization. For example, insurers may be reluctant to use the services of an adjusting firm that that has suffered the loss of claims data in its care.

Loss of data can also result in the firm breaching its obligations under privacy legislation. The Personal Information Protection and Electronic Documents Act (PIPEDA) requires insurers and independent adjusters – like all private-sector businesses – to ensure that personal information is properly stored, managed and safeguarded.

Claims files typically contain detailed information on the claimant, and can also contain information on third parties. For example, if an adjuster takes a statement from someone who witnessed a car accident, the witness’s name and contact information will be on file, and the statement itself could include information about other thirdparty witnesses. Loss of such data can represent a breach of the privacy of these various third parties.

protocols and a requirement for strong passwords (mix of uppercase and lowercase letters and numbers).

• Install software patches as soon as possible.

• Implement strong backup routines.

• Log usage and monitor online activities.

• Remove unused software and unused user accounts; disable a former

Cybercrime can result in direct financial loss for a firm (through fraudulent activity), indirect financial loss (such as through business interruption and the costs of restoring data and services), and the loss of intellectual property or other forms of competitive advantage.

Cracking the case To protect a firm against cybercrime, business operations should be analyzed to identify areas vulnerable to IT risks. A strong business continuity plan should be developed, and a mix of IT security controls, enterprisewide security policies and procedures, and appropriate employee behaviours should be implemented. Here are some of the key components.

employee’s access to the network as soon as possible.

• Conduct regular diagnostic testing and monitoring.

• Access reputable outside help or technical expertise when required.

IT security controls • Install and maintain anti-virus software, firewalls and anti-spyware tools.

• Establish regular password change

Security policies and procedures • Implement reference checks of employees.

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• Deal with disruptive behaviour and threatening comments from internal and external sources.

• Limit access to financial and other confidential information.

• Limit or restrict use of wireless hot spots, chat rooms, blogs and instant messaging.

• Prohibit downloads, including music, movies and software.

• Document and implement all policies and procedures.

• Implement a “user technology agreement,” to be signed by all staff, that specifies appropriate and inappropriate use of company computer technology and how violations will be handled.

Employee behaviours • All staff should safeguard their passwords.

• Users should lock their computers when they are away from their desk.

• All staff should be trained in security awareness, including how to recognize and thwart social engineering attempts.

• Staff should control and monitor the physical business environment so that company computers are not physically attacked or damaged by disgruntled employees or by outsiders visiting the premises.

• As the digital integration of commercial and personal information and activities increases, so does the potential impact of computerrelated crime for all businesses, including adjusting firms. Reducing cybercrime exposures involves implementing the right tools and processes plus constantly monitoring and testing the firm’s networks and systems.  This article is based on excerpts from ADVANTAGE Monthly, a series of topical papers on emerging trends and issues provided to members of the CIP Society. The Chartered Insurance Professionals’ (CIP) Society is the professional organization representing more than 15,000 graduates of the Insurance Institute’s Fellow Chartered Insurance Professional (FCIP) and Chartered Insurance Professional (CIP) programs.

August/September 2012

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• on the scene OTS Winmar Celebrates 35th Anniversary in Canada

The CIAA/CICMA Joint Conference was held in Stanhope, PEI from June 20-22. In attendance at the conference were several members of the CIAA executive and sub-committees. Pictured from left are Grant King, NS Regional President, CIAA, Luc Aucoin NB/PEI Regional President, CIAA, Greg Merrithew, National President, CIAA, Marcel Pitcher, NL Regional President, CIAA, and Patti Kernaghan, CIAA National. l

Pierre Trudeau was Prime Minister. The Toronto Blue Jays played their first game. Disco was alive and well, with ABBA and the Bee Gees topping the charts. And the Toronto Maple Leafs were … well, the same as ever!

1977 was also the year Winmar had its humble beginnings. Founded by Paul Wormith and John White, the company started as a small operation in Sarnia, Ontario (Winmar was an abbreviation of the names of the two co-founders’ mothers – Winifred and Margaret.)

Today, Winmar has grown to a nationwide network of 87 franchises offering quality property restoration work from St. John’s, Newfoundland to Victoria, British Columbia.

