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December/January 2014

Years of Representation Official Journal of the Canadian Indeépendent Adjusters’ Association

CIAA remains the singular voice of independent adjusters across Canada.

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Contents DECEMBER / JANUARY 2014 • VOLUME 7 • NUMBER

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Cover Feature 12 60 Years of Representation The Canadian Independent Adjusters’ Association is celebrating its 60th anniversary this year as the profession’s singular voice of advocacy, education and membership.

Evolving from an elite conference of like-minded independent adjusters in the 1950s to mid-1980s to a truly national association in the modern era, CIAA has seen its share of changes – yet many of its goals have stayed the same.

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BY CRAIG HARRIS

Spotlight 24 Claims Traveler B.C. native John Russell takes the reins of president of the Canadian Insurance Claims Managers Association.

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BY CRAIG HARRIS

Education Forum 46 Risky Business How can adjusters identify the range of risks to their reputation?

News Features 26 Keys to Closure

38 A Day in the Life

How environment claims can be handled quickly and cost effectively.

Can today’s claims adjuster find a balance between work and personal life?

BY JOEL VAN POPTA

BY DEBORAH CROWE

30 The Arbitration Option

42 The Value of Accreditation

A national arbitration agreement, managed

by CICMA, can represent a quick and informal alternative to litigation.

Adjusters searching for quality health care providers can look to standards established by an international commission, known as CARF.

BY CATHY WISMER

32 Adjuster Privilege What kinds of information and files can be protected in litigation?

BY RYAN EWASIUK

BY GAYE SYDENHAM

44 No Vacancy?

How one legal case addressed the issue of reduced occupancy and material change.

BY MARK SKORAH

36 Defining the Limitation Period

38 Departments 4 First Notice 48 On The Scene

Columns

In Ontario, the application of limitation periods for commercial policies is tested.

10 President’s Message

BY MITCH KITAGAWA

46 Education Forum

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• first notice FN More feedback needed on Ontario auto dispute resolution The Ontario Ministry of Finance is seeking written submissions of feedback to an interim report on the auto insurance dispute resolution system delivered Nov. 8.

J. Douglas Cunningham, former associate chief justice of the Ontario Superior Court of Justice, was tasked in August to conduct a review of the DRS, delivering an interim report in the fall and a final report in February 2014.

His interim report outlines some preliminary observations about the system and recommendations for improving it, based on issues of timeliness, proportionately (smaller claims versus larger ones), accessibility to the system, predictability within it, streamlining, costs and overall culture.

While the Financial Services Commission of Ontario (FSCO) recently eliminated its backlog of mediation applications, a significant arbitration backlog remains.

Overall, the report recommends a more streamlined mediation and arbitration system that includes different processes based on the complexity of the case, including the monetary amount at stake.

“I would like to see a future system that could accommodate different processes based on the complexity of the case,” Cunningham suggests. He also recommends eliminating the

neutral evaluation stage introduced in 1996, which is “littleused.”

“To a certain extent, the system has been a victim of its own success,” Cunningham writes in the report, noting that easy access, as well as increased use of legal representatives, has created a parallel system to the courts that is only “marginally faster.”

Using legal representatives has slowed down the system, since scheduling with lawyers and paralegals can be challenging, he notes in the report.

The report also points out, based especially on feedback Cunningham has received, that claimants don’t always have a large financial risk involved with the process (for example if their legal representatives are working on a contingency basis). The mediation cost is free, while the arbitration cost is only $100, the report notes.

Cunningham also notes in his report that there has been “strong support among stakeholders for moving dispute resolution to the private sector” or creating a tribunal model similar to the Workplace Safety Insurance Appeal Tribunal.

“I see no reason why the DRS adjudicative function needs to be housed at FSCO,” the report says. “I recommend that the government consider that FSCO’s DRS adjudicative functions be delivered externally.” l

Regulators release final paper on electronic commerce The Canadian Council of Insurance Regulators has released its final position paper on the use of electronic commerce in insurance products, stressing the need for consumers to have access to more information on their coverage.

The CCIR began its look at electronic commerce in the industry in January 2012. Last May, the group released its first position paper and requested feedback from industry and consumer stakeholders.

The final report, released Nov. 15, does highlight a divide between brokers and insurers, in terms of how consumers should receive information online.

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“Generally, brokers and intermediaries are of the view that a licensed agent should be involved in each insurance transaction,” the report says.

While insurers support consumer choice and the option of using an intermediary, they also “generally believe that the Internet allows for the same level of advice as other methods of interaction,” the paper suggests.

The CCIR committee that produced the paper suggests that “the level of advice provided could be tailored to the nature of the product offered,” adding that consumers need access to clear, straightforward advice at all times.

Consumers must also be made aware that they are dealing with a regulated entity, the paper notes. It is critical to have information such as the legal name of the provider, its regulator registration number and type, and contact information available on a provider’s website, the report suggests.

The position paper also notes the importance of insurance providers having strong technology infrastructure (to avoid information not being transmitted or transactions not completed), as well as secure systems to protect consumer information. l www.claimscanada.ca

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• first notice FN Regulatory risk on the rise: IBC CEO The events of 2013 have demonstrated the insurance industry in Canada is facing a significant tide of risks, including regulatory risks, Don Forgeron, president and CEO of the Insurance Bureau of Canada, noted at IBC’s 2013 Regulatory Affairs Symposium in Toronto October 31.

“Clearly, we are at a historic moment in the tone and scope of regulatory activity around the world after the great recession of 2008,” Forgeron told attendees.

Citing the Insurance Banana Skins report for 2013, produced by the Centre for the Study of Financial Innovation and PwC, Forgeron noted that natural catastrophes have been identified as the top risk for property and casualty insurers globally.

However, the report lists regulatory risk as the number two global risk in 2013. “Let’s pause to consider that for a moment... second only to natural catastrophes,” Forgeron said.

“Insurers are now operating in an environment characterized by a rising tide of regulatory and legislative issues and initiatives,” he pointed out. This long list includes ongoing auto insurance reforms, GST review, excess taxation of reinsurance transactions, Canadian capital framework

changes, new accounting standards for insurance contracts, the International Association of Insurance Supervisors’ proposed new international capital standard and the risk of uncertainty itself.

“Regulators are always focusing on risks: insurance risk, market risk, credit risk, to name a few,” Forgeron said. “Well, now regulatory risk has joined those clear and certain risks, at least from the perspective of insurers,” he told attendees.

“The pendulum of regulation must not swing too far,” Forgeron cautioned. If that happens, “it endangers healthy and robust insurance markets, and, therefore, availability and affordability of products,” he said.

Another major risk has been political, Forgeron said. Citing Ontario auto, “political gamesmanship posed a serious threat this spring when the Ontario government announced plans, pushed by the opposition, to target a 15% rate reduction for auto insurance,” he told attendees. “At the time, without a clear commitment to cutting the costs of delivering Ontario’s troubled auto product, this had the potential to do serious damage,” he said. l

Insurers, non-profits join forces on building resilient cities A group of non-profit and industry organizations have launched a new set of resources that identifies priorities for the insurance industry and cities to build resilience against climate change.

“The Building Climate Resilience in Cities” resources were developed through a series of workshops in 2012 and 2013 in the United States and Canada, which included participation from more than 150 insurance industry executives, developers, city leaders and other stakeholders in Boston, San Diego and Toronto.

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Aviva Canada, The Co-operators Group and Swiss Re were among the property and casualty participants in the process.

The effort was driven by U.S. non-profit Ceres, which focuses on sustainable business issues and ClimateWise, part of the University of Cambridge, a global insurance industry leadership group focused on climate risk issues.

ICLEI, a global network of more than 1,000 local governments leading on sustainability and resilience issues, also helped convene city stakeholders.

“A well integrated cross-sectoral approach will be critical to effectively manage the growing risks facing our climatevulnerable cities in the decades ahead,” Kathy Bardswick, president and CEO of The Co-operators noted in a statement.

“The challenge of harnessing the expertise and resources of various stakeholders, and catalyzing a collective response to better protect our societal and economic interests is no small undertaking. But through innovation and collaboration, we can succeed in building more resilient cities that serve as an engine for sustainable development for this and future generations.” l www.claimscanada.ca

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• first notice FN Overhaul of property insurance needed in Alberta: industry groups Changes need to be made to the current property insurance product for it to be sustainable, especially in the wake of major flooding in Alberta, several industry participants agreed during a recent event held by the Insurance Brokers Association of Alberta (IBAA).

On Sept. 12, the group held a forum on property insurance in Edmonton, bringing together stakeholders from across the country.

Participants represented insurance companies including Aviva, Economical, Intact, Peace Hills, SGI, The Dominion, and Wawanesa, the IBAA, the Canadian Independent Adjusters’ Association, Alberta Insurance Council, Insurance Bureau of Canada, Institute for Catastrophic Loss Reduction, and Alberta Finance.

Most agreed that government disaster funds are being stretched in the wake of damage not covered by traditional property insurance, the IBAA said in a release Wednesday.

“I have no direction whatsoever, either explicit or implicit, that the government is interested in increasing its regulatory stance regarding property insurance,” said Alberta’s Superintendent of Insurance Mark Prefontaine, although he did say” the government is concerned about what it’s seeing and what it’s hearing.

IBC’s vice president for the Western and Pacific Region William Adams also noted that the proposal from the Office of the

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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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Superintendent of Financial Institutions Canada (OSFI) for a 5% to 20% increase in capital charge on insurers’ personal and commercial property exposure will inflate required capital reserves or reinsurance and thus inflate product cost, the IBAA noted.

“Concern was voiced that property insurance premiums and deductibles have been underpriced for years, while the product has incurred minimal change,” the association noted. “Opinion on consumer response to price increases ranged from the need for consumer insurance education to mitigate sticker shock to fear that some consumers will find the product unaffordable or that revamping the product to maintain affordability would restrict availability, either in type of coverage or to high-risk property areas.”

IBAA past president Dean Bailey also cautioned that a perilsbased underwriting approach, using postal code territories and other forms of risk mapping, is becoming more common and changing the original concept of insurance whereby the premiums of the many pay for the claims of the few.

Alberta has been hit particularly hard in terms of natural catastrophes recently, with its insured losses from severe weather representing 62% of the Canadian total in 2012, according to a study from the Institute for Catastrophic Loss Reduction. l

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December/January 2014

Mike Wells Account Manager • (416) 510-5122 mike@canadianunderwriter.ca

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 MARIE GALLAGHER It is with great pleasure that we bring you this special anniversary edition of Claims Canada in celebration of our association`s 60th anniversary.

History will tell us that it was due to changing times and conditions in the late 40’s, that prompted a number of independent adjusters to begin talking about the need to rally together for the benefit and security of the insurance industry. With Norman Helwig, of Morden and Helwig Limited pushing the project and W.R. Durance of Durance and Maltman making arrangements, a meeting was held in 1948 at the King Edward Hotel in Toronto. It was agreed by all those in attendance that if the Department of Insurance and the insurance companies could approach an association representing independent adjusters, problems could be worked out on an official basis.

It was on December 1, 1953, with over 100 affirmative responses from firms invited to become charter members, and under the chairmanship of Frederick C. Maltman that CIAA’ s founding fathers met to form an association of independent adjusters which they named the Canadian Independent Adjusters’ Conference (becoming the Canadian Independent Adjusters’ Association in 1985).

Those in attendance were pleased to hear that the Ontario Department of Insurance had taken a positive attitude toward the new conference. During that organizational meeting, the founding members ploughed through a massive amount of business; adopting a constitution, setting up a system of regional directors and identifying qualifications and restrictions for membership.

Aims considered of vital importance at the time included the necessity of an educational program; exchange of information and availability to the membership of the experience and knowledge of all members and the need for unity and mutual understanding.

Firms represented at that first meeting were: Morden and Helwig Limited; A.K. Macdonald and Company; F.C. Maltman and Company; Adamsons Limited; Andrew Hamilton Limited; Commercial Adjustment; Gilday and Stewart; McDonell-Stewart Company; Dalgleish Adjustment Bureau and Vern Walker and Company.

As the only nationwide group of independent adjusters, gradually over the years, CIAC gained stature and recognition, partly by marshalling claims forces when earthquakes, floods and hurricanes struck and placing them at the disposal of insurers and governments obliged to compensate victims for uninsured losses.

As CIAC was approaching its 20th anniversary, it was at the 1973 CIAC National Convention that founding member L. Vernon Walker (whose son Craig Walker would eventually become President in 2006) was handing over the reins from his year as President.

Ten years later, in January 1983 (when I began my insurance career), Stewart Ponton (who I had not yet met but who would hire me 3 years later) was half way through his term as CIAC President.

Five years later, G. Fred Plant (whose son Fred R. Plant would eventually become President in 2008) was bidding farewell to his year as CIAA President.

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Nous sommes très heureux de vous présenter ce numéro spécial d’anniversaire de Claims Canada pour célébrer le 60e anniversaire de notre association.

L’histoire nous enseignera que c’est en raison de l’époque de l’évolution et des conditions à la fin des années 40 qu’un certain nombre d’ajusteurs indépendants ont commencé à discuter de la nécessité de se regrouper pour favoriser l’industrie de l’assurance et assurer la sécurité de celle-ci.

Sous l’égide de Norman Helwig, chez Morden and Helwig Limited, qui a fait avancer le projet, et de W.R. Durance, chez Durance and Maltman, qui s’est occupé de l’organisation, une réunion a eu lieu à l’Hôtel King Edward de Toronto, en 1948. Les participants ont été unanimes pour dire que si le Département des Assurances et les sociétés d’assurances pouvaient discuter avec une association qui représente les ajusteurs indépendants, les problèmes pourraient se régler de manière officielle.

C’est donc le 1er décembre 1953, après avoir reçu plus de 100 réponses positives d’entreprises invitées à devenir membres fondatrices et sous la présidence de Frederick C. Maltman, que les fondateurs de l’ACEI se sont réunis pour constituer une association d’ajusteurs indépendants qu’ils ont appelé la Conférence canadienne des ajusteurs indépendants (qui est devenue l’Association canadienne des ajusteurs indépendants en 1985).

Les participants ont été ravis d’apprendre que le Département des Assurances de l’Ontario avait adopté une attitude positive face à la nouvelle conférence. Lors de cette réunion d’organisation, les membres fondateurs ont abattu un travail considérable, en adoptant une constitution, en établissant un réseau de directeurs régionaux et en définissant les critères d’admissibilité et les restrictions pour devenir membre.

Les buts, considérés comme d’une importance vitale à l’époque, comportaient, entre autres, la mise en place d’un programme éducatif, des échanges d’information, l’accès de l’effectif à l’expérience et au savoir de tous les membres, ainsi que l’unification et la compréhension mutuelle.

