Claims Canada December January 2016

www.claimscanada.ca

December/January 2016

Official Journal of the Canadian Indeépendent Adjusters’ Association

The Measure of Adjusting Metrics and KPIs define a new world for IA firms

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Contents DECEMBER / JANUARY 2016 • VOLUME 9 • NUMBER

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Cover Feature 12 The Measure of Adjusting Insurance company claims departments are using a wide range of metrics to measure adjusting efficiency, such as shelf life, cycle time and service indexes. Independent adjusters are accustomed to being accountable for their work, time and professional expertise through ongoing measurements. But are these key performance indicators relevant to all aspects of the claims handling process? Are the metrics truly effective at improving claim resolution? And how can adjusters and claims managers agree on the measurements that matter most?

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BY CRAIG HARRIS

Spotlight 20 Absolute Commitment Keith Wright runs Absolute Claims Adjusters in Moose Jaw, Saskatchewan – a firm dedicated to small town service.

BY CRAIG HARRIS

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News Features 22 Ontario Auto Evolution Upcoming changes to the province’s auto insurance system will come into effect June 2016 – what adjusters need to know.

BY DANIEL STRIGBERGER

26 Expanding the Pollution Exclusion A recent court case may broaden the application of the pollution exclusion in commercial liability coverage.

BY MICHAEL TEITELBAUM and YULIA PESIN

28 Cyber Challenges What recent American developments reveal about the potential future of cyber liability in Canada.

BY ANNE JUNTUNEN

30 Liability Notice In Lloyd’s Underwriters v. Blue Mountain Log Sales Ltd., a B.C. court wrestled with the issue of pre-tender defense costs.

BY TODD DAVIES and SCOTT HARCUS

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Departments 4 First Notice 32 On The Scene

Columns 10 President’s Message

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• first notice FN IBC leads national flood program The Insurance Bureau of Canada (IBC) and other partners are collaborating on a national flood program to be led by the private sector.

The new flood maps and supporting data, developed in partnership with LexisNexis Risk Solutions, JBA Risk Management, DMTI Spatial and Brookfield RPS, will use the latest technology, local climate data and geospatial data, and will cover the entire country. They will clearly identify the cities and regions at risk of flooding, and the associated economic costs, as well as, the resilient areas and regions in Canada, the IBC said in a press release.

LexisNexis Risk Solutions, a provider of data, analytics and technology to help organizations predict and manage risk, said in a statement that the IBC has selected the company as the lead vendor to manage its national flood program initiative.

Working closely with IBC, LexisNexis Risk Solutions will lead the development of a new set of flood hazard maps and property-level exposure data, leveraging LexisNexis Map View, its risk assessment and exposure management technology, the company said in the statement. Map View will enable IBC to perform advanced analytics and reporting against millions of data points quickly and efficiently. IBC will be able to

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clearly identify the number of properties at risk of flooding and the associated economic losses for virtually any geography in Canada, the statement noted.

A key component of this initiative is the creation of all new pluvial and fluvial flood maps for Canada, LexisNexus Risk Solutions said. These new models, produced by LexisNexis partner, JBA Risk Management, fully leverage local river, rainfall, snowmelt and higher resolution Digital Terrain Model datasets, resulting in completely updated river flow and rainfall estimates based upon a much more detailed hydrological study where snowmelt is now explicitly modelled, the company explained.

“Extreme weather events driven by climate change have increased in frequency and severity,” said Don Forgeron, president and CEO of IBC, at an Economic Club of Canada event in Edmonton on Nov. 26, where he announced the initiative.

“Storms and flooding in recent years have turned extreme and at times, tragic. That’s why mitigation and preparedness are vital and why IBC is stepping up to collaborate on a national flood program.” l

EY finds confidence lacking in cyber-security More than one-third (36%) of global organizations still lack confidence in their ability to detect sophisticated cyberattacks, according to Ernst & Young’s (EY) annual Global Information Security Survey 2015, released in November.

The survey, titled Creating trust in the digital world, included participants from 1,755 organizations in 67 countries. Chief information officers, chief information security officers, chief financial officers, chief executive officers and other IT executives from across all major industries were surveyed.

The study examined “some of the most important cybersecurity issues facing businesses today” and found that 88% do not believe their information security structure fully meets their organization’s needs, EY said in a press release. When it comes to IT security budgets, 69% say that their budgets should be increased by up to 50% to align their organization’s need for protection with its managements’ tolerance for risk.

According to the survey, criminal syndicates (59%), hacktivists (54%) and state-sponsored groups (35%) retained their top rankings as the most likely sources of cyberattacks. However, compared with last year’s survey, respondents rated these sources as more likely: up from 53%, 46%, and 27%, respectively, in 2014.

“Organizations are embracing the digital world with enthusiasm, but there must be a corresponding uptick in addressing the increasingly sophisticated cyber threats,” said Ken Allan, EY’s global cybersecurity leader, in the release.

“Businesses should not overlook or underestimate the potential risks of cyber breaches. Instead, they should develop a laser-like focus on cybersecurity and make the required investments.” l

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• first notice FN Alberta judge issues injunction against Uber The Court of Queen’s Bench of Alberta recently issued a temporary injunction against drivers offering rides for a fee in Calgary using the Uber app.