“After 35 years experience in the insurance restoration business, we understand what it takes to make our clients happy. Our recipe for success is really very simple,” says Paul Wormith, co-founder and CEO of Winmar. “We treat each customer’s claim as if it were our own, applying the same standards of quality workmanship that we would expect ourselves.” l

Also at the CIAA/CICMA joint conference in PEI, Randy Driscoll (right) of CIAA PEI/NB presents a donation of $5,000 each to Mike Macdonald (middle) of The Upper Room Food Bank and Tom Blois (left) of Camp Gencheff.

The $10,000 in donations came from the proceeds of the joint conference. l Malik, Giffen & Burnett Claims Consultants Inc. are pleased to announce Layne Gardner has joined the firm as an Executive General Adjuster effective July 11, 2012.

Layne has been an adjuster since 1999, and for the past 7 years with an international independent commercial / industrial / energy firm, based in their Toronto office.

Licensed in all lines, Layne focuses on commercial property and liability losses, and with his national and international experience, will add significant depth and strength to MGB’s growing team. As a specialized adjusting firm, MGB is committed to the Commercial / Industrial Risk Insurance market. l 48 Claims Canada

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August/September 2012

Intact Financial Corporation, Canada’s largest provider of home, auto and business insurance, announced in June that it has selected Guidewire ClaimCenter® as its new claims management system. Intact Financial Corporation will implement ClaimCenter to help manage all of its commercial and personal lines’ claims. In August, Frank Cowan Company also announced it has chosen Guidewire ClaimCenter® as its new claims management system. l

www.claimscanada.ca

12-08-21 4:00 PM

APPOINTMENT

The Financial Services Commission of Ontario (FSCO) has awarded the consulting contract to develop the Minor Injury Protocol to Dr. Pierre Côté, associate professor of the Dalla Lana School of Public Health at the University of Toronto.

Côté is an associate professor in the Faculty of Health Sciences at the University of Ontario Institute of Technology. He also holds appointments at the Dalla Lana School of Public Health at The University of Toronto and at the Canadian Memorial Chiropractic College. FSCO announced on its website that the contract was awarded to Côté following a competitive request for proposal (RFP) process. The Minor Injury Treatment Protocol will include clinical prediction rules to screen for patients who may be at higher risk for developing chronic pain and disability. In addition, it will focus on treatment outcomes and provide health care providers with numerous milestones that could be used to measure progress. l High winds and heavy rain on July 29 yielded more than 600 claims filed with Manitoba Public Insurance (MPI). Figures from MPI show that it had received 615 related claims as of August 3. Of that total, 348 claims are for hail damage, 266 for “other, comprehensive” – most likely damage from high winds, which may have caused flying debris or things to blow over – and one for lightning damage. Reports indicate driving rain and winds of as much as 98 kilometres/hour hit the province at about 6:30 pm on July 29. Just days later on August 1, there was another storm, producing 154 claims so far. l FirstOnSite Restoration has expanded its operations to the United States. The company’s U.S. operations will work closely with insurers and commercial property owners to mobilize expertise and equipment to respond to large loss and commercial catastrophes throughout the U.S. and the Caribbean. Currently, FirstOnSite works with U.S. clients who have property in Canada and this new initiative brings the company’s proven experience to American soil to serve Canadian customers who have property in the U.S., as well as U.S. customers directly. The newly minted U.S. operations will be based out of Nashville, which will act as a hub to support nationwide response efforts. l

Craig Smith

Gino Fiorucci, Chief Executive Officer of ISB Canada is pleased to announce the appointment of Craig Smith to the position of Vice president, Sales and Marketing.

Craig Smith has spent almost 30 years in the insurance industry. During this time Mr. Smith has held various senior

Paul Davis Systems Canada, Ltd. recently announced franchise locations under new management. Paul Davis Systems of Brampton has new franchisees managing the location- Paul Suddes, Peter Heary, and Russ Toering. Paul Davis Systems of Grey Bruce and Paul Davis Systems of Guelph/Wellington County will be managed by franchisees: Glenn Wilkinson, Brian Newmaster, and Randy Higgins. Paul Davis Systems of Durham West, Stacey Wicks and Carmen Siciliano are the new franchisees with Joanne Carmichael, managing this particular location. l

positions at a principle insurer as well as sales and marketing positions within the insurance vendor market.