Les entreprises représentées à cette première réunion étaient les suivantes : Morden and Helwig Limited; A.K. Macdonald and Company; F.C. Maltman and Company; Adamsons Limited; Andrew Hamilton Limited; Commercial Adjustment; Gilday and Stewart; McDonell-Stewart Company; Dalgleish Adjustment Bureau et Vern Walker and Company. À titre de seul groupe d’envergure nationale d’ajusteurs indépendants, peu à peu, avec les années, la CIAC a acquis une renommée et une reconnaissance, établies en partie par la mobilisation des forces lors de tremblements de terre, d’inondations et d’ouragans, pour les mettre à la disposition des assureurs et des gouvernements qui se voyaient dans l’obligation d’indemniser les victimes pour leurs pertes non assurées. À l’approche du 20e anniversaire de la CIAC, au congrès national de la CIAC de 1973, on a appris que le membre fondateur L. Vernon Walker (dont le fils, Craig Walker, deviendrait éventuellement président en 2006) était prêt à quitter son poste après tant d’années à la présidence.

Dix ans plus tard, en janvier 1983 (quand j’ai commencé ma carrière en assurance), Stewart Ponton (que je ne connaissais pas encore, mais qui m’embaucherait 3 ans plus tard) était à la moitié de son mandat comme président de la CIAC. Cinq ans plus tard, G. Fred Plant (dont le fils Fred R. Plant deviendrait éventuellement président en 2008), mettait fin à son année à la présidence de l’ACEI. www.claimscanada.ca

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Five years after that, in 1993, I attended my first Annual Conference in Toronto and met incoming President David B. Hart (whose son Allan Hart I met many years later at the 2010 Annual Conference in Victoria.)

Five years later in 1998, I was honoured to be part of the organizing committee for the Annual Conference for outgoing President Rexford C. Stephenson, held in Niagara-on-the-Lake.

Also on that organizing committee was Bill Hendry, formerly of Cunningham Lindsey. I recently ran into Bill at an industry function and we ended up chatting about the history of CIAA. Bill started with Morden & Helwig over 40 years ago and although now retired, still keeps his hand in the industry. What I didn’t know was that Bill’s father opened the first branch office for Morden & Helwig in St. Catharines, having come from their Hamilton head office. I found that kind of neat, considering I opened the first branch office for Ponton Coleshill, also in St. Catharines in 1990. Bill told me his father was a friend of Norman Helwig and I was pleased to remind him that Norman was one of the founders of our association.

It is interesting to note that for the first five decades of our association, each one of our Presidents were male. In the last decade, we have had four female Presidents, myself included, with the first being Carol Messervey in 2006, followed by Patti Kernaghan five years later and then Mary Charman. Probably not surprising given the number of females in our industry however I do think it noteworthy all the same.

To all our past Presidents as well as the many others who have served our association, your dedication has helped to keep the flame of our torch alive all these years. Thank you.

I would like to take this opportunity to wish each and every one of our members a very happy and prosperous new year. I look forward to seeing you at our Mid-Year meeting in Toronto on February 3rd. n

Ensuite, cinq ans après, en 1993, j’ai assisté à mon premier congrès annuel à Toronto et rencontré le nouveau président, David B. Hart (dont j’ai rencontré le fils beaucoup plus tard au congrès annuel de 2010, à Victoria).

Cinq autres années se sont écoulées et, en 1998, j’ai eu l’honneur de faire partie du comité organisateur du congrès annuel du président sortant Rexford C. Stephenson, qui s’est déroulé à Niagara-on-the-Lake.

Bill Hendry, anciennement de Cunningham Lindsey, faisait aussi partie de ce comité. J’ai récemment rencontré Bill, lors d’une activité de l’industrie et nous avons parlé de l’histoire de l’ACEI. Bill a fait ses débuts chez Morden & Helwig il y a plus de 40 ans et, bien que maintenant à la retraite, il reste quand même au fait de ce qui se passe dans l’industrie. Ce que j’ignorais, c’est que le père de Bill a ouvert la première succursale de Morden & Helwig à St. Catharines, à partir de son bureau de Hamilton. J’ai aimé cette histoire, surtout parce que j’ai ouvert la première succursale de Ponton Coleshill, aussi à St. Catharines, en 1990. Bill m’a raconté que son père était un ami de Norman Helwig et j’ai eu le plaisir de lui rappeler que Norman était un des fondateurs de notre association.

Il est intéressant de souligner que, pendant les cinq premières décennies de notre association, chacun de nos présidents était un homme. Au cours des dix dernières années, nous avons eu quatre présidentes, dont moi, la première étant Carol Messervey en 2006, suivie de Patti Kernaghan, cinq ans plus tard, puis de Mary Charman. Ce n’est probablement pas surprenant, vu le nombre de femmes dans notre industrie, mais je pense quand même qu’il vaut la peine de le souligner. À tous nos anciens présidents, ainsi qu’aux nombreuses autres personnes qui ont servi notre association, votre dévouement a fait en sorte que la flamme continue à briller pendant toutes ces années.

Merci.

J’aimerais profiter de cette occasion pour souhaiter à tous nos membres une très heureuse et prospère année. Au plaisir de vous voir à notre réunion de mi-année à Toronto, le 3 février. n

NATIONAL EXECUTIVE 2013-2014 2011-2011 PRESIDENT Marie C. Gallagher, FCIP, CRM Granite Claims Solutions 71 King Street, Suite 204 St. Catharines, ON L2R 3H7 Phone: (905) 984-8282 • Fax: (905) 984-8290 E-mail: marie.gallagher@graniteclaims.com 1ST VICE-PRESIDENT David Porter, LL.B., FCIP, CRM Granite Claims Solutions 400 – 4370 Dominion Street Burnaby, BC V5G 4L7 Phone : (604) 659-6559 • Fax : (604) 659-6570 E-mail : david.porter@graniteclaims.com 2ND VICE-PRESIDENT Albert Poon, CIP Cunningham Lindsey Canada 1102 – 50 Burnhamthorpe Rd. W., Mississauga, ON L5B 3C2 Phone: (905) 896-8181 • Fax: (905) 896-3485 E-mail: apoon@cl-na.com SECRETARY Dara Banga, FCIP, CFEI DSB Claims Solutions Inc. 204 Main Street North, Brampton, ON L6V 1P1 Phone: (416) 400-8933 • Fax: (905) 915-4685 E-mail: dara.banga@dsbclaims.com

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TREASURER Russell Fitzgerald, CIP Kernaghan Adjusters Limited 203 – 4246 97 Street N.W. Edmonton, AB T6E 5Z9 Phone: (780) 488-2371 Fax: (780) 488-0243 E-mail: rfitzgerald@kernaghan.com PAST-PRESIDENT John D. Seyler, CIP ProFormance Group Inc. 5080 Timberlea Blvd., Suite 214 Mississauga, ON L4W 4M2 Phone: (905) 238-4985 Fax: (905) 238-2735 E-mail: jseyler@prospecialty.ca 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 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 DIRECTOR Albert Poon, CIP Cunningham Lindsey Canada 1102 – 50 Burnhamthorpe Rd. W., Mississauga, ON L5B 3C2 Phone: (905) 896-8181 • Fax: (905) 896-3485 E-mail: apoon@cl-na.com 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

Years of Representation

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The Canadian Independent Adjusters’ Association is celebrating its 60th anniversary this year as the profession’s singular voice of advocacy, education and membership. Evolving from an elite conference of like-minded independent adjusters in the 1950s to mid-1980s to a truly national association in the modern era, CIAA has seen its share of changes – yet many of its goals have stayed the same. We take a brief look at the history of the association, share some observations from past presidents and, perhaps most importantly, glimpse into where CIAA is headed in the future.

BY CRAIG HARRIS

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lus ça change, plus c’est la même chose. The more things change, the more they stay the same. Or at least similar.

Looking back on 60 years of the Canadian Independent Adjusters’ Association, one can quickly spot the central issues that have dominated discussion and led to small and large victories, ongoing challenges and recurrent negotiations. Whether the matter at hand is education, licensing or professional standards, the CIAA’s mandate continues

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to be to provide leadership and represent the interests of independent adjusters.

Sifting through past issues of the Canadian Independent Adjuster magazine (first issue: 1958!), it’s easy to pick out passages that are relevant today.

To wit: “The (insurance) companies have some legitimate complaints about the independent adjuster and the independent adjuster has some pet peeves about certain aspects of and approaches to

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claims handling among the companies.” Gregor Hope, June president (2001-2002). “I don’t see that changing into the 1971. “Continuous progress could be made from the (regu- future. Our clients have ever-increasing expectations in lator’s) standpoint regarding licensing of adjusters, which terms of the level of professionalism and customer serwould involve rigid testing for the betterment of adjusting vice adjusters provide. When I look back over my history caliber.” Kirk McDonald, Winter 1974. “Claims handling is as an adjuster and my involvement with the association becoming increasingly more centralized and what level of in the pursuit of professional standards, I am struck by personal contact is there in a telephone adjustment from how relevant this is to this day.”

The inaugural meeting of the Canaone hundred miles distant?” Keith dian Independent Adjusters’ ConferEdwards, Fall 1976.

“Our clients have ence (CIAC), the precursor to CIAA, And yet the business environment ever-increasing was held December 1, 1953 in Toronto. has changed dramatically – can you expectations in terms of According to CIAA archived docuimagine talking about Twitter at an adjuster conference in 1954? Or disthe level of professionalism ments, its first chairman Fred Maltman “outlined to the delegates aims cussing the concept of telematics in and customer service which he considered of vital impormodern vehicles or cyber liability in adjusters provide.” tance: the necessity of an educational 1972? Or trying to explain the current program; exchange of information level of consolidation in the propKeith Edwards, and availability to the membership erty and casualty insurance industry CIAA president, of the experience and knowledge of and the resultant impact on adjuster all members; raising the standard of firms?

2001-2002 all spheres of adjusting; and the need Recurrent Themes for unity and mutual understanding.”

While the industry has evolved, adjusters are still deal- The motto of the newly minted association: Experience, ing with recurrent themes that resonate throughout the Service and Integrity. decades.

A stimulus to the formation of the CIAC was the cre“We are in many ways wrestling with same issues and ation of the Underwriters’ Adjustment Bureau in 1951. challenges as we always have,” says Keith Edwards, CIAA UAB was co-owned by 146 insurance companies operating in Canada, with the stated purpose of improving the settlement of claims and ensuring more equitable and uniform adjustments in fire and casualty insurance. In other words, insurers were increasingly considering in-house claims adjusting.

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14 Claims Canada

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CIAC Gains Stature Gradually, the CIAC grew its membership, gaining stature and recognition. It did this in many ways: through the development of standardized claims documents and forms, the formation of a discipline committee for member oversight, the establishment of educational courses and ongoing contact with government bodies in ten provinces regarding insurance regulations and adjuster licensing.

Another accomplishment at that time was marshalling the resources of independent adjusters for natural disasters and making them available to private insurers and government agencies, which were obliged to compensate victims for uninsured losses but lacked the capacity or means to handle the claims.

“For the more serious types of claims, they (companies and government) still needed the professional adjusters who could do research, reporting and documentation,” www.claimscanada.ca

13-12-06 1:35 PM

Baillie says. “Beyond just a junior company claim person justers. It seems that almost every insurance legal decision sitting in an office for a lot of claims, they wanted a pro- that comes down has some application to the role of the fessional, technically trained adjuster who could go to the professional adjuster and our standards.” loss scene and conduct a proper investigation.”

As the CIAC moved into the next decade, the issue of This reliance on the technical skills of adjusters contin- membership and national representation took precedence. ued on into the 1970s, when the CIAC was tapped by the The Conference represented roughly half of the indepenB.C. government and CP Railway to coordinate handling dent adjuster community and was sometimes chastised by of large scale losses from disasters. insurance regulators for being fragFor example, extensive flooding in the mented and speaking on behalf of Thompson and Fraser River Valleys in only a small percentage of the profes“We realized that if 1972 prompted the B.C. government sion. you can’t speak for all to retain CIAC members to carry out That all changed with the developassessment of hundreds of claims. ment of a “Unity Committee” chaired adjusters with one voice, Similarly, the 1979 train derailment

by Skip Sutherland. CIAA president you will not be heard.” and evacuation in Mississauga led to (1983-1984), whose purpose was to dozens of CIAC adjusters joining with examine the amalgamation of larger Skip Sutherland, CP claims handlers to process 500national and smaller regional adjustCIAA president, 700 claims daily. ing firms into one entity. In February “This disaster assistance program 1985, the CIAC formally changed its 1983-1984 by the government was an external constitution and name to the Canarecognition of the CIAC as a profesdian Independent Adjusters’ Assosional body,” says Gregor Hope, CIAA ciation. The CIAA became, from the president (1970-1971). “They realized that we could han- time of its formation, the only recognized group speaking dle claims in non-insured loss situations and we did that for the independent adjusting profession. for flooding in New Brunswick and other natural disasters “A high priority for us was representation,” says Skip across the country. We were recognized for our skill and Sutherland. “We realized that if you can’t speak for all adknowledge as professional loss adjusters.” justers with one voice, you will not be heard. We worked Hope notes that at the time “one of the big differences in the business environment for independent adjusters was there were fewer multi-office companies, ‘big chains’ if you will. There were many smaller, owner-operated firms.”

Pursuit of Standardized Licensing In the context of representing these firms, the CIAC focused on educational resources, professional qualifications and licensing.

“One thing we pursued was standardized licensing across Canada,” Hope says. “We met with various Superintendents of Insurance and it took up a lot of time. Unfortunately, it did not materialize, but one thing we did accomplish was to emphasize that staff adjusters should have the same licensing and standards provincially as independent adjusters. Insurance companies were set against this, but I know in provinces like New Brunswick, this became the standard.”

Others echo the viewpoint that the CIAC was pursuing the right goals and made important accomplishments in key areas.

“We were discussing professional standards, mandatory education and licensing in the mid-1970s; we were on the right track but when I look at it today the expectations are higher – for many reasons,” says Keith Edwards, who was editor of the Canadian Independent Adjuster magazine during that time and later went on to become CIAA president. “One is our clients and the expectation of service levels, but another important factor is the courts are cranking up standards that apply to professional loss adwww.claimscanada.ca

p12-22 COVER STORY.indd 15

Congratulations

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Claims Canada 15

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to include as many adjusters as possible in the national as- firms submit to a series of exams administered by the Insociation and the transition from the CIAC to the CIAA surance Institute of Canada. This new professional desreally brought that representation of adjusters across the ignation was known as CLA (Chartered Loss Adjuster).

Another designation, FCIAA, would replace the old CLA country. We now truly could speak with one voice.”

Along with the unification came a stronger push for and continue to recognize outstanding ability and qualiuniform licensing and a renewed emphasis on education. fications for veteran adjusters. Craig Walker, then educaOne of the first items given to the new Association by the tion chairman and CIAA president (2005-2006), tackled the arduous work of developing the Superintendents of Insurance was the examinations for the new CLA desigformulation of a universal licensing “Every president that nation, which were completed in 2001. plan for all adjusters in Canada, which, comes on board has his The 1990s were also a time of sigagain, did not come to fruition. On nificant natural disasters across Canthe education front, Stewart Ponton or her wish list, but there ada.