“ISB Canada is looking to expand in Ontario and across Canada and we are excited to have Craig on board to be an

Crawford & Company (Canada) Inc. has promoted Barbara White to the position of branch manager, Thunder Bay. White joined Crawford in 1997 and currently reports to Rod McDonald, assistant vice president, Field Branch Operations, Ontario Region. White has more than 30 years of experience in the property and casualty industry, most in the Thunder Bay area. In recent years, she has undertaken numerous supervisory roles in Crawford’s growing accident benefits product line. l More than 2,500 contractors, insurance carrier representatives and service provider partners attended the Crawford Contractor Connection Conference in June in Nashville, Tennessee, setting another attendance record for the popular invitation-only educational and networking event despite interruption by a gas explosion and evacuation. The 14th annual conference, one of the largest expos in the restoration industry, offers insurance carriers, affinity partners, network members and Contractor Connection personnel an opportunity to focus on contractor program service offerings and the needs and challenges of both providers and clients. l www.claimscanada.ca

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integral part of our growth strategy.”

Gino Fiorucci, CEO. ISB Canada is Canada’s only ‘One Stop Shop’ supplier of source documents to the insurance industry allowing customers to reduce administrative overheard while adjudicating claims.

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12-08-21 4:01 PM

• on the scene OTS Crawford & Company has announced that Glenn T. Gibson is leaving his role as executive vice president for global strategy, projects and development to become chief executive officer of a consulting practice the Company is building in Canada. “Glenn has made a number of important contributions to both Crawford and the claims Glenn Gibson industry during his 40 years in the business,” said Jeffrey T. Bowman, president and chief executive officer. “He has voluntarily stepped away from the position he has held for four years to use his considerable experience to help us grow a part of our business that we believe holds a great deal of promise.”

In this new role, Gibson will be responsible for further developing Crawford’s Canadian consulting practice in the areas of technical loss adjusting, arbitrations, strategic planning and enterprise risk management. “Glenn has a unique skill set that combines technical knowledge with skills in strategic planning and enterprise risk management, and we expect him to leverage those abilities to provide the Canadian market with a tremendous resource,” Bowman said. l CRDN, the Certified Restoration Drycleaning Network, has launched a third platform for its new mobile application that enables insurance professionals to assign claims, upload claim data and loss site photos, view the progress of open jobs and directly contact their local CRDN service provider.Previously offered for iPhone and Android, CRDN Mobile now is available to Blackberry users seeking expert textile restoration services that help insureds recover from damage to their homes. l ISB Canada has announced the appointment of Craig Smith to the position of vice president of sales and marketing. With almost 30 years in the insurance industry, Smith has held various senior positions at a principle insurer, as well as sales and marketing positions within the insurance vendor market. “ISB Canada is looking to expand in Ontario and across Canada and we are excited to have Craig on board to be an integral part of our growth strategy,” says Gino Fiorucci, CEO of ISB Canada. ISB Canada is a onestop supplier of source documents to the insurance industry, allowing customers to reduce administrative overheard while adjudicating claims. l CARSTAR Collision & Glass Centres across North America participated in the ninth annual Soaps It Up National Car Wash Fundraiser on Saturday, June 9, 2012. This year, CARSTAR reached their $2 million milestone in funds raised for Cystic Fibrosis Canada by raising $101,340.01 for Cystic Fibrosis Canada and local fundraising groups.

There were over 70 events throughout Canada and over 40 events in the US, which raises funds for the Make-A-Wish foundation. l 50 Claims Canada

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CIAA New Members — June 2012 CORPORATE MEMBERSHIP AMG Claims Inc. — Halifax, NS INDIVIDUAL MEMBERSHIP AMG Claims Inc. Andrew Williams Michael Sieber Greg Potten

Halifax, NS Halifax, NS Fredericton, NB

Level 3 Level 3 Level 3

Crawford & Company (Canada) Inc. Shelley Upton-Landry, CIP Dartmouth NS Gary Warner, CIP Brockville ON Nancy McCulloch Mississauga, ON Vanessa Thompson Mississauga, ON

Level 2 Level 3 Level 1 Level 1

Kernaghan Adjusters Limited Diana Tremblay, CIP Calgary, AB

Level 2

Leslie Cantwell

Level 1

Toronto, ON

ProFormance Specialty Claims Inc. Don Wall Mississauga, ON

Level 2

CIAA New Members — July 2012 CORPORATE MEMBERSHIP Capital Claims Adjusters Ltd. Regina, SK INDIVIDUAL MEMBERSHIP Capital Claims Adjusters Limited Justin Braaten Regina, SK Chris McGregor Regina, SK Stuart Ties Regina, SK Michael Flaman Regina, SK

Level 3 Level 2 Level 1 Level 1

Crawford & Company (Canada) Inc. Sarah Klassen Nanaimo, BC Chun Zhu Vancouver, BC Daryl Foreman Saskatoon, SK Deepa Jaiprashad Mississauga, ON Nancy Tozer Mississauga, ON Joanne Morgan-Westall Dartmouth, NS Bethany Robertson Dartmouth, NS

Level 2 Level 1 Level 1 Level 1 Level 1 Level 2 Level 1

Coast Claims Service Ltd. Kevin Despins David Cherrie

Campbell River, BC Level 3 Victoria, BC Level 3

Cormier Adjusting Limited Jim Dewar

Huntsville, ON

Level 3

NWO Claims Services Inc. Sheri Turgeon

Dryden, ON

Level 1

Peninsula Adjusting Services Ltd. Margaret Hynes Creston North, NL

Level 1

Claims Canada Wants You!

Claims Canada magazine wants you to send us your company news, appointments and event photos for possible inclusion within our ‘On the Scene’ department.

Please help us share your items with the claims industry across the country. For more information, please email: craig@editinsight.com

www.claimscanada.ca

12-08-21 4:15 PM

The League of Ordinary Gentlemen held a fundraising event, “Music Heals,” on June 20 at the Hard Rock Café in downtown Toronto to benefit The Biggar Endowment for Muscular Dystrophy at the Holland Bloorview Kids Rehab Hospital.

More than 400 insurance industry-related patrons attended the live music performance, which collectively raised more than $25,000 for the cause through ticket sales, a silent auction and raffles.

Including its previous fundraising efforts, The League has raised more than $100,000 in support of Street Kids International, as well as WICC (the Women in Insurance Cancer Crusade) and The Daily Bread Food Bank. l

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• on the scene OTS CSN Collision & Glass hosted its third annual Date Night on May 23 with food, cocktails and a private screening of the new release, What to Expect When Expecting. The CSN Team and its members invited insurance adjusters and industry partners to join them for a night out. The festivities began in Jack Astor’s at Square One in Mississauga, Ontario, where everyone enjoyed an after-work cocktail and nibbled on great food. The evening then continued at the Mississauga Coliseum, where the movie was on the big screen for the private audience of 140. l

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• on the scene OTS The GTA Fellows and their guests gathered for the CIP Society’s annual Fellows’ Golf Tournament on June 11, 2012 at ClubLink’s Wyndance Golf Club in Uxbridge, Ontario. Everyone had a fabulous time on a beautiful day.

A $3,450 donation to the John E. Lowes Education Fund capped off a wonderful evening of cocktails, dinner and prizes. l

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The Ontario Risk and Insurance Management Society (ORIMS) held its annual golf tournament on June 19 at Deer Creek Golf Club in Ajax, Ontario. Two hundred and eighty golfers attended the event, which included a raffle that raised $3,640 in support of the Junior Achievement Risk Management Student Day Seminar. l

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National Standing Committees 2011-2012 ADVISORY John D. Seyler, AIIC ProFormance Group 5080 Timberlea Blvd., Suite 214 Mississauga, ON L4W 4M2 Phone: (905) 238-4985 Fax: (905) 238-2735 E-mail: jseyler@prospecialty.ca