Whether it was the Calgary hail (CIAA president, 1981-1982) worked are also things that are storm of 1991, the Saguenay, Quebec with the Insurance Institute of Canada already on the boil and you floods of 1996 or the “flood of the cento establish new courses on the practihave to continue on with; tury” in Manitoba in 1997, the memcal side of insurance adjusting. ber adjusters of the CIAA were called that is the nature of it.”

Update to Credentials upon to adjust both insured and nonArnold Pike, The focus on professionalism exinsured losses. And then came the Ice tended well into the next decade. In CIAA president, 2002-2003 Storm of 1998 in Eastern Ontario and the early 1990s, CIAA recognized the Quebec – the single largest insured need to update the credentialing proloss event in Canada at the time (begram in order to keep pace with advancements in the ad- fore the Alberta floods of June 2013). The nature of these justing profession. A task force on professional qualifica- calamities only served to underscore the need for harmotions was spearheaded by Keith Edwards to examine major nized licensing across provinces and adjuster mobility at a revisions to existing designation. time of crisis.

In 1993, CIAA membership agreed that the adjusting Arnold Pike, CIAA president, 2002-2003, says the assoprofession would be better served by introducing a new ciation often faces issues that span more than a one yearprofessional designation whereby employees of member term and require a continuation of effort.

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R

e

“Every president that comes on board has his or her January 2004 for all private sector firms in Canada. Before wish list, but there are also things that are already on the that, CIAA had lobbied extensively with Industry Canada boil and you have to continue on with; that is the nature of to obtain “investigative body” status, which would exempt it,” he says. “One of those issues is harmonized licensing. certain groups from consent provisions if the matter at There are many territorial restrictions on how claims can hand related to fraud investigation.

As of March 31, 2004, independent adjusters were desbe handled in a certain province, PEI was about the worst, ignated investigative bodies as a “class,” meaning that, to but others had their rules.” qualify, adjusters had to be incorpoPike notes that the provincial lirated or operate as a partnership and censing system, which applies to inde“I was always very be licensed pursuant to their enabling pendent adjusters, can be circumventconscious of the legislation. ed by others involved in the claims “During my term as national presipresidents who came arena, echoing Hope’s concerns more dent, PIPEDA took up a lot of our than two decades earlier. before me and the time,” Pike says. “This was a hot is“What we found was that some work they had done; sue for members; we were getting calls companies were constantly infringing it was quite a daunting from members who questioned if they on these licensing rules in how they task and big shoes to fill.” could still do the business of collectadjusted claims,” he says. “They were ing information and adjusting claims using telephone adjusters in different Carol Messervey, with this legislation. We met regularly provinces and even going straight to contractors, who were certainly not CIAA president, 2004-2005 with Industry Canada, and we were successful in obtaining investigative licensed. We went to the superintenbody status.” dents of insurance and we also went to Jim Eso, CIAA president (2003-2004), says the CIAA the insurance companies, and got great results.” played a pivotal role in educating adjusters about privacy Investigative Body Status Big Win issues, including forming a privacy committee that looked While harmonized licensing has been a continuing at subjects like consent forms, and participating in an Inchallenge for the CIAA, the association scored one of its surance Bureau of Canada (IBC) working group on privacy.

After a lot of hard work on the privacy file, Eso had the big wins in 2004. The Personal Information Protection and Electronic Documents Act (PIPEDA) came into effect distinct pleasure in passing the CIAA executive baton to

Restoration Industry

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the association’s first female president, Carol Messervey (2004-2005).

First Female President

“I was always very conscious of the presidents who came before me and the work they had done; it was quite a daunting task and big shoes to fill,” Messervey says. “Also, as the first female president, that was in the back of my mind. I felt like I had to give 110% in order to know that I accomplished everything I could.”

“One of my priorities was to ensure that the interests of all members were represented,” she adds. “I wanted to know that members had an equal say and input regardless of the size of the firm. A lot of the smaller firms should have this input, and they get a great deal of benefit from the CIAA, whether that is from online access to educational sessions and forums or online forms, or participating at the regional level.”

Messervey also was involved in the early stages of the association’s stra-

tegic planning exercise, which blossomed under the leadership of Patti Kernaghan, CIAA president (20092010) later in the decade. That process is ongoing and continues to guide the direction of the CIAA to this day. In

“Two things that have come out of the advisory board are, one, how we deal with catastrophes and, two, education,” Patti Kernaghan, CIAA president, 2009-2010 fact, one can see the threads of the past woven into the current fabric of strategic priorities for the association.

Kernaghan explains that during her term, the CIAA surveyed both members and non-members and

Congratulations to the Canadian Independent Adjusters’ Association on its 60th Anniversary of serving the common business interests of licensed independent adjusters within the Canadian insurance industry.

CIAA has done a tremendous job promoting: uniform standards of conduct in the adjustment of insurance claims; continuing education; professional development; advocacy with provincial and federal government bodies; as well as advancing cooperation and good working relations amongst its members, the insurance industry, and the public.

CIAA stands on solid ground as it looks to the future service of its members and we at Network Adjusters are proud to be a part of this elite group of professionals.

Well done CIAA! Miles Barber, B Comm. (Hons) FCIP, CRM, RF mbarber@mymts.net Ph: (204) 897-5793

18 Claims Canada

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Craig Shanks, CIP

craig.shanks@mymts.net Ph: (204) 725-7436

held focus groups with various industry sectors, including brokers, risk managers, insurer personnel and representatives from other trade associations. The resultant feedback was invaluable, and a little startling.

Strategic Planning “For example, in the survey and discussions, we received feedback from some external stakeholders who didn’t even know we had a designation or what it stood for,” Kernaghan says. “That was a real ‘a-ha’ moment for us.”

This feedback was incorporated into CIAA’s identification of key strategic priorities – short-term communication, long-term branding plan, designation program, education program and advocacy plan for harmonized licensing. Much of this work is ongoing, according to Kernaghan and other past presidents. For example, the CIAA is working on a new designation, pushing hard on harmonized licensing and has revamped its professional educational program.

“We continue to meet with the Canadian Insurance Services Regulatory Organizations (CISRO) on harmonized licensing. They are insurance regulators; they understand our issues but they don’t have huge motivation to move forward. However, I think we are getting closer and making significant progress,” says Kernaghan, who credits Miles Barber with much of the heavy lifting on licensing.

She adds that inter-provincial trade pacts, such as the British-Columbia-Alberta Trade, Investment and Labour Mobility Agreement (effective April 2007), could provide a leg up on harmonized licensing of adjusters.

Kernaghan also notes that the strategic planning exercise led to the creation a national insurance advisory board that provides regular feedback to the association.

“Two things that have come out of the advisory board are, one, how we deal with catastrophes and, two, education,” she says. “We need to have CIAA able to help adjusters across Canada when there is a major disaswww.claimscanada.ca

13-12-06 1:35 PM

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ter and we can do that through our Catastrophe Response Program. On the education front, we now have educational courses and resources that fill in the gaps between on the job experience and technical requirements.”

The industry advisory board is one example of shifting winds at the CIAA and a renewed focus on value for members and non-members alike, according to some sources.

Adjusters Aligned with Industry “CIAA has become more aligned with the insurance company needs in recent years,” Eso says. “The creation of our CIAA strategic plan, the revision of our professional education program and the formation of our national insurance industry advisory board (ensures) that our association moves beyond any perception of being a trade association only for the benefit of members and is instead seen as a trusted partner with the insurance companies that member firms work for.”

Not surprisingly, this is a chord that resonates with many past CIAA presidents.

“I think adjusters need to see themselves as part and parcel of this industry, not separate from it,” Baillie observes. “That was a tendency in the past to sort of keep to ourselves and have the conference for our benefit. I would like to see adjusters have more contact with the companies and claims managers. If you take an interest in the business as whole, it will benefit you as an adjuster – people will take an interest in you as a professional.”

“The creation of our CIAA strategic plan, the revision of our professional education program and the formation of our national insurance industry advisory board (ensures) that our association moves beyond any perception of being a trade association only for the benefit of members and is instead seen as a trusted partner with the insurance companies that member firms work for.”

Jim Eso, CIAA president, 2003-2004 “We realized we had to build relationships with insurance companies within the industry,” Sutherland says.

“That is why we forged closer ties with the claims managers association (CICMA), which represented all or most of the companies. That became a particularly good working relationship.”

20 Claims Canada

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“I think unfortunately, there has been an atmosphere of ‘us versus them’ between companies and adjusters,” Hope notes. “There have been questions about the true independence of the adjuster and the potential for bias. I have always thought that the value of the adjuster is that we call it as we see it. We provide another set of eyes on a claim. We understand the policy and we can apply that to the loss situation at hand. That is a real benefit to the companies – and to the public.”

Host of Issues Ahead Finding the right balance with insurance companies is just one factor that adjusters face now and into the future. A host of other issues include demographics and an aging workforce, rapidly evolving technology and computerized claims handling processes, severe natural disasters, CAT response and ability to meet customer needs during crisis, fluctuating claims volumes for independent adjusters, the pressure from companies to reduce claims/ indemnity expenses and regulatory challenges.

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ue to members – and its role in the broader insurance industry, according to Kernaghan.

“We have to be careful about vague goals and terms; these can represent just white noise that we have to move beyond,” Kernaghan argues. “We are working in the adjusting profession; the association has to work for the benefit of this profession. We are not a social club, and we can’t start trying to do things that don’t work well. We have to be focused on what we can accomplish, which is why our identified strategic priorities are so important.”

“Through my editorship and later at the executive culminating in my presidency, the (CIAA) was committed to promoting and encouraging the professional standards of its members,” says Edwards. “That goal still stands but challenges remain.

Any organization must continue to question its relevance and the value it brings to its members.”

“Going forward, I would like to see 95% of independent adjusters as members of the CIAA,” concludes Kernaghan. “That is how we can protect and promote our profession.

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• spotlight S

Claims

Traveler

B.C. native John Russell takes the reins of president of the Canadian Insurance Claims Managers Association.

BY CRAIG HARRIS

J

ohn Russell has an interesting window on claims trends across the country and, in particular, the nasty spate of weather surprises that have hit Western Canada in recent times. As assistant vice president of property claims for Aviva Canada for seven years, he was responsible for managing all property catastrophe claims west of Manitoba. Tornadoes in Pine Lake, AB, wildfires in Kelowna, B.C., hail storms across the Prairies (and the fire in Great Slave Lake) and severe flooding; he has pretty much seen it all.

Russell was recently tapped by the Toronto head office of Aviva to help in the implementation of a national claims technology platform, so he missed the historic flooding in southern Alberta in late June. No matter; he was in the GTA when record rainfalls swamped the city July 8 and caused more than $850 million in insured losses. Sometimes, it seems, no matter where you move in Canada, the bad weather can follow.

Russell took over as president of CICMA at the group’s annual general meeting in September, by coincidence held in southern Alberta in Kananaskis. In addition to the AGM, traditionally the CICMA national organization meets with the local chapter to discuss current issues and challenges in their region. According to Russell, there was no shortage of topics with the Southern Alberta Chapter.

“With the flooding in southern Alberta, there was a lot to talk about — the CAT response, the role of the media, the evolving role of social media, and some of the challenges that we faced as an industry,” he says. “There is a huge benefit in sharing this kind of information; what lessons were learned, what worked, what didn’t work, and how as an industry we can do better the next time.” It is not about sharing strategies of each company, but a sharing of in24 Claims Canada

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formation on how we as an insurance industry responded.

Russell adds that the conversation included the flooding that quickly followed in Toronto. “We were also able to compare this to what happened in Ontario, how resources were stretched in terms of contractors and adjusting staff, how companies had to shift people to Ontario after being in Alberta,” he notes. ”We got a chance to discuss these types of challenges first-hand.”

This informal networking across CICMA’s regional chapters (there are 11) is invaluable for the association, Russell says. It is a complement to the formal education sessions that he says are one part of his three priorities as CIMCA president. He notes that continuing education, driven by the regional chapters, is essential for claims managers across the country, whether in the form of breakfast meetings, lunch-and-learn sessions or all-day educational seminar.

“We would like to encourage sharing of educational sessions as much as possible across the country,” Russell says. “So if an issue, such as preservation of evidence, is presented by an expert or generally discussed at an Ontario session, it can be possibly leveraged out in BC, either for that content or for another speaker to be brought in.”

The formal education also extends to partnerships with the CIAA. “CICMA and CIAA have a long history of sharing information and hosting joint educational sessions,” Russell says. “My goal is to solidify and continue that relationship going forward. I know that in B.C. we had many excellent joint sessions with CIAA that involved rotating responsibilities for speakers and educational topics. I want to continue that information sharing and increase the communication back and forth.”

Another member-driven goal for the CICMA is to leverage its web site. “We want to provide significant value for www.claimscanada.ca

13-12-06 1:45 PM

our members online, whether that is educational material, For example, Russell explains that during a CAT situsharing of information, or just a one-stop shop for services, ation, such as the floods in southern Alberta, Aviva tends documents/forms, membership,” according to Russell. to use its own adjusters for consistency of claims service. It Not surprisingly, CICMA faces many of the same mem- then looks to independent adjusters to pick up the “regubership challenges that confront the lar, business- as-usual claims.” Other CIAA, in terms of ongoing industry companies have different approaches, There is a consolidation. “As with most associaand may look to independents to hantions, maintaining membership is an dle all CAT claims, bringing in addihuge benefit in issue,” Russell notes. “We face issues tional resources from other regions or sharing this kind with mergers and acquisitions as well, even other countries. where some companies may be con“There is no cookie-cutter process of information; solidating or closing certain branches. to when companies respond to CAT what lessons were The old joke with M&A is that those claims, “ he says. “It is ‘all hands on two people you see sitting across the learned, what worked, deck’ when it comes to a CAT, as our table are now one.” goal as an industry is to help our cuswhat didn’t work, However, Russell says that memtomers as quickly as we can in often bership in the CICMA is open to some very tragic circumstances.” and how as an more than just the traditional Claims For Russell, this open and back-andindustry we can Manager. “For example, a claims deforth sharing of general industry inforpartment may be centralized into one mation between adjusters and company do better the office, but there may be claims leaders claims personnel marks a big opportunext time. in property, casualty, accident bennity and a departure from an “us verefits or auto physical damage lines. sus them” mentality in the industry. As These people can become members of the CICMA; you CICMA president, and someone who knows a fair bit about don’t have to be a traditional claims manager to join the the regional issues facing the claims management profession, association and derive value from it,” he says. he is eager to leverage that opportunity across Canada.  A third priority for CICMA this year is to continue to promote the Inter-Company Arbitration Agreement (see page 30). “We find that some pockets of the country are not as aware of it, while others are using it, we want to push it down to the front line members and file handlers at a desk level,” Russell says. “We have an educational video in both French and English on our website, and we want to educate all claims professionals that for those claims under $50,000 (and even for some above that amount when agreed upon by the parties involved), this is an excellent way to avoid legal fees to get a dispute resolved.”