Jo-Ann Eccleston, CIP Aviva Canada Inc. 2206 Eglinton Ave. East Toronto, ON M1L 4S8 Phone: (416) 689-3328 Fax: 1-866-805-8585 E-mail: jo-ann_eccleston@avivacanada.com

E. Brian Gough, FCIP, CLA, FCIAA Marsh Adjustment Bureau Limited 1550 Bedford Highway, Suite 711 Bedford, NS B4A 1E6 Phone: (902) 469-3537 Fax: (902) 469-2396 E-mail: ebgough@marshadj.com

Mary Charman, CIP Crawford & Company (Canada) Inc. 1 – 120 Mulock Drive Newmarket, ON L3Y 7C5 Phone: (905) 898-0008 Fax: (905) 898-1705 E-mail: Mary.Charman@crawco.ca

Bob Grouchy, BA, FCIP, CRM Allianz Global 1600 – 130 Adelaide Street West Toronto, ON M5H 3P5 Phone: (416) 915-4247 Fax: (416) 849-4555 E-mail: bob.grouchy@agr.allianz.ca

Robert V. Pearson, CLA, FCIAA LSW & Associates Ltd. 2424 4 Street S.W., Suite 600 Calgary, AB T2S 2T4 Phone: (403) 452-2195 Fax: (403) 452-3568 E-mail: rvp@lswadjusters.com

Carol Jardine, FCIP, CRM TD Insurance 2161 Yonge Street, 4th Floor Toronto, ON M4S 3A6 Phone: (416) 486-2507 Fax: (416) 545-6022 E-mail: Carol.Jardine@tdinsurance.com

DISCIPLINE Mary Charman, CIP Crawford & Company (Canada) Inc. 1 – 120 Mulock Drive Newmarket, ON L3Y 7C5 Phone: (905) 898-0008 Fax: (905) 898-1705 E-mail: Mary.Charman@crawco.ca

Justin J. MacGregor Martin Merry & Reid Limited 3 Church Street, Suite 404 Toronto, ON M5E 1M2 Phone: (416) 366-3333 Fax: (416) 366-0730 E-mail: jmacgregor@mmr.ca

EDITORIAL Fred Silvestri, BA, CIP Sedgwick CMS Canada Inc. 21 Four Seasons Place, Suite 100 Toronto, ON M9B 6J8 Phone: (416) 695-5100 Fax: (416) 695-5120 E-mail: fred.silvestri@sedgwickcms.ca

James B. Eso, BA, CIP Crawford & Company (Canada) Inc. 539 Riverbend Drive Kitchener, ON N2K 3S3 Phone: (519) 578-5540 Fax: (519) 578-2868 E-mail: Jim.Eso@crawco.ca John Jones, BA Granite Claims Solutions Suite 300, 5915 Airport Road Mississauga, ON L4V 1T1 Phone: (905) 671-3164 Fax: (905) 671-1889 E-mail: john.jones@graniteclaims.com Craig J. Walker, CIP, FCIAA, FIFAA Maltman Group International 3550 Victoria Park Ave., Suite 301 Toronto, ON M2H 2N5 Phone: (416) 492-4411 Fax: (416) 492-5657 E-mail: cwalker@maltmans.com CIAA NATIONAL INSURANCE INDUSTRY ADVISORY BOARD Patti M. Kernaghan, FCIP, CRM Kernaghan Adjusters Limited 300 - 1575 West Georgia Street Vancouver, BC V6G 2V3 Phone: 1-800-387-5677 Fax: 1-800-387-5644 E-mail: pkernaghan@kernaghan.com Greg G. Merrithew, CIP, FIFAA Arctic West Adjusters Ltd. 201 – 5204 – 50 Ave. Yellowknife, NT X1A 1E2 Phone: (867) 920-2212 Fax: (867) 873-2244 E-mail: gregm@arcticwest.ca Mary Charman, CIP Crawford & Company (Canada) Inc. 1 – 120 Mulock Drive Newmarket, ON L3Y 7C5 Phone: (905) 898-0008 Fax: (905) 898-1705 E-mail: Mary.Charman@crawco.ca Craig J. Walker, CIP, FCIAA, FIFAA Maltman Group International 3550 Victoria Park Ave., Suite 301 Toronto, ON M2H 2N5 Phone: (416) 492-4411 Fax: (416) 492-5657 E-mail: cwalker@maltmans.com Patricia M. Battle Canadian Independent Adjusters’ Association/L’Association Canadienne des Experts Indépendants 5401 Eglinton Ave. West, Suite 100 Etobicoke, ON M9C 5K6 Phone: (416) 621-6222 Toll Free: 1-877-255-5589 Fax: (416) 621-7776 E-mail: pbattle@ciaa-adjusters.ca