He observes that Alberta has made good use of the agreement, perhaps due to the nature of the auto insurance system (most claims in the agreement involve auto).

For Russell, his term as president of CICMA will involve a blending of informal networking and structured educational opportunities to raise the profile of the association.

As someone who has risen from road adjuster to supervisor to AVP to business-technology specialist over 17 years with one company, he has experienced the claims management side of the p&c industry from the ground up. And Russell says there are several opportunities to share this information with independent adjusters.

“There are less formal networking and information sharing we have (with adjusters), Russell notes. “We don’t get into specific company claims philosophies, procedures and how they use or don’t use independent adjusters; that’s not really what we are about,” he says. “However, we can share our approaches what may work for one company to the next.”

“

“

www.claimscanada.ca

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Keys to

Closure How environmental claims can be handled quickly and cost effectively.

BY JOEL VAN POPTA

An environmental loss can present a challenge for any adjuster or claims representative. A claim can escalate in complexity due to the circumstances of the loss and the number of stakeholders involved – the insured, the insurer, regulatory agencies, vendors, experts and concerned neighbours.

We know your main goal is to close this file in a cost effective manner, and quickly. Can you see the end from here?

Picture this: the date of loss was six months ago. As you add up the invoices rolling across your desk you realize that the project spend is approaching the reserve limit and perhaps even approaching the policy limit. The latest correspondence from your environmental expert is a proposal for additional remedial or assessment work and a request for additional budget. You need to close this file. But how can you get there? The process begins when the claim comes in.

Engage a seasoned and experienced team that will work with you throughout the project and provide the necessary justification for scope and budget numbers. With advice from your team, establish the end goal, select the right remedial approach and keep everyone involved throughout the process to drive the claim to closure. This process is essential to keeping the project on track and achieving file closure. The following are four keys to getting it done:

Key #1: Assemble your team Each claim you respond to presents its own challenges and curve balls. Assembling your team of experts and contractors is your first key to ensure success. For example, a leak from a residential fuel oil tank will likely result in an Order from a regulatory agency. The Order usually requires an assessment report to be prepared by a Qualified Person, defined as either a provincially-licensed Professional Geoscientist (P.Geo.) or Professional Engineer (P.Eng.). It just makes sense to retain a qualified professional early in the process so you have access to the advice you need right from the start.

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If the environmental loss is associated with a fuel oil system, there likely is an opportunity for subrogation to recover expenditures. The team needs to understand how to respond quickly to mitigate the loss, move the project forward and preserve evidence for potential subrogation. Your consultant should know when to bring in a forensic expert who could identify the cause of the fuel oil loss. Typically, intrusive testing of the tank should not be done until relevant stakeholders are given the opportunity to have their own expert involved.

Forensics can also play a part for other types of environmental losses. Consider a rail yard solvent spill. The investigation identifies a much larger impacted area than expected considering the amount of solvent alleged to have been lost.

Forensic investigation reveals that some of the solvent is aged and not consistent with the current loss. The site professional has just provided an opportunity to recognize a significant cost savings by simply recognizing the two unrelated losses.

Understanding the circumstances of the loss and retaining your experts early in the process is essential to adjust your claim efficiently by collecting the necessary information.

Remediation of contamination in an environmental claim should be handled by an experienced and reputable site professional and contractor that specializes in enviwww.claimscanada.ca

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Would gathering more site information change assumptions associated with one or more options, making them more realistic and comparable?

Have contractor markups been included in each option?

Without them, your actual costs could rise by 10%-20% or more.

Key #2: Start with the end in mind Who is working for whom? Can the consultant act as This is an important aspect of a project. Without an end Project Manager and Contract Administrator rather than as goal, a large environmental loss can easily become an expen- General Contractor? Consultants acting as a General Consive and aimless undertaking. A typical environmental loss tractor can add significant costs to the project as items are investigation involves the assessment of soil and groundwa- marked up twice as they pass through the contractor and the ter conditions. Smaller losses may not require an extensive consultant. assessment and it may be more efficient to clean up as you Are you being creative? Think outside the box! Are there go with the understanding that the exother options that would get you to the tent of the loss is manageable. But for end goal? For example, does the cost of larger losses with many unknowns it is remediating exceed the building cost? prudent to complete a full assessment to It may be an option to demolish the understand the extent and magnitude of building, reducing remedial costs by the impacted area. This approach will saving unrealistic restoration costs and result in a reliable remedial action plan avoiding a complicated remediation. and realistic reserves.

Have you done a Risk Analysis? What A remedial action plan uses the asconditions could change the proposed sessment data to plan for the project’s scope and associated costs? Would winend goal. Understanding the end goal ter conditions or road weight restricinvolves the selection of cleanup targets tions completely change your budget? to meet regulatory criteria. Selecting Are there building code issues (expenthe appropriate environmental qualsive upgrades to electrical or plumbing) ity standards is an issue of managing or other site issues that a municipality contractual liability (policy wording), needs addressed prior to closing off a regulatory liability (meeting appropripermit? Once you start the work, it is ate legislation), and civil liability (pooften too late to turn back. tential for third party claims now and in Understand the limitations of each the future). Further, every loss or spill approach to avoid spending money that comes with a unique set of issues and will not move the project towards cloConfirm with your resulting solution. Your environmental sure. Confirm with your experts that the experts that the consultant should be able to assist in proposed work and expenditures are inidentifying the site specific issues relattended to meet the project cleanup goals proposed work and ed to the environmental loss and reguand are part of the closure plan. expenditures are latory standards connected to provinKey #4: Communicate, intended to meet the cial regulations; however, you should communicate, communicate! also consult your policy wording, senior project cleanup goals The assessment and remediation staff and legal counsel to select the right and are part of the of an environmental loss can extend clean-up targets for your claim. through several months or, in some casUnderstanding the cleanup target is closure plan. es, years.

Make sure you request regular the driver for the remediation process. updates from your project team, and alKey #3: Select the right ways insist on the realization of scope changes that will affect approach cost.

As with most things in life, there are options. Your consulEnvironmental losses are not straightforward. You are altant and contractors should provide you with a few different most always dealing with unknowns, and the cost implicaoptions for remediating the environmental loss. tion of these unknowns can be huge. The implementation When reviewing options and estimates, ask your team of the right team, with a clear understanding of the insurer’s these questions: needs, will go a long way toward ensuring a satisfactory projHave they included all potential costs for each option? ect outcome.  Pay attention to the details! Estimates can come in missing key items (e.g., no groundwater management for a proJoel van Popta, M.Sc., P.Geo., is a Professional Geoscientist posed excavation next to a wetland). Spend time going in the Province of Ontario and has been practicing in Enviover each option and make sure that the costing matches ronmental Assessment and Remediation since 2003. He can be each scope item. reached at joel.vanpopta@stantec.com ronmental remediation. Spare yourself the frustration of having an inexperienced team attempt a complicated remediation project. It sounds cliché but it pays to have the right team on the job.

28 Claims Canada

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The Arbitration Option

A national arbitration agreement, managed

by CICMA, can represent a quick and informal alternative to litigation.

BY CATHY WISMER

Bersenas, Jacobsen, Chouest, Thomson, Blackburn LLP BARRISTERS, SOLICITORS

We advise and act for a large number of domestic and international insurers and for their insureds in our areas of specialty, which include: Professional Liability & Indemnity Transportation Media, Libel & Slander Financial Institutions Directors and Officers Fidelity and Surety Property and Casualty Surplus and Reinsurance For information contact: James P. Thomson jthomson@lexcanada.com 416-982-3805

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30 Claims Canada

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December/January 2014

T

he Canadian Inter-Company Arbitration Agreement, more commonly known as the Arbitration Agreement, is a formal agreement that has been in place for years.

The purpose of the Arbitration Agreement is to provide a quick and informal alternative to litigation of liability and damage disputes on subrogation claims between insurance companies.

The role of the CICMA is to manage this Agreement. Each province has an Arbitration Director that administers the program. As well there is a National CICMA director whose role is to communicate and assist the provincial directors with any issues that may affect the program on a national level.

The program is quite frequently used where auto physical damage claims are still subrogated.

In provinces where physical damage to autos is part of a public insurance scheme or where automobile physical damage subrogation is pre-determined by fault determination rules (as is the case in Ontario) the opportunity to use this process is still available for both personal and commercial property damage.

Typically the types of claims that work well with the Inter- Company Arbitration Agreement are those issues where the average value of the loss is less than the $50,000 limit.

The Arbitrators for losses under $50,000 are picked from the CICMA membership roster and are your peers.

In response to the industry’s concerns about rising litigation costs and the length of time claims are tied up in the court process, the CICMA, in conjunction with the Insurance Bureau of Canada (IBC) Claims Committee and the Canadian Defense Lawyers (CDL) are looking for losses where insurwww.claimscanada.ca

13-12-06 1:53 PM

ers may be willing to arbitrate that are greater than $50,000 but no more than $200,000. We are currently looking for cases to pilot this idea.

To service this pilot project, we have a roster of Canadian Defense Lawyers who are interested in acting as the Arbitrator for claims with a value between $50,000 and $200,000. To this end we are hoping that insurers will take advantage of this cost saving idea by bringing more complex or higher valued losses to our CDL arbitrators and get the benefit of their legal expertise at a considerably reduced cost when compared to the usual cost of litigation.

For more information on the pilot project with CDL and the types of claims what would fit the pilot project, adjusters can contact the provincial director.

At the CICMA website, adjusters will find a video introduction with an overview about the Inter-company Arbitration Agreement available in both official languages, as well as documents on how to appoint a Pre- Arbitration Officer and formally apply for arbitration. There are also documents outlining the responsibilities as a respondent, as well as the role of the Arbitration Panel along with issues that are outside the mandate of the arbitration agreement www.cicma.ca You do not need to be a CICMA member to view the video, or review the documents.

We recommended that you share the video with members of your claims team that have responsibility for subrogation claims and consider this alternative to litigation.

If there are any questions, or if you wish to participate in our pilot project please do not hesitate to contact: Hall Noble, CICMA National Arbitration Chair at Hall.Noble@tdinsurance.com

Local arbitration directors are: • Bluenose – Paul Ross – paul.ross@economical.com • British Columbia – Marie-Ann Alward malward@wawanesa.com • Manitoba – Luc Dupis - ldupuis@sgi.sk.ca • New Brunswick – Lynn Prescott – Lynn.Prescott@assestplus.ca www.claimscanada.ca

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• Newfoundland and Labrador –Paula Monks – paula_monks@cooperators.ca • Northern Alberta – Melissa Nilson – Melissa.nilson@teig.com • Ontario – Kevin Chasty - kchasty@thedominion.ca • Ottawa – Michael-Elizabeth Paczek – Michael-Elizabeth.Paczek@intact.net • Quebec – Francois Reneault – Fancois.reneault@intact.net

• Saskatchewan – Rod Wotherspoon – rwotherspoon@saskmutual.ca • South Alberta – Gail Fisher – Gfisher@phgic.com  Cathy Wismer is National Co-Communication Director with the Canadian Insurance Claims Manager Association (CICMA).

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Claims Canada 31

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Adjuster Privilege

What kinds of information and files can be protected in litigation?

BY RYAN EWASIUK

An adjuster’s file is ripe with documents that insurance companies who hired the adjuster would not want to end up in the hands of plaintiffs. For example, adjuster’s files will often contain witness statements, reports of various types, legal opinions, and documents setting out the insurer’s position and strategy.

Some of what is found in an adjuster’s file will be subject to litigation privilege.

However, only those documents that can meet the “dominant purpose” test will be subject to privilege; all other documents may be subject to production to an adversary in a lawsuit. The “dominant purpose” test is applicable in most Canadian provinces, including British Columbia, Alberta, Manitoba, Ontario, New Brunswick, and Nova Scotia: Hubbard at 12-47.

Litigation privilege is separate and distinct from solicitor-client privilege.

Solicitor-client privilege attaches to all communications made between a lawyer and client where the client is seeking the lawyer’s advice. Litigation privilege is different; it is “broader in scope”: Moseley v Spray Lakes Sawmills (1980) Ltd., [1996] 39 Alta LR (3d) 141 (CA) at para. 18.

Litigation privilege “applies to communications between a lawyer and third parties or a client and third parties, or to communications generated by the lawyer or client for the dominant purpose of litigation when litigation is contemplated, anticipated or ongoing. Generally, it is information that counsel or persons under counsel’s direction have prepared, gathered or annotated”: Hubbard, Magotiaux, and Duncan, The Law of Privilege in Canada (Aurora: Canada Law Book, looseleaf) (“Hubbard”) at 12-3.

Thus the “dominant purpose” test means that communications and documents prepared, gathered or annotated for the dominant purpose of either ongoing or anticipated litigation will be subject 32 Claims Canada

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to litigation privilege: Blank v Canada (Minister of Justice), [2006] 2 SCR 319 (SCC) at para. 60.

The following elements are generally required to establish litigation privilege over communications or documents: • Documents or communications must be prepared, gathered or annotated by counsel or persons under counsel’s direction; • Any preparation, gathering and annotating must be done in anticipation of litigation; • Communications or documents must meet the dominant purpose test; • Documents and facts contained in the documents need not be disclosed; and • Documents and facts have not been disclosed to the opposing party or the court: Hubbard at 12-3 – 12-4.

It is not necessary for communications to be made by or to a lawyer for litigation privilege to apply. However, Hubbard notes: “the onus of claiming privilege is unlikely to be satisfied by solely asserting that the document was prepared for the dominant purpose of pending or contemplated litigation. There must be some connection between the communication over which privilege is claimed and legal counsel” [Emphasis added]: Hubbard at 12-50.10.

The case of Moseley v Spray Lakes Sawmills (1980) Ltd. illustrates this point.

Moseley involved a motor vehicle accident in which a plaintiff was seriously injured.

The defendant’s insurance company sent an adjuster to interview the defendant and conduct an investigation into the accident to decide if there was a possible liability claim against the defendant company. The adjuster prepared a report and gave it to the insurance company. The insurance company then closed its file before the plaintiff brought his lawsuit; the insurance company did not contact its lawyer prior to closing the file.

During the course of litigation, the plaintiff applied for production of the

December/January 2014

driver’s statement given to the adjuster.