Mark Stewardson, FCIP Royal & SunAlliance 2225 Erin Mills Parkway, Suite 1000 Mississauga, ON L5K 2S9 Phone: (905) 403-2333 Fax: (905) 403-2326 E-mail: Mark.Stewardson@ rsagroup.ca Mark Weir Intact Financial Corporation 700 University Avenue, 13th Floor Toronto, ON M5G 0A1 Phone: (416) 341-1464 Fax: (416) 217-0562 E-mail: mark.weir@intact.net Peggy Wong, CIP The Economical Insurance Group 111 Westmount Road South Waterloo, ON N2J 4S4 Phone: (519) 570-8500 Fax: (519) 570-8690 E-mail: Peggy.Wong@teig.com CAREER RECRUITMENT PLANNING Richard Swierczynski, BA, CIP AZ Claims Services Inc. 1500 Upper Middle Rd., Unit #3 P.O. Box 76041 Oakville, ON L6M 3G3 Phone: (905) 825-0027 Fax: (905) 825-5543 E-mail: Richard@azclaims.ca COMMUNICATIONS Teresa Mitchell, FCIP, CRM, FCLA, FCIAA, FIFAA Crawford & Company (Canada) Inc. 14 – 431 Bayview Drive Barrie, ON L4N 8Y2 Phone: (705) 728-5597 Fax: (705) 728-2167 E-mail: Teresa.Mitchell@crawco.ca CONSTITUTION & RULES John Jones, BA Granite Claims Solutions Suite 300, 5915 Airport Road Mississauga, ON L4V 1T1 Phone: (905) 671-3164 Fax: (905) 671-1889 E-mail: john.jones@graniteclaims.com

John M. Sharoun, FIIC, CFE, FCIAA Crawford & Company (Canada) Inc. 300 – 123 Front Street West Toronto, ON M5J 2M2 Phone: (416) 867-1188 Fax: (416) 867-1925 E-mail: John.Sharoun@crawco.ca

CONVENTION Karen Kuronen, CIP, Dip. Mech. Eng. Arctic West Adjusters Ltd. 201 – 5204 – 50 Ave. Yellowknife, NT X1A 1E2 Phone: (867) 920-2212 Fax: (867) 873-2244 E-mail: kkuronen@arcticwest.ca

Dennis N. Schembri, CIP, CFEI Granite Global Solutions 133 King Street East, 3rd Floor Toronto, ON M5C 1G6 Phone: (647) 789-2438 Fax: (647) 789-2449 E-mail: dennis.schembri@graniteglobalsolutions.com

DESIGNATION Paul W. Greening, CLA, FCIAA Greening Aviation Claims Inc. 26C Palliser Park, Box 190 Riverhurst, SK S0H 3P0 Phone: (306) 353-2000 Fax: (306) 353-2200 E-mail: pgreening@sasktel.net

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LICENSING J. Miles O. Barber, B.Comm. (Hons.), FCIP, CRM Network Adjusters Ltd. 67 Folkestone Blvd.