The Court of Appeal held that the statement was not subject to litigation privilege, noting at para. 24: The key is, and has been since this Court adopted the dominant purpose test in Nova, that statements and documents will only fall within the protection of the litigation privilege where the dominant purpose for their creation was, at the time they were made, for use in contemplated or pending litigation. While a lawsuit need not have been initiated, and while a lawyer need not have been retained at the time the statement or document was made, the party claiming privilege must establish that at the time of creation the dominant purpose was use in litigation. The words “by reason of an intention to provide information to solicitors” are not superfluous. The test is a strict one. As has often been stated, it is not enough that contemplated litigation is one of the purposes. So litigation privilege will not automatically apply to statements taken or reports made by insurance adjusters investigating serious personal injury accidents. The converse, however, is also not true. It will not automatically fail to apply in such circumstances, as suggested by the appellant.

The Court of Appeal also noted the importance of the connection between privileged documents or information and legal counsel. Litigation privilege is “intended to permit a party to freely investigate the facts at issue and determine the optimum manner in which to prepare and present the case for litigation. As a rule, this preparation will be orchestrated by a lawyer, though in some cases parties themselves will initiate certain investigations with a view to providing information for the “lawyer’s brief””: at para. 21.

Clearly, there is no blanket statement that adjusters’ files as a whole are protected or not protected by litigation privilege.

Each document in an adjuster’s file will www.claimscanada.ca

13-12-06 1:54 PM

have to be subjected to the “dominant purpose” test: Hosanna Enterprises Ltd. v Laser City Audio Video Ltd. (1999), 8 ACWS (3d) 359 (BCSC). Some documents will be privileged and some will not. Documents created with the dominant purpose of determining and adjusting a loss will not be privileged: Ferris v Shell Canada, 2000 CarswellOnt 2886 (ON SCJ). Documents created for the dominant purpose of ongoing or anticipated litigation will be privileged.

What does an insurer or adjuster have to do to establish the “dominant purpose” test? It may not be enough for a party to simply say or depose, “this document was created for the dominant purpose of ongoing or current litigation”, if there is an equally likely explanation that the document was created for some other purpose.

Courts instead will look at all of the facts surrounding the creation of the document and determine the application of the privilege on a case-by-case basis. For example, Courts may look at the way the party claiming privilege treated the document or statement prior to the request for production: Semkiw v Wilkosz (2009), 178 ACWS (3d) 333 (BCSC). Was the document available for anyone to look at or was it kept confidential? Courts may also look at whether the document was created because of a usual policy or practice of a party. For example, if incident reports are regularly completed after incidents on a premises, these reports may not be privileged because they are made as a matter of course: Fred v Westfair Foods Ltd, 2003 YKSC 39 (YK SC).

In conclusion, the “dominant purpose” test is used by Courts in most provinces to determine whether the contents of an adjuster’s file will be privileged or not. In a recent case out of the Ontario Superior Court of Justice, a judge appeared to move away from the “dominant purpose” and factspecific test when he determined that in third-party or tort claims (as opposed to claims of an insured against his or her own insurer) there is no preliminary investigative phase where privilege does not attach to the adjuster’s notes, files and reports. In these types of cases privilege attaches to the entire adjuster’s file because litigation is always contemplated: Panetta v. Retrocom Mid-Market www.claimscanada.ca

p32-33 BROWNLEE.indd 33

Real Estate Investment Trust, 2013 ONSC 2386 (ON SC).

It will be interesting to see if this case is appealed and if so, what a higher court would say about this decision, particularly since it seems to run contrary to the “dominant purpose” test applied on a case-by-case basis. That said, it is imperative for adjusters, in undertaking their duties and dealing with insurers and insureds, to be mindful of the test

for privilege and take appropriate steps to maintain privilege, where possible and appropriate. That may include involving counsel at a very early stage, even if only to ensure that privilege can be established and maintained.  Ryan Ewasiuk is partner with Brownlee LLP with over 15 years of experience on a vast array of litigation matters, including large and complex insurance claims.

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CIAA REGIONAL PRESIDENTS 2013 – 2014 NEWFOUNDLAND & LABRADOR TBA 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 Claude Nadeau Cunningham Lindsey Canada Claims Services Ltd. 1250 Guy Street, #1000 Montreal, QC H3H 2T4 Phone: (514) 939-1570 Fax: (514) 938-5445 E-mail: cnadeau@cl-na.com

MANITOBA Timothy W. Bromley J.P. Hamilton Adjusters Ltd. 125 Enfield Crescent Winnipeg, MB R2H 1A8 Phone: (204) 944-1057 Fax: (204) 944-1606 E-mail: tbromley@mts.net SASKATCHEWAN Cheryl Hanson Crawford & Company (Canada) Inc. 210 – 227 Primrose Drive Saskatoon, SK S7K 5E4 Phone: (306) 931-1999 Fax: (306) 931-2212 E-mail: Cheryl.Hanson@crawco.ca WESTERN Russell Fitzgerald, CIP Kernaghan Adjusters Limited 203 – 4246 97 Street N.W. Edmonton, AB T6E 5Z9 Phone: (780) 488-2371 Fax: (780) 488-0243 E-mail: rfitzgerald@kernaghan.com PACIFIC David Porter, LL.B., FCIP, CRM Granite Claims Solutions 400 - 4370 Dominion Street Burnaby, BC V5G 4L7 Phone: (604) 659-6559 Fax: (604) 659-6570 E-mail: david.porter@graniteclaims.com

p34 CIAA NSC.indd 34

ADVISORY David Porter, LL.B., FCIP, CRM Granite Claims Solutions 400 – 4370 Dominion Street Burnaby, BC V5G 4L7 Phone: (604) 659-6559 Fax: (604) 659-6570 E-mail: david.porter@graniteclaims.com Albert Poon, CIP Cunningham Lindsey Canada Claims Services Ltd. 1102 – 50 Burnhamthorpe Rd. W. Mississauga, ON L5B 3C2 Phone: (905) 896-8181 Fax: (905) 896-3485 E-mail: apoon@cl-na.com John D. Seyler, CIP ProFormance Group Inc. 5080 Timberlea Blvd., Suite 214 Mississauga, ON L4W 4M2 Phone: (905) 238-4985 Fax: (905) 238-2735 E-mail: jseyler@prospecialty.ca James B. Eso, CIP, CIOP Crawford & Company (Canada) Inc. 539 Riverbend Drive Kitchener, ON N2K 3S3 Phone: (519) 578-5540 Fax: (519) 578-2868 E-mail: Jim.Eso@crawco.ca 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

ONTARIO Dorothy Lowry, FCIP Crawford & Company (Canada) Inc. 15 - 431 Bayview Drive Barrie, ON L4N 8Y2 Phone: (705) 728-5597 Fax: (705) 728-2167 E-mail: Dorothy.Lowry@crawco.ca

34 Claims Canada

National Standing Committees 2013-2014

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 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 David Porter, LL.B., FCIP, CRM Granite Claims Solutions 400 – 4370 Dominion Street Burnaby, BC V5G 4L7 Phone: (604) 699-6550 Fax: (604) 659-6570 E-mail: david.porter@graniteclaims.com John D. Seyler, CIP ProFormance Group Inc. 5080 Timberlea Blvd., Suite 214 Mississauga, ON L4W 4M2 Phone: (905) 238-4985 Fax: (905) 238-2735 E-mail: jseyler@prospecialty.ca Patricia M. Battle Canadian Independent Adjusters’ Association/L’Association Canadienne des Experts Indépendants Centennial Centre, 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 James B. Eso, CIP, CIOP Crawford & Company (Canada) Inc. 539 Riverbend Drive Kitchener, ON N2K 3S3 Phone: (519) 578-5540 Fax: (519) 578-2868 E-mail: Jim.Eso@crawco.ca

December/January 2014

Laurie Walker, CIP Granite Claims Solutions 5915 Airport Road, Suite 300 Mississauga, ON L4V 1T1 Phone: (905) 740-1784 Fax: (905) 671-1889 E-mail: laurie.walker@graniteclaims.com Albert Poon, CIP Cunningham Lindsey Canada Claims Services Ltd. 1102 - 50 Burnhamthorpe Rd. W. Mississauga, ON L5B 3C2 Phone: (905) 896-8181 Fax: (905) 896-3485 E-mail: apoon@cl-na.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 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 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 Paul Hicks, FCIP, CRM TD Insurance 2161 Yonge Street, 4th Floor Toronto, ON M4S 3A6 Phone: (416) 486-2507 Fax: (416) 545-6022 E-mail: Paul.Hicks@tdinsurance.com

CONVENTION Matt Allan, CIP, CRM Granite Claims Solutions Suite 300, 5915 Airport Road Mississauga, ON L4V 1T1 Phone: (905) 671-3164 Fax: (905) 671-1889 E-mail: matt.allan@graniteclaims.com

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

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

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

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

NOMINATING John D. Seyler, CIP ProFormance Group Inc. 5080 Timberlea Blvd., Suite 214 Mississauga, ON L4W 4M2 Phone: (905) 238-4985 Fax: (905) 238-2735 E-mail: jseyler@prospecialty.ca

Robert V. Pearson, CLA, FCIAA Hansen Labelle Adjusters Ltd. 1328 17th Avenue N.W. Calgary, AB T2M 0R1 Phone: (403) 284-2211 Fax: (403) 284-2299 E-mail: bob@hansenlabelle.ca EDITORIAL Mary Charman, CIP Crawford & Company (Canada) Inc. 1 – 120 Mulock Dr. Newmarket, ON L3Y 7C5 Phone: (905) 898-0008 Fax: (905) 898-1705 E-mail: Mary.Charman@crawco.ca John M. Sharoun, FCIP, FCIAA, CRM Crawford & Company (Canada) Inc. 300 – 123 Front Street West Toronto, ON M5J 2M2 Phone: (416) 867-1188 Fax: (416) 867-1925 E-mail: John.Sharoun@crawco.ca

Justin MacGregor Past President Insurance Brokers Association of Canada EDUCATION Phone : (416) 859-4567 Gary Ellis, BBA, FCIP, RF, FCLA, FCIAA Mark Stewardson, FCIP AMG Claims Inc. Royal & Sun Alliance 535 North River Road, Unit 3 2225 Erin Mills Parkway, Suite 1000 Charlottetown, PE C1E 1J6 Mississauga, ON L5K 2S9 Phone: (902) 628-9091 Phone: (905) 403-2333 Fax: (902) 628-9093 Fax: (905) 403-2326 E-mail: gary.ellis@amgclaims.ca E-mail: EMERGENCY MEASURES Mark.Stewardson@rsagroup.ca Richard Van Horne Action Investigations Inc. Mark Weir 2 Catelina Court Intact Financial Corporation Dartmouth, NS B2X 3G9 700 University Avenue, 13th Floor Phone: (902) 462- 1222 Toronto, ON M5G 0A1 Fax: (902) 462-3688 Phone: (416) 341-1464 E-mail: Fax: (416) 217-0562 richardvanhorne@actioninvestigations.ca E-mail: mark.weir@intact.net Beth Bull ACE INA Insurance 1400 – 25 York Street Toronto, ON M5J 2V5 Phone: (416) 594-3067 Fax: (416) 368-0641 E-mail: beth.bull@acegroup.com Alex Walker, CIP Royal & Sun Alliance 2225 Erin Mills Parkway, Suite 1000 Mississauga, ON L5K 2S9 Phone: (905) 412-1397 Fax: (905) 403-2328 E-mail: Alex.Walker@rsagroup.ca 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 TBA 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

FINANCE Russell Fitzgerald, CIP Kernaghan Adjusters Limited 203 – 4246 97 Street N.W. Edmonton, AB T6E 5Z9 Phone: (780) 488-2371 Fax: (780) 488-0243 E-mail: rfitzgerald@kernaghan.com

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 James B. Eso, CIP, CIOP Crawford & Company (Canada) Inc. 539 Riverbend Drive Kitchener, ON N2K 3S3 Phone: (519) 578-5540 Fax: (519) 578-2868 E-mail: Jim.Eso@crawco.ca Craig J. Walker, CIP, FCIAA, FIFAA Maltman Group International 3550 Victoria Park Ave., Suite 301 Toronto, ON M2H 2N5 Phone: (416) 492-4411 Fax: (416) 492-5657 E-mail: cwalker@maltmans.com PRIVACY James B. Eso, CIP, CIOP Crawford & Company (Canada) Inc. 539 Riverbend Drive Kitchener, ON N2K 3S3 Phone: (519) 578-5540 Fax: (519) 578-2868 E-mail: Jim.Eso@crawco.ca Keith P. Edwards, FCILA, CLA, FUEDI-ELAE 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 PROFESSIONAL PRACTICES John D. Seyler, CIP ProFormance Group Inc. 5080 Timberlea Blvd., Suite 214 Mississauga, ON L4W 4M2 Phone: (905) 238-4985 Fax: (905) 238-2735 E-mail: jseyler@prospecialty.ca

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 John D. Seyler, CIP ProFormance Group Inc. 5080 Timberlea Blvd., Suite 214 Mississauga, ON L4W 4M2 Phone: (905) 238-4985 Fax: (905) 238-2735 E-mail: jseyler@prospecialty.ca 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

www.claimscanada.ca

13-12-06 1:57 PM

Canadian Insurance Claims Managers’ Association / Canadian Independent Adjusters’ Association United & Committed Leadership through - Education • Professionalism • Communication

CICMA/CIAA Ontario Chapters’ 47th Annual Joint Conference

Technology

Supporting Claims…

It’s in the Clouds

Tuesday, February 4, 2014 Metro Toronto Convention Centre, Toronto, Ontario Registration 8:00 a.m. • Seminar 8:45 a.m.

Reception and Lunch 12:00 p.m.

Carol Kreiling, VP, Swiss Re Steve Dubenow, National SIU Manager, CKR Global Jamie Blundell, SVP Business Development, CarProof Reporting on Big Trends and Predictions including: Technology Support for Claims Investigation; Data Mining; Cyber Risks and Efficiencies Gained/Lost

Keynote Speaker:

Amber MacArthur, Relentless Adaptation Speaker, Consultant, TV Host and bestselling Author.

Luncheon Guest Speaker:

Simon Cotter, Corporate Comedian

CICMA

DELEGATE REGISTRATION FEE:

Price: $195.00 — CIAA/CICMA Members Price: $225.00 — Non Members Register early - Space is limited Tickets will not be sold at the door.

RETURN WITH CHEQUE PAYABLE TO CICMA/CIAA JOINT CONFERENCE to: Jane Rogers, Crawford & Company, 155 Cheryl Lynn Street, Mount Forest, ON N0G 2L2 (ICS registered address)

CICMA/CIAA ad DEC 2013.indd 1

NAME: __________________________________________________ COMPANY: ______________________________________________ ADDRESS: ______________________________________________ CITY: ___________________________ POSTAL CODE:____________ E-MAIL:_________________________________________________ PHONE: _________________________________________________ FAX:____________________________________________________ Please indicate affiliation: CICMA ❏ CIAA ❏ OTHER ❏

13-11-27 2:58 PM

Defining the

Limitation Period

In Ontario, the application of limitation periods for commercial policies is tested.