Winnipeg, MB R3P 0B4 Phone: (204) 897-5793 Fax: (204) 897-5797 E-mail: mbarber@mts.net MEMBERSHIP & QUALIFICATIONS Georgiana Chen, CIP ProFormance Group Inc. 1101 Kingston Rd., Suite 280 Pickering, ON L1V 1B5 Phone: (877) 539-3111 Fax: (905) 554-3776 E-mail: gchen@proadjusting.ca NOMINATING Mary Charman, CIP Crawford & Company (Canada) Inc. 1 – 120 Mulock Drive Newmarket, ON L3Y 7C5 Phone: (905) 898-0008 Fax: (905) 898-1705 E-mail: Mary.Charman@crawco.ca Greg G. Merrithew, CIP, FIFAA Arctic West Adjusters Ltd. 201 – 5204 – 50 Ave. Yellowknife, NT X1A 1E2 Phone: (867) 920-2212 Fax: (867) 873-2244 E-mail: gregm@arcticwest.ca

John M. Sharoun, FIIC, CFE, FCIAA Crawford & Company (Canada) Inc. 300 – 123 Front Street West Toronto, ON M5J 2M2 Phone: (416) 867-1188 Fax: (416) 867-1925 E-mail: John.Sharoun@crawco.ca

James B. Eso, BA, CIP Crawford & Company (Canada) Inc. 539 Riverbend Drive Kitchener, ON N2K 3S3 Phone: (519) 578-5540 Fax: (519) 578-2868 E-mail: Jim.Eso@crawco.ca

Mary Charman, CIP Crawford & Company (Canada) Inc. 1 – 120 Mulock Drive Newmarket, ON L3Y 7C5 Phone: (905) 898-0008 Fax: (905) 898-1705 E-mail: Mary.Charman@crawco.ca

Craig J. Walker, CIP, FCIAA, FIFAA Maltman Group International 3550 Victoria Park Ave., Suite 301 Toronto, ON M2H 2N5 Phone: (416) 492-4411 Fax: (416) 492-5657 E-mail: cwalker@maltmans.com

EDUCATION Santo Carbone, CRM, FCIAA Crawford & Company (Canada) Inc. 300-123 Front Street West Toronto, ON M5J 2M2 Phone: (416) 364-6341 Fax: (416) 435-0546 E-mail: Santo.Carbone@crawco.ca

PRIVACY James B. Eso, BA, CIP Crawford & Company (Canada) Inc. 539 Riverbend Drive Kitchener, ON N2K 3S3 Phone: (519) 578-5540 Fax: (519) 578-2868 E-mail: Jim.Eso@crawco.ca

EMERGENCY MEASURES Richard Van Horne Action Investigations Inc. 2 Catelina Court Dartmouth, NS B2X 3G9 Phone: (902) 462- 1222 Fax: (902) 462-3688 E-mail: richardvanhorne@actioninvestigations.ca FINANCE Randy P. LaBrash, CIP, CFE, CFEI Crawford & Company (Canada) Inc. 300 – 191 Lombard Avenue Winnipeg, MB R3B 0X1 Phone: (204) 947-2340 Fax: (204) 943-9168 E-mail: Randy.Labrash@crawco.ca Greg G. Merrithew, CIP, FIFAA Arctic West Adjusters Ltd. 201 – 5204 – 50 Ave. Yellowknife, NT X1A 1E2 Phone: (867) 920-2212 Fax: (867) 873-2244 E-mail: gregm@arcticwest.ca Mary Charman, CIP Crawford & Company (Canada) Inc. 1 – 120 Mulock Drive Newmarket, ON L3Y 7C5 Phone: (905) 898-0008 Fax: (905) 898-1705 E-mail: Mary.Charman@crawco.ca IBC: LIAISON, LEGISLATIVE & FORMS Paul Hancock, B.Sc., CIP Crawford & Company (Canada) Inc. 300 – 123 Front Street West Toronto, ON M5J 2M2 Phone: (416) 867-1188 Fax: (416) 867-1925 E-mail: Paul.Hancock@crawco.ca

August/September 2012

Keith P. Edwards, FCILA, CLA, FUEDI-ELAE CIAA Honorary Life Member c/o CIAA National Office 5401 Eglinton Ave. W., Suite 100 Etobicoke, ON M9C 5K6 Phone: (416) 621-6222 Fax: (416) 621-7776 E-mail: info@ciaa-adjusters.ca

CIAA REGIONAL PRESIDENTS 2011 – 2012 NEWFOUNDLAND & LABRADOR Marcel Pitcher, CIP, CRM Crawford & Company (Canada) Inc. 300 – 44 Torbay Road St. John’s, NL AlA 2G4 Phone: (709) 753-6351 Fax: (709) 753-6129 E-mail: Marcel.Pitcher@crawco.ca NOVA SCOTIA E. Grant King, BA, B.Ed., CIP Crawford & Company (Canada) Inc. 120 – 237 Brownlow Avenue Dartmouth, NS B3B 2C7 Phone: (902) 468-7787 Fax: (902) 468-5822 E-mail: Grant.King@crawco.ca NEW BRUNSWICK & PRINCE EDWARD ISLAND Luc Aucoin, BBA, FCIP Plant Hope Adjusters Ltd. 85 Englehart Street Dieppe, NB E1A 8K2 Phone: (506) 853-8500 Fax: (506) 853-8501 E-mail: laucoin@planthope.com QUEBEC/AESIQ Elaine Savard, LL.B., FPAA Les Expertises Richard Racette 1090, rue Principale Sainte-Agathe des Monts, PQ J8C 1L6 Phone: (819) 326-0012 Fax: (819) 326-2023 E-mail: elaine.savard@exprr.ca ONTARIO Teresa Mitchell, FCIP, CRM, FCLA, FCIAA, FIFAA Crawford & Company (Canada) Inc. 14 – 431 Bayview Drive Barrie, ON L4N 8Y2 Phone: (705) 728-5597 Fax: (705) 728-2167 E-mail: Teresa.Mitchell@crawco.ca MANITOBA Timothy W. Bromley J.P. Hamilton Adjusters Ltd. 125 Enfield Crescent Winnipeg, MB R2H 1A8 Phone: (204) 944-1057 Fax: (204) 944-1606 E-mail: tbromley@mts.net SASKATCHEWAN Lee Dixon Midwest Claims Services Box 37006 North Park PO Saskatoon, SK S4P 2R6 Phone: (306) 361-5285 Fax: (306) 249-4114 E-mail: lee@midwestclaims.ca WESTERN Russell Fitzgerald, CIP Kernaghan Adjusters Limited 203 – 4246 97 Street N.W. Edmonton, AB T6E 5Z9 Phone: (780) 488-2371 Fax: (780) 488-0243 E-mail: rfitzgerald@kernaghan.com PACIFIC David Porter, LL.B., FCIP, CRM Granite Claims Solutions 206 - 2323 Boundary Road Vancouver, BC V5M 4V8 Phone: (604) 642-0660 Fax: 1-888-452-5246 E-mail: david.porter@graniteclaims.com

www.claimscanada.ca

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• on the scene OTS The 2012 version of the Canadian Cancer Society’s Relay for Life featured the largest-ever number of insurance industry participants. The Relay is a tribute to the lives of loved ones who have been touched by cancer. Teams of 10 people took part in the 12-hour, overnight, non-competitive relay, taking turns walking, running or strolling around a track. In Ontario, more than 1,000 friends and members of the insurance industry formed teams under the Team WICC banner in 13 different locations. Sixty-five teams raised more than $303,000 in pledges; sponsorships raised the total to $394,391.

Relay For Life is now WICC Ontario’s largest fundraising activity. l

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12-08-22 9:31 AM

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• on the scene OTS Giffin Koerth held its first annual golf tournament, the “Giffin Koerth BIG DIVOT Forensics Invitational,” on July 20 at Wooden Sticks Golf Course in Uxbridge, Ontario. Fifty-four guests played Wooden Sticks’ storied greens — an 18-hole championship layout featuring holes inspired by courses such as Augusta, Royal Troon, Oakmont, TPC Sawgrass and St. Andrew’s. l

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12-08-22 9:33 AM

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• on the scene OTS More than 260 golfers attended the 13th Annual WICC Ontario Golf Tournament on July 9 at Angus Glen Golf Club in Markham, Ontario. Attendees enjoyed a barbeque lunch, silent auction, raffle and dinner. A WICC cheque for $125,000 was presented to the Canadian Cancer Society. l

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