BY MITCH KITAGAWA

In May 2013, the Ontario Court of Appeal upheld a contractual one-year limitation period in a commercial property policy. The Co-operators denied the claim and when the plaintiffs brought an action against the insurer, it was struck out because it was commenced beyond the one-year mark as specified in their policy, but before the two-year limitation period as set out in the Limitations Act, 2002. In October 2013, the Supreme Court of Canada denied leave to appeal. Â This decision has important ramifications for insurers writing commercial insurance policies. While the Ontario limitations act provides two years from the date of the loss for actions to be commenced, this ruling allows insurers to rely on an exception in the Act, which permits businesses to contract out of the statutory limitation period. (Note of disclosure: The Co-operators was represented by the author throughout the proceedings).

Background The Insurance Act (R.S.O. 1990 c.

I.8) of Ontario has, for a very long time, contained within it a one-year limitation period for an insured to commence an action against their insurer for a claim on the policy. It can be found in s. 148 of the Act, which contains the statutory conditions in the Fire Insurance (also known as Part IV) section. The original Act was drafted at a time when one would buy separate policies for different perils, such as fire.

Today, most insureds purchase multi-peril policies. The Insurance Act states that all policies in Ontario are deemed to include these statutory conditions.

In a case known as International Movie Conversions Ltd. v. ITT Hartford Canada (ONCA 23581, CanLII), the Ontario Court of Appeal affirmed in 2002 that the statutory conditions could be included in a multi-peril policy. In order to do so, the 36 Claims Canada

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policy must have some contractual language stating that the statutory conditions apply to all of the perils in the policy. The appeal court noted that while the statutory conditions are said in the Act to apply to fire insurance, it did not preclude the insurer from including them in policies for other perils.

In an unrelated 2003 case from British Columbia, known as KP Pacific Holdings v. Guardian Insurance Co of Canada, the Supreme Court of Canada found that the statutory condition limitation only applied to fire policies, not multi-peril policies. However, it did not comment on contracting out of any other limitation period, as that question was not put before the court.

Limitations Act, 2002 On January 1, 2004, the Limitations Act, 2002 of Ontario came into force, which, but for some scheduled exceptions, made the general limitation period for commencing most actions two years from the date of the loss. The statutory condition in the Insurance Act was one of the scheduled exceptions; however, due to the KP Holdings decision, it only related to fire policies.

As a result, some insurers changed their commercial property policies to reflect a two-year limitation period and others left their policy as it was, but simply treated the policy as though it contained a twoyear limitation period.

In 2006, the Ontario Legislature amended the Limitations Act, 2002 to allow businesses to contract out of the limitation period by adding section 22(5) and (6). To put it simply, as of October 19, 2006, businesses could contractually alter the length of the limitation period. However, this had not yet been applied by the courts to commercial multi-peril policies until the case of Boyce v. The Co-Operators

Boyce v The Co-Operators The Boyces owned a clothing store business known as Portside Boutique,

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which was insured with a multi-peril property policy with The Co-operators. The policy was renewed on a yearly basis. On October 30, 2010, Marilyn Boyce arrived at the store in the morning and discovered a strong odour. The Boyces contacted The Co-operators to complain that a skunklike smell had destroyed their inventory.

They alleged that the smell may have been caused by vandalism, as it was the day before Halloween.

The Co-operators advised the plaintiffs that there may not be coverage for the loss.

It wrote to Ms. Boyce to let her know that there was no coverage and that should she wish to commence a claim that it must be commenced within one year of the date of the loss. The Boyces then commenced their action on February 17, 2012; more than one year, but less than two years after the date of the loss.

The Motion for Summary Judgment The Co-operators brought a summary judgment motion (Boyce v. Co-Operators General Insurance, 2012 ONSC 6381 CanLII) before Superior Court Justice Quigley to dismiss the action, as the limitation period had expired. It argued that the business agreement exception to the Limitation Act, 2002 applied, as the parties had contracted out of the two-year limitation period.

Justice Quigley dismissed the motion by relying on the case of Bell Canada v.

Plan Group Inc. (2012 ONSC 42 CanLII) and finding that in order to rely on s. 22 of the Limitation Act, 2002, a business agreement must contain four things: 1) A specific reference to the statutory limitation period; 2) Clear and unequivocal language that the parties are intending to vary the application of the statutory protection contained in the applicable limitation period; 3) Provisions which clearly alert the prospective claimant that they are foregoing a statutory right to a longer limiwww.claimscanada.ca

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tation period within which to make a claim; and 4) Any variation of the limitation period should be accompanied by a signed acknowledgment by the insured of the waiving of such an important right.

The Honourable Justice also found that the term “statutory condition” could be misleading because an insured could be led to believe that the conditions were actually mandated by statute when they were simply a term of the contract.

Finally, he disagreed that the policy was a business agreement as defined by s. 22(6) of the Limitations Act, 2002 on two bases.

The first was because the insurance policy was a “Peace of Mind” contract and the second was because the Consumer Protection Act, 2002 does not deal with contracts of insurance and instead defers to the Insurance Act.

The Ontario Court of Appeal The motion decision was appealed to the Ontario Court of Appeal (2013 ONCA 298 CanLII). The appeal court first dispensed with the suggestion by Justice Quigley that the term “statutory condi-

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tion” was misleading by referring to International Movie Conversions Ltd., which found that the term was not misleading and that the limitation period in the policy was clear and unambiguous.

As for the contractual limitation period, the appeal court found that s. 22 of the Limitation Act, 2002 did not require the four indicia of the variance of a limitation period as set out by the Hon. Quigley, J. in the motion decision. It found that: A court faced with a contractual term that purports to shorten a statutory limitation period must consider whether that provision in “clear language” describes a limitation period, identifies the scope of the application of that limitation period, and excludes the operation of other limitation periods. A term in a contract which meets those requirements will be sufficient for s. 22 purposes, assuming, of course, it meets any of the other requirements specifically identified in s.

22.

Finally, the Court of Appeal found that while insurance contracts may be “Peace of Mind” contracts, this does not mean that they cannot also be business agreements.

It also wrote that the scope of the Consumer Protection Act, 2002 was irrelevant and that the legislature used the definition of “consumer” in the act in order to draw a bright line between activities performed on behalf of individuals, families or households, as opposed to businesses.

The Court of Appeal allowed the appeal and reversed the motion decision, thereby dismissing the claims made on the policy. The plaintiffs sought leave to appeal to the Supreme Court of Canada and this too was dismissed (Thomas Boyce, et al. v. Co-Operators General Insurance Company, 2013, CanLII 65411, SCC).

Currently in Ontario, if a commercial property policy has contractual language, which makes it clear that the statutory conditions apply to all of the perils outlined in the policy, the limitation period is one year.  Mitch Kitagawa is a partner with Kelly Santini LLP. He focuses on the defence of property, personal injury, casualty and professional negligence matters, as well as prosecuting subrogated claims on behalf of insurers.

December/January 2014

Claims Canada 37

13-12-06 2:04 PM

A Day in the

Life

Can today’s claims adjuster find a balance between work and personal life?

BY DEBORAH CROWE

Work. Life. Balance. What a nice ring to it. Sure we all want it. So how do we get it then? Further, when we do get it how can we possible sustain it?

In the world of insurance it’s apparent that claims are on the rise. Mother Nature, catastrophic events and ongoing legislative changes have led the world of claim adjusting into a new realm.

Adjusters have unrelenting demands and pressures.

Ironically, long period of stress could result in short and long-term disability claims for the individuals on the front lines of insurance adjusting.

So, let’s turn the table on the risk management world.

Is it not a risk to put this type of pressure on those who work within the risk management/insurance industry? It is not healthy on any level (physical/emotional/psychological/emotional) to live at this level of stress or let’s call it hypervigilance.

After an average eight-hour workday (which is not average for most adjusters), how can you drop from the level of hypervigilance to live a ‘normal’ balanced lifestyle? It’s not impossible, but it comes from a place of pure 100% effort.

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December/January 2014

It doesn’t matter what type of claims you are handling.

Behind the claim number is a human attachment. If you add in the level of technology that our world now lives and breathes, it’s no wonder there are people struggling with work-life balance. Look at how we communicate now, Cell phones, emails, and text messages, Facebook, Twitter, Linked In and Skype. The list is endless, lengthy and growing rapidly on a daily basis - new innovation to communicate. Literally, no one has to pick the phone up and call someone; they can relay their message in a non-verbal fashion on a screen. This is a great facet in the risk management world – documentation!

In Canada alone, we send 270 million text messages daily, yes, daily. Isn’t that a scary thought?

You have to take those transferrable skills of time and organizational management and put them into your daily life to balance out all elements in your life – family, career, health and friends. It is possible. Effort is the key here along with the ability to look at it as a simplistic task in your everyday challenge to balance yourself.

The definition of work-life balance is being able to separate work and personal life in order to handle stress, feel happier and get along better with everyone (colleagues and family/friends). This is a daunting task if your cell phone is www.claimscanada.ca

13-12-06 2:06 PM

© 2013. RSA is a registered trade name of Royal & Sun Alliance Insurance Company of Canada. “RSA” and the RSA logo are trademarks used under license from RSA Insurance Group plc.

24/7 365

OUR CLAIMS SERVICE TEAM IS ALWAYS AVAILABLE. RSA Insurance’s Canada-based Claims team is committed to assisting your clients immediately, wherever and whenever they need us. From our mobile response vehicles and guidance and counselling services to our Fast Track claims and preferred recovery and repair suppliers, our dedicated, compassionate team has the resources your clients need to keep moving forward. It’s all part of the RSA Advantage.

We stand behind the facts. We stand behind our brokers. rsabroker.ca Personal Insurance

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Commercial Insurance

Global Specialty Lines

2013-10-31 11:55 AM 13-12-03 6:07 PM

Why do people wait until they receive a diagnosis supplied by your employer and you use it for both work and personal. All of your emails for both aspects of your life com- with a not so welcoming prognosis? What has happened ing on one device – is this positive or negative? Some may to planning, organizing, thinking and being preventative – also known as work-life balview this as extreme organization and ance? handy, yet others may find it intrusive.

Consider the simplicity of taking When we look at where we have the time to learn a new way to think come from to where we are today it before you can change your lifestyle is no wonder we are struggling with (see attached tips). Work-life balwork-life balance. Changing technolance is not achieved overnight. Like a ogy and evolving demands of different claim, a baseline must be established generations put enormous pressure on before you can observe and see the how we achieve, maintain and sustain changes. work-life balance.

So, don’t take the old adage been If we are presented with a life-threatthere, done that, issued a claim numening scenario, our lives stop. We think ber, got the t-shirt. Be pro-active and of nothing else. A good example of this is a diagnosis of cancer. If you were exercise the right to take control of Changing given this terrible news but were told your life on all accounts – personal that the ‘magic’ pill was $100,000.00 and work. You cannot issue a claim technology and and you were cured. Where would your number on a life that cannot be lived evolving demands mindset take you? The only thing on anymore.  of different generations your mind would be to call the bank or family and do what you have to do.

Deb Crowe is a work-life-balance put enormous pressure Buy that magic pill. Problem solved. specialist. She works as a professional on how we achieve, Now, if it were only that easy. My point speaker & coach within the insurmaintain and sustain is that life would stop because of your ance and corporate sectors. She can be mindset. You would do what you had reached at (519) 878-5839 and at www. work-life balance. to do – period. mamadeb.com.

Balance Tips • Track your time. Pay attention to your daily tasks, including work-related and personal activities. Decide what’s necessary and cut or delegate activities you don’t enjoy or can’t handle — or share your concerns and possible solutions with your employer or others.

• Take advantage of your options. Ask your employer about flex hours, a compressed workweek, job sharing, telecommuting or other scheduling flexibility.

• Learn to say no. Whether it’s a co-worker asking you to spearhead an extra project or your child’s teacher asking you to organize a class party, remember that it’s OK to respectfully say no.

• Bolster your support system. At work, join forces with co-workers who can cover for you — and vice versa — when family conflicts arise. At home, enlist trusted friends and loved ones to pitch in with child care or household responsibilities when you need to work overtime or travel.

• Nurture yourself. Eat a healthy diet, include physical activity in your daily routine and get enough sleep. Set aside time each day for an activity that you enjoy.

Source: The Mayo Clinic

• Leave work at work. With the technology to connect to anyone at any time from virtually anywhere, there might be no boundary between work and home — unless you create it. Make a conscious decision to separate work time from personal time.

• Manage your time. Organize household tasks efficiently, such as running errands in batches or doing a load of laundry every day, rather than saving it all for your day off.

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December/January 2014

www.claimscanada.ca

13-12-06 2:06 PM

Your Insurance Digital Newsstand is now Mobile: NO APP REQUIRED

1 of 68

iPad/iPhone/Android users - go to the links below and select Digital Edition of the magazine of choice:

Publications with Digital Editions:

Claims Canada: http://bit.ly/CCarchives [case sensitive, capitalize CC only] Canadian Underwriter: http://bit.ly/CUarchives [case sensitive, capitalize CU only] Within Digital Edition, to flip through the pages, simply swipe or tap at the right or left side of the screen. Scroll through multiple pages by ‘dragging the page number indicator’ at the bottom of the screen to the left or right.

.ca

Via Computer: As always, everyone can view the Digital Edition of each issue of Canadian Underwriter magazine (including the Annual Statistical Issue and the Insurance Marketer) and Claims Canada magazine – simply visit the above links!

CU Digital Edition PROMO.indd 1

13-10-16 10:45 AM

The Value of

Accreditation

Adjusters searching for quality health care providers can look to standards established by an international commission, known as CARF.

BY GAYE SYDENHAM

A

ccreditation is a process in which certification of competency, authority or credibility is evaluated against official standards. Organizations seek accreditation to provide objective evidence that they meet or exceed industry recognized quality standards to those who seek their goods and services. Accreditation processes are used in a variety of fields, and are administered by a variety of accreditation bodies that are recognized as authorities in their field.

When evaluating the relevance of an organization’s accreditation claims, one must consider the focus of the accrediting body. For example, the International Organization for Standardization (ISO) is a well-known, worldwide organization that has a wide variety of accreditation standards covering almost all aspects of technology and business. A search of the ISO Standards Catalogue using the search word “healthcare” returns 53 standards, all of which apply generalized standards to specific components of a healthcare business, such as Data Exchange standards, Medical Electrical Equipment standards, or ergonomics standards. A search in this catalogue using the search word “Medical Assessment” or “Insurer’s Examination” returns “no matching results”.

If you were looking for a company to provide high quality healthcare or insurer’s examinations, there are accreditation organizations that will provide a much more comprehensive and integrated measurement of a company in this field.

Who is CARF? According to its web site, the Commission on Accreditation of Rehabilitation Facilities (CARF) was founded in 1968.

CARF International is an independent, nonprofit accreditor of health and human services. The CARF family of organizations currently accredits close to 50,000 programs and services at more than 22,000 locations. More than eight million 42 Claims Canada

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persons of all ages are served annually by more than 6,500 CARF-accredited service providers. CARF accreditation extends to countries in North and South America, Europe, Asia, and Africa.

CARF International accreditation provides a visible symbol that assures the public of a provider’s commitment to continually enhance the quality of health and human services and programs. CARF surveyors use a consultative approach during the survey process. Each survey team is selected based upon a match of the surveyors’ areas of expertise and the organization’s unique needs. Service providers earning CARF accreditation are recognized for their ongoing innovation and continued conformance to the standards.

CARF’s roots and primary focus started with rehabilitation and grew within the health care treatment industry. In the 40 years that CARF has been in existence, the Independent Examination Service has emerged within the medical community, providing independent medical opinions to the insurance industry, Workers Compensation Boards, employers and other stakeholders. Stakeholders have expressed need for an accreditation process for this sector of medical services for quite some time, In September 2011, CARF met this need by convening an International Standards Advisory Committee (ISAC) to develop CARF’s first set of standards for Independent Evaluation Services. This ISAC included representatives from Independent Medical Examination (IME) companies, the Financial Services Commission of Ontario (FSCO), Insurance companies, the CARF Surveyor Roster and CARF Resource Specialists.

The Independent Evaluation Services program standards focus on evaluating an assessment company’s practices to coordinate and facilitate objective, unbiased evaluations based on the following:

December/January 2014

• Individualized referral questions.

• Effective and efficient use of resources.

• Regulatory, legislative, and financial implications.

• Relevant communication with stakeholders.

In view of the multiple stakeholders involved, the Independent Evaluation Services standards require that the company supports transparency and exchange of information. As of August 14, 2013 only three organizations worldwide have achieved accreditation for this new program; one in each of Canada, England and the USA.

CARF Accreditation Process The CARF accreditation process starts with a provider’s commitment to continuous improvement and culminates with external review and recognition that the provider’s business and service practices meet international standards of quality -- with all the steps in between focused on optimal outcomes for the persons the provider serves. The core CARF standards have been developed over 40 plus years by international teams of service providers, policy makers, payers, family members, and consumers. The standards have also been submitted to the public for review to validate relevancy and ensure input from all interested stakeholders.

After a service provider commits to accreditation, the accreditation process begins with a thorough self-evaluation that applies the relevant CARF standards against the organization’s practices. Once the organization is in conformance to the standards, a request for a CARF survey is submitted at least three full months in advance of the desired date for an on-site survey. By the date of the survey, the provider should be in conformance with the standards for at least six months.

The survey team comprises industry peers who follow a consultative (rather www.claimscanada.ca

13-12-06 2:12 PM

than an inspective) approach in conducting the on-site survey. In addition to interviews of staff, persons served and their families, the surveyors observe organizational practices, review appropriate documentation, answer questions, and suggest ways to improve the provider’s operations and service delivery.

Following completion of the survey, CARF renders an accreditation decision and delivers a report that identifies the service provider’s strengths and areas for improvement and its level of demonstrated conformance to the standards.

To demonstrate its ongoing conformance to the CARF standards, an accredited provider completes a Quality Improvement Plan after receiving the survey report and submits an Annual Conformance to Quality Report each year throughout the accreditation term.

An organization may be functioning between the level of a Three-Year Accreditation and that of a One-Year Accreditation. In this instance, accreditation will be awarded for one year. An organization will not be awarded a second consecutive OneYear Accreditation.

Non-accreditation. The organization has major deficiencies in several areas of the standards; there are serious questions as to the benefits of services or the health, welfare, or safety of those served; the or-

ganization has failed over time to bring itself into substantial conformance to the standards; or the organization has failed to satisfy one or more of the CARF Accreditation Conditions.  Gaye Sydenham is vice president of accreditation & professional development for Centric Health, a health care company with a complete range of innovative and wholelife solutions centred on patients and health care providers (www.centrichealth.ca).

Accreditation Decisions To be accredited by CARF, an organization must satisfy each of the CARF Accreditation Conditions and demonstrate through a site survey that it meets the standards established by CARF. The number of surveyors and the length of time it takes to undergo the site survey depends on the size of the organization being surveyed and the type and complexity of programs being evaluated. A typical survey is conducted by 2 surveyors over the course of 2 to 3 days. he accreditation decision will be based on the balance of its strengths with those areas in which it needs improvement.

CARF uses the following guidelines to determine each accreditation decision.

Three-Year Accreditation. The organization satisfies each of the CARF Accreditation Conditions and demonstrates substantial conformance to the standards. It is designed and operated to benefit the persons served.

Its current method of operation appears likely to be maintained and/or improved in the foreseeable future. The organization demonstrates ongoing quality improvement and continuous conformance from any previous period of CARF accreditation.

One-Year Accreditation. The organization satisfies each of the CARF Accreditation Conditions and demonstrates conformance to many of the standards. Although there are significant areas of deficiency in relation to the standards, there is evidence of the organization’s capability to correct the deficiencies and commitment to progress toward their correction. On balance, the services benefit those served, and the organization appears to protect their health, welfare, and safety. www.claimscanada.ca

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13-12-06 2:13 PM

No Vacancy?

How one case addressed the issue of reduced occupancy and material change.

BY MARK SKORAH

On November 1, 2013 in Peebles v. The Wawanesa Mutual Insurance Company, 2013 BCCA 479, the British Columbia Court of Appeal allowed the insureds’ appeal from the trial judge’s order dismissing their claim. This article will give a short review of the case and highlight some of the issues it raises.

The two insureds, Peebles and Quinn, bought a house in Surrey, BC on July 1, 2006 as an investment. They insured it starting June 29, 2006 and renewed that policy of insurance on June 29, 2007. It was that policy which was in force when the house was destroyed by explosion and fire on April 26, 2008.

Peebles never lived in the house, but resided nearby and would drive by a few times a week and drop in occasionally to inspect his investment. Quinn did live there from the summer of 2006 to late 2007. At that time, he began spending more time at his girlfriend’s house as she was uneasy with Peebles’ unexpected drop-ins.

Due to friction and rising real estate prices, in late 2007 Peebles and Quinn decided to sell the property. Beginning in February 2008, Quinn’s job took him to the Northwest Territories for three weeks of each month. He was away from February 7 to 27, March 4 to 26, and April 1 to 23. During his time in Surrey, he was often with his girlfriend except at points at which their volatile relationship caused him to spend the night at the property in question. In the 30 days before the fire, he was at the house overnight for one night.

During that time, he also redirected his cell phone bill to the home of his girlfriend and his tax information was also sent there. When the loss occurred, the insurer denied the claim because 44 Claims Canada

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the house was vacant and there was a material change in risk.

The term vacant was defined as follows in the policy: “’Vacant’ refers to the circumstances where, regardless of the presence of furnishings: all occupants have moved out with no intention of returning and no new occupant has taken up residence; or in the case of a newly constructed house, no occupant has yet taken up residence.”

Statutory Condition 4, prescribed by the Insurance Act, RSBC 1996, c. 226 was also argued. It states: “Material change is… any change material to the risk and within the control and knowledge of the insured voids the contract as to the part affected by the change, unless the change is promptly notified in writing to the insurer or its local agent, and the insurer when so notified may return the unearned portion, if any, of the premium paid and cancel the contract, or may notify the insured in writing that, if the insured desires the contract to continue in force, the insured must, within 15 days of the receipt of the notice, pay to the insurer an additional premium; and in default of such payment the contract is no longer in force and the insurer must return the unearned portion, if any, of the premium paid.”

The trial judge found that vacancy had not been proved, as Quinn had not permanently moved out. However, the trial judge went on to deal with the question of material change and found that the failure by the insured to tell the insurer of “the material change in the risk arising out of the tenuous occupancy ... justified the insurer in voiding coverage pursuant to Statutory Condition 4.”

At the trial, there was evidence from two underwriters. Mr. Grass, a senior

December/January 2014

underwriting manager with Wawanesa, said that had the facts been known (and he worked from assumed facts), then he would have changed the policy from all risks to fire and extended perils. In addition, the policy wouldn’t have been guaranteed replacement cost and exclusions would have been added, all with a 36% premium increase.

Bev Johnson, a senior personal lines underwriter, had her opinion admitted by consent without cross-examination.

She agreed with Grass’ view of materiality and also said that occupancy is material to underwriters for both issuance of the policy and premium.

The Court of Appeal relied on Laurentian Insurance Co. v. Davidson [1932] SCR 491. In Laurentian, the loss occurred within 30 days of the insured’s moving to a new residence. The vacancy clause in the policy of insurance allowed 30 days of vacancy. The court held that the insurer had accepted the risk of vacancy of less than 30 days when it drafted that vacancy clause.

Did the Court of Appeal need to follow Laurentian? Arguably not. In Laurentian, the Supreme Court said: “Evidence was offered at the trial to show that the vacancy of the property was a change material to the risk, but there was no evidence of any change material to the risk in addition to the bare fact of vacancy.”

The Court of Appeal in Peebles at paragraph 30 said: “Although material change in risk for purposes of the statutory condition might otherwise have arisen from the ‘circumstances’ as a whole, no change was identified in this case apart from the ‘bare fact’ of (alleged) non-occupancy test, as was the case in Laurentian.”

In saying non-occupancy instead of vacancy, the Court of Appeal equated www.claimscanada.ca

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vacancy and occupation. Vacancy has an element of intention and occupation is a question of fact independent of intention.

As well in that same paragraph 30, the Court said it was “not referred to any case that stands for the proposition that ‘reduced’ occupancy – as opposed to ‘non-occupancy’ – constitutes a material change in risk that must be reported...” In saying that, the Court seems to have ignored or overridden the evidence of the two experts as to materiality.

Finally in paragraph 33, the Court of Appeal dealt with an argument that should have been made during the hearing of the appeal. It said: “If a fire occurred after the 30 day period, the insurer could clearly argue that the insured’s absence from the house … (and from Canada) would constitute a material change in risk.”

In saying that, again, the Court seems to not deal with the point that there can be material changes to a risk that fall short of vacancy. In Peebles, there was evidence about the effect of tenuous occupancy on the risk; it is arguably distinguishable from Laurentian.

So what is the upshot of this? For an insurer, there were many factors in this case that would point to a material change entitling a denial of coverage.

Indeed, on some of the evidence that is recited by the Trial Judge, it might well be argued to be vacant. The approach taken by the Court of Appeal arguably doesn’t deal with the impact of the facts relating to materiality. The Court of Appeal focused more on the wording of the vacancy clause and did not deal with the expert evidence by essentially equating vacancy and non-occupancy.

This makes it difficult for insurers faced with similar situations in the future to analyze the effect of underwriting opinions as to materiality.

Further, while this judgment benefits these particular insureds, it may not be of benefit to the insurance-purchasing public generally. The Court twice refers to the fact that these wordings were the insurer’s wordings. If that is an invitation for the insurer to place more restrictive wordings, then such wordings will potentially not benefit insureds. www.claimscanada.ca

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As just one example, if vacancy was reduced to 15 days, is that a benefit to an insured? It’s hard to contemplate every possible fact pattern when drafting policy wording. The trial judgment relied on the time-tested and time-honoured principles of materiality and good faith as they apply to contracts of insurance.

Those principles embody the sense and the mutual obligations that are at the core of insurance. Applied in accord

with existing precedents, those principles will provide clear guidance in almost every situation.  Mark M. Skorah, Q.C., is a senior partner at Guild Yule LLP. He regularly represents insurers on coverage matters and defends claims against their insureds, including professional negligence, products liability, and complex personal injury matters.

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December/January 2014

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EF

• education forum

A SERIES OF ARTICLES PROVIDED BY THE INSURANCE INSTITUTE OF CANADA

Risky

Business:

Assessing Threats to Reputation

I

n last issue of Claims Canada, Education Forum looked at the interplay between stakeholder relationships and a firm’s brand and reputation. In this issue, we look at how to identify risks to that reputation.

A good reputation can be a significant intangible asset for any firm. For service providers such as adjusters, whose offerings can’t be evaluated before purchase, reputation is especially important.

The risks that any business faces can be grouped into four broad categories:

categories because all risks can potentially have an impact on reputation.

Withdrawal from a line of business; a drop in financial results; a breach of customer data security because of a technology failure – any of these can impair the trust that insurers or regulators have in an independent adjusting firm.

Since it can be affected by so many potential sources of risk, reputation can be a significant concern for anyone running a business. To get to grips with reputation risk, start by identifying and assessing the various other risks that contribute to it.

• hazard risks, such as the risk of having staff injured while adjusting a loss at the site of a catastrophe • financial risks, such as credit or liquidity risk, or the risk of changes in interest rates • operational risks, such as the risk of internal fraud or a computer failure • strategic risks, such as changes in regulatory requirements or the launch of a new competitor “Reputation risk” is not really a separate category of risk. Instead, it is associated with all of the above risk

What’s the risk?

Risk identification is the first step in any risk management process. It involves identifying, defining and prioritizing all sources of risk that might affect the firm, including current sources, expected sources and potential sources.

Some risks are easy to identify; others can be difficult to spot or to isolate.

It’s important to establish consistent processes for identifying risks – both risks that represent threats and those that represent opportunities.

Some qualitative approaches that can be used to identify risks include: • surveys • internal workshops

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• brainstorming sessions • internal auditing • reviewing strategic analyses (analyses of the internal and external environments, SWOT analyses, etc.)

• reviewing external sources of information • analyzing new trends or phenomena Once risks have been identified, they need to be analyzed to determine their potential impact.

Analyzing financial risks often involves quantitative tools that are be-

Qualitative analysis should include assessing not just the risk of harm but the risk of missed opportunities.

Questions to ask include: • How likely are we to be successful with this opportunity?

• What could this opportunity be worth if we succeed?

• What factors could determine success or failure?

• Which of those factors can we control or influence?

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yond the scope of this article. Qualitative assessment, on the other hand, can be applied to most risks and involves thinking about how the organization’s most significant risks affect the business as a whole.

Sometimes qualitative assessment is the only form of risk assessment possible – some risks don’t lend themselves to numerical analysis because the required quantity and quality of data are not available. For example, it would be difficult to quantify regulatory risk or a social risk such as long-term trends in claim inflation.

For these kinds of risks, qualitative assessment methods are important tools for measuring the significance of the threat or opportunity.

Ideally, qualitative assessments are done by a team that includes people from different parts of the organization, to ensure that risks are considered from multiple angles and

Mapping the terrain Risk maps provide a visual overview of a firm’s risks. At its simplest, a risk map can be a matrix on which you plot risks according to their relative impact and probability – high, medium, or low. Risks that fall into the upper right corner of the grid have

The risk map should involve enough levels to meaningfully differentiate between risks, but not so many that you get bogged down in assigning the values.

risk is related to, the risk owner (the business unit or individual responsible for managing the risk), the risk management measures currently being taken, and the risk measures that are planned.

Risk maps can be developed for the organization as a whole or for a business unit or program. They can also be based on clusters of risks that have things in common, such as risk category, source or impact.

Exercising judgment Whatever the specific technique used, qualitative analysis requires using business judgment to assess the various potential consequences of each risk and of combinations of risks – including the impact on reputation.

The assessment team should ask hard questions about the magnitude of risk, the acceptable level of risk, and the risk management measures that

High impact

Risk 1 Risk 7

Medium impact

Risk 5

Risk 4

Low impact

Risk 8

Risk 6

Risk 3

Low probability

Medium probability

High probability

perspectives. The exercise involves making relative judgments about the probability, impact and priority of different risks. Tools that can be used to analyze risks qualitatively include • questionnaires • internal workshops or brainstorming sessions • interviews • internal audits • expert opinion • checklists • decision trees • risk maps and priority rankings www.claimscanada.ca

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Risk 2

the highest overall priority ranking; those in the lower left corner have the lowest.

Alternatively, you can use a limited numerical scale such as 1–3, 1–5, or 1–10 instead of the descriptors highmedium-low. The risk map should involve enough levels to meaningfully differentiate between risks, but not so many that you get bogged down in assigning the values.

By using additional columns or colour-coding, you can also capture other related information such as the business objectives or program the

are currently in place. Once this level of assessment is available, it’s easier to decide what additional risk management measures are needed to protect the firm and its reputation.  This article is based on material used in the Insurance Institute’s FCIP program, the pinnacle of learning in Canada’s p&c industry. Focusing on strategic leadership and advanced management principles, the program blends academic business theory with practical insurance application.

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• on the scene OTS

The CIAA National Executive 2013-2014 gathered for a photo shoot in Banff. Pictured (from left) are John Seyler, Immediate Past President; Dara Banga, Secretary; Albert Poon, 2nd Vice President/Director; Marie Gallagher, President; Jim Eso, Director; Patricia Battle, Executive Director; Craig Walker, Director; Russ Fitzgerald, Treasurer. (Absent - David Porter, 1st Vice President; John Jones, Director) l In June 2013, the annual CIAA/CICMA Joint Conference was held in Stanley Bridge, PEI. Funds raised from this event, including proceeds from the Thursday night silent auction, were pledged to two worthy organizations: Kids Help Phone Atlantic and RespectED, the anti bullying program of the Canadian Red Cross. $10,000 was shared between these two groups. In the first photo, Kristel Doucet of CICMA is seen with Paul Kells of REspectED. In the second, Grant King of CIAA presents a cheque to Shelley Richardson of Kids Help Phone Atlantic. l

CIAA Western Region hosted a Halloween Party on October 26 at the Shaw Conference Centre in Edmonton.

There were approximately 50 attendees, a mix of Independent adjusters, company claims adjusters, contractors, engineers, and car rental vendors. Raffles held that evening raised $485.00 for the Cross Cancer Institute and Edmonton Salvage Disposal donated an additional $200 to a great cause. Best costume was won by Rich Chudek of Clear Choice Exteriors. l 48 Claims Canada

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Scott Marshall

Director of Specialty Services/ TFS, Joel McQuilkin is pleased to announce Scott Marshall (top) has joined Cunningham Lindsey as Central Region Transportation Fleet Services Director. Scott was previously a Transportation/Equipment/Cargo (TEC) Specialist at a national insurance adjusting company and brings 34 years of experience in the industry. AVP Commercial Risk Division (CRD) and Specialty Services, Mike Alwyn is pleased to announce Lee Powell (below) has been promoted to CRD Director of Property Claims.

Lee has over 16 years of insurance adjusting experience and has been an Executive General Adjuster since 2011. l

Lee Powell

Greg Somerville

Greg Somerville, part of Aviva’s Canadian Executive Committee since 2004, has been named Aviva Canada’s new president and CEO. Most recently executive vice president of broker distribution, Somerville has also served as executive vice president of claims and reinsurance, responsible for the technical and strategic direction of Aviva Canada’s national claims and reinsurance operations, over his more than 20 years with the insurer. l

Michael Holden, President and CEO of Granite Claims Solutions, is pleased to welcome Blair McGregor to the Granite Team as the new Vice President of Operations for Western Canada. Blair, a seasoned veteran of the insurance industry, has spent many years in various roles within national insurers and independent adjusting firms across the country. Granite Claims also welcomed Grace Dattomo in the role of Business Development Manager, effective October 2. Grace has over 15 years experience in the insurance industry, having held numerous senior sales and leadership roles for two national firms. In other company news, Greig Boyle, National Vice President of Operations announced the move of Denis Houle and Catherine Whiten to Granite Claims Halifax Branch. l Ken Tucker, CEO of DKI Canada, is proud to announce that HI-TECH Restorations & Contracting has joined the organization. Hi-Tech has provided property restoration services in the Hanover, ON area since February 2006.

HI-TECH also services surrounding areas such as Grey & Bruce Counties. In other company news, DKI Canada announced that M&G General Services has joined the organization. M&G has provided property restoration services in the Greater Moncton area for almost 20 years.l www.claimscanada.ca

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Itech Environmental Services welcomed Dean Cluff to its team in November. Dean joins Itech as Project Manager for Industrial and Railroad related services. Dean brings with him over 18 years of experience in business development and project management roles. l Dean Cluff On Side Restoration is pleased to announce that as of September 2013, Harold Druken has joined as the Company’s new St. John’s Branch Manager. l

Harold Druken A.R.S. Assessment Rehabilitation Services Inc., a fullservice national assessment company, is pleased to announce the opening of two new offices in Edmonton and Halifax. l

The Government of Prince Edward Island is proposing that the cap on court awards for pain and suffering from minor personal injuries following vehicle accidents increase from $2,500 to $7,500, aligning the province with limits elsewhere in the region. In line with increasing the minor injury cap (indexed annually by CPI), the definition of minor personal injuries would be amended to include only strains, sprains and whiplash-associated disorders that do not result in a serious impairment, notes a statement issued mid-November by the province’s Department of Environment, Labour and Justice. The PEI government is asking Islanders to share their views on whether or not to implement the proposed reforms. l

Alberta has posted the highest frequency of collisions of the four provinces considered in Allstate Canada’s recent analysis of its customer claims data. Allstate Canada’s fifth annual Safe Driving Study, released Nov. 27, ranks 50 Canadian communities by the frequency of collisions per 100 cars insured by the company. It considers customer claims data in Ontario, Alberta, New Brunswick and Nova Scotia over a two-year period from July 1, 2011 to June 30, 2013.

In terms of frequency of collisions, Nova Scotia had a rate of 4.45%; New Brunswick, 4.73%; Ontario, 4.99%; and Alberta, 5.20%. l

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• on the scene OTS

Bruce Patterson

Bruce Patterson has operated under the name Kawartha Claim Services for 17 years in Peterborough. Bruce has recently moved to Collingwood and has changed the name of his company to Patterson Insurance Adjusters Inc. Bruce specializes in property, casualty, general liability & municipal claims. Service area incorporates Owen Sound, Midland, Collingwood & Barrie. l

Audatex Canada ULC, a wholly owned subsidiary of Solera Holdings, Inc., the leading global claims solutions provider serving the automotive industry, today announced an agreement to bring Chrysler vehicle manufacturing build data to vehicles sold in Canada through Audatex AudaVIN™ vehicle identification technology. Adding Chrysler build data to AudaVIN technology further supports the accurate vehicle identification technology that Audatex brings to the Canadian marketplace to help insurers and repairers provide industry-leading partial and total loss solutions for the benefit of vehicle owners. l Simmlands Insurance Services announced in November the launch of its branded healthcare practice, MedThree Insurance Group. In the increasingly complex and fragmented world of specialized coverage, MedThree will focus on helping brokers identify and manage the integral risks faced by their Healthcare and Life Science clients. l Tim Dempsey has joined Catastrophe Response Unit (CRU) as Director of Catastrophe Claims. In other news, CRU introduced a new Mobile Power Unit (MPU) – a portable solar powered generator that acts as a source for silent uninterrupted operations, without dependence on a potentially damaged power grid. l Three Ontario mutual insurance companies have officially amalgamated, creating The Commonwell Mutual Insurance Group, which will begin operation Jan. 1. Farmers’ Mutual Insurance Company (Lindsay), Glengarry Mutual Insurance Company and Lanark Mutual Insurance Company received regulatory approval to amalgamate from the Financial Services Commission of Ontario on Oct. 25. l The Insurance Bureau of Canada (IBC) has thrown its support behind an Ontario bill that would make carbon monoxide detectors mandatory in homes across the province. Bill 77 expands the scope of the Fire Protection and Prevention Act, 1997 so that it covers measures relating to the presence of unsafe levels of carbon monoxide, in addition to fire safety. The bill was tabled by Progressive Conservative MPP Ernie Hardeman on May 29, 2013, the motion to arrange proceedings occurred on Oct. 3. and debate in the Ontario legislature during second reading is scheduled for Oct. 31. l 50 Claims Canada

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The number of people working for companies categorized as property and casualty insurance carriers in the Toronto area has dropped 5.7% over 10 years, while total employment in the insurance industry in the area increased 11.3% over the same time, according to a report by the Conference Board of Canada. The report, titled Ensuring the Future: Understanding the Importance of Toronto’s Financial Services Sector, discusses the importance of the entire financial services industry to the economy of the Toronto area and to the Canadian economy. l The Centre for Study of Insurance Operations will be releasing its industry standard for delivering telematics data in January 2014. The organization said it has been working for the past several months on delivering the standard for proving a secure way to transmit telematics information among multiple business partners and allowing for data quality and consistency across the industry. l The tornado outbreak that tore through the U.S. Midwest Nov. 17-18, reducing some areas to rubble, will likely rank as one of the top five most significant November outbreaks since 1950 and could become the country’s first billion-dollar severe weather event in November, notes a storm report issued by catastrophe modeling firm RMS. Although damage estimates are far from final, there is a good chance the “outbreak will become the insurance industry’s first billion-dollar severe weather event to occur in November,” suggests Matthew Nielsen, a meteorologist and director of model product management at RMS. l Relatively low insurance penetration in the wake of Super Typhoon Haiyan, which made landfall in the Philippines November 8, means insurable losses are also expected to be comparatively low – as much as US$700 million – against a backdrop of staggering property damage estimates ranging as high as US$14.5 billion, AIR Worldwide reports. In a statement Nov. 17, insured losses are estimated at between US$300 million and US$700 million compared to total damage to residential, commercial and agricultural properties of US$ 6.5 billion to US$14.5 billion. AIR Worldwide notes estimates reflect insured physical damage to property (residential, commercial and agricultural) for structures and their contents as a result of wind and precipitation-induced flooding in the Philippines, the assumed insurance take-up rates, and current industry exposure. l A majority of Calgary-based businesses reported having had effective emergency plans prior to the major flooding that hit the city this past summer, but gaps remain, according to a poll from Ipsos Reid released in November.

The polling firm conducted 50 phone interviews in September with Calgary-based businesses that have 100 or more employees in Alberta and that were directly impacted by the flooding. Of those surveyed, 80% said they have had an emergency plan prior to the flooding this year, and 81% rated their plans as effective. l www.claimscanada.ca

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Ernst & Young announced in November the results a survey of executives on information security in which half of the respondents said business continuity and disaster recovery will be among their top priorities over the next year. In its Global Information Security Survey 2013, the consulting firm suggested organizations who allow employees to use their own personal smart phone face some hard security questions. EY stated this year’s survey “shows only 13% of Canadian respondents prioritize the innovation of security services and technologies to address new and emerging threats.” l Insurers and capital markets need to harness big data to close the disaster gap – the difference between insured and economic costs of natural catastrophes – suggests a new report from BNY Mellon that indicates the cat bond market could balloon to US$50 billion by 2018. The number of cat bonds outstanding could more than double from the current level of US$19 billion (as reported by Aon Benfield) to US$50 billion by the end of 2018, notes a statement issued in November by BNY Mellon, which provides investment management and investment services. l The Vancouver based marine and cargo surveying firm AVA Marine and its exclusive bunker surveying division, the ‘Bunker Detective’ is pleased to announce the opening of new business operations in Rio de Janeiro, Kuwait, Singapore and Shanghai. l

CIAA New Members — October 2013 INDIVIDUAL MEMBERSHIP Crawford & Company (Canada) Inc. Ben Savage Dartmouth NS Jason Scott Regina, SK Nathan Rivard, CIP Saskatoon, SK

Level 1 Level 1 Level 2

Granite Claims Solutions Shelley Foss Diana Tsinokas Kucerak Jean Marion Audra McKay Robert Vid Amour

Level 1 Level 3 Level 3 Level 3 Level 3

Edmonton, AB Mississauga, ON Ottawa, ON Toronto, ON Windsor, ON

Kernaghan Adjusters Limited Anthony McDermott Toronto, ON

Level 2

NWO Claims Services Stephanie Loewen

Level 1

Kenora, ON

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

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• on the scene OTS The 6th Annual Wish Upon a Star Charity Golf Tournament was held in support of the Starlight Children’s Foundation on October 2 at Deer Creek Golf and Country Club. Generous golfers at the sold-out event teed up to help make a difference in the life of children. Tournament organizers presented more than $45,000 to the Starlight Children’s Foundation. For more than 20 years, the foundation has committed itself to improving the quality of life for children with chronic and life threatening illnesses and life-altering injuries. The foundation provides entertainment, education and family activities to help cope with any pain, fear and isolation associated with prolonged illness. l

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• on the scene OTS Granite Claims Solutions, CKR Global, Rochon Engineering and Sibley and Associates (Granite Global Solutions companies) held their annual RIMS Canada Conference, Victoria, ‘Kick-Off’ reception on October 5 at The Clubhouse at the Strathcona Hotel in downtown Victoria, British Columbia. l

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• on the scene OTS Cunningham Lindsey held its annual RIMS Canada Conference dinner on October 5 at Café Brio Restaurant in Victoria. l

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• on the scene OTS ARC Group Canada hosted a reception at the RIMS Canada Conference in Victoria at 10 Acres Bistro and Bar Market on October 7. The event included mingling and delightful appetizers and beverages. l

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• on the scene OTS More than 60 companies and organizations providing products and services filled the Exhibit Hall at the 2013 RIMS Canada Conference in Victoria, October 6-8. l

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Crawford and Company (Canada) Inc. held its annual RIMS Canada Conference dinner on October 5 at Belmiro’s Restaurant and Lounge in Victoria, British Columbia. l

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• on the scene OTS FirstOnSite Restoration hosted a Meet and Greet reception at the RIMS Canada Conference on October 8 at Spinakers Gastro Pub Brewpub in Victoria. l

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