Justice G. H. Poelman issued the injunction in late November to run until a full hearing on Dec. 17, the City of Calgary said in a statement. At that time, the city will argue the injunction should be permanent to stop drivers from offering or providing rides for a fee using a vehicle hired through the Uber app until safety, insurance and regulatory requirements are met.

The city filed an application to temporarily stop drivers using the Uber mobile app from offering rides for a fee in breach of the Livery Transport Bylaw. A total of 57 people were named in the application as a driver or registered owner of a private vehicle offering rides for a fee, the statement said. The court also granted an application for legal counsel representing 45 of the 50 drivers named in the injunction application to protect the personal information of those drivers.

Justice Poelman said “evidence showed drivers using the Uber app were breaching the bylaw.” He added that the temporary injunction would extend to the drivers named in the

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December/January 2016

city’s application as well as to all other people operating as an Uber driver in Calgary.

City lawyer Colleen Sinclair said she was pleased with the ruling. “This is recognition that private for-hire vehicles operating under the Uber umbrella are breaching The City’s bylaw and they have been ordered to stop,” said Sinclair. “This pulls a number of vehicles that are not appropriately insured, licensed or inspected off the road and prevents them from offering a potentially unsafe service.”

Since Uber launched in Calgary on Oct. 15, the city has charged 19 people driving under the Uber banner with 52 offences under the bylaw and the Traffic Safety Act. Investigations are ongoing in relation to another 19 drivers facing 48 charges, the city added. l

Co-operators teams up with TIRF on distracted driving The Co-operators Group Limited announced in November a new partnership with the Canadian Traffic Injury Research Foundation (TIRF) aimed at reducing the incidence of distracted driving in Canada.

Research suggests that distracted driving is a substantial factor in road fatalities, and may be equal to or even exceed impaired driving in at least some jurisdictions in Canada, The Co-operators note. The partnership was announced on the National Day of Remembrance for Road Crash Victims and is part of The Co-operators’ Drive out Distraction program.

Through the partnership, The Co-operators will support TIRF’s research and educational work focusing on reducing distracted driving. TIRF is a national, independent road safety research institute that focuses on identifying the causes of road crashes and developing programs and policies to address them effectively.

The partnership will include the creation of a public online repository of data, information and resources that can serve as an easily accessible tool for stakeholders and others with an interest in the issue, the release said. In addition, a multistakeholder working group will be created, which will develop a national, evidence-informed, comprehensive action plan to combat distracted driving in 2016.

“As an insurer of more than one million vehicles, we see first-hand the devastating effects of traffic injuries and fatalities on the lives of our clients,” said Kathy Bardswick, president and CEO of The Co-operators, in the release. “Distracted driving is a contributing factor in one of every four major injury crashes.

We are determined to make a difference by working to change behaviour around distracted driving to make our roads and communities safer for everyone.” l

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• first notice FN Intact funds Waterloo climate change centre Intact Financial Corporation (IFC), Canada’s largest provider of property and casualty insurance, and Ontario’s University of Waterloo recently announced the creation of the Intact Centre on Climate Adaptation (ICCA).

The centre, based in the Faculty of Environment at the University of Waterloo (UoW), will focus on research and building awareness for “innovative adaptation solutions to climate change risks facing Canadian homeowners, communities, industries and governments,” the UoW said in a press release.

Under the leadership of Professor Blair Feltmate, university researchers, consultants, industry specialists and non-governmental agencies will: • monitor applied research developments on adaptation solutions and technologies from around the world; • conduct their own research; and • mobilize adaptation technologies and practices that are most promising to reducing climate-related extreme weather risk.

With funding of $4.25 million provided by Intact, the ICCA’s initiatives include implementation of a green infrastructure program aimed at reducing the impact of severe precipitation in Canadian communities, the university said. Another program will identify the extreme weather vulnerabilities of various Ca-

nadian industrial sectors and recommend appropriate industryspecific adaptation strategies.

“While political leaders from across the world gather for COP21, we should remind ourselves that climate change is already a reality here in Canada,” said Charles Brindamour, chief executive officer of IFC, in the statement. “We must step up our efforts towards building strong, prosperous, resilient and sustainable communities. Our partnership with Waterloo’s Faculty of Environment will foster innovative solutions that will reduce the physical, financial and social impacts of extreme weather.”

The ICCA will also launch its national Home Adaptation Audit Program (HAAP) to assess the vulnerability of homes to flood damage, and make specific recommendations to help homeowners across the country avoid costly damage from extreme weather.

The centre represents the next step in a five-year partnership between Toronto-based Intact and the University of Waterloo in tackling the impacts of extreme weather. Previously, the organizations partnered on The Climate Change Adaptation Project, which identified the most vulnerable areas of Canadian society to climate change; provided a national roadmap for adaptation; and identified numerous solutions to protect Canadians against the growing threat of severe weather events. l

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Produced by the publishers of Canadian Underwriter magazine

A bi-monthly magazine (6x per year), Claims Canada is published by NEWCOM Business Media Inc. 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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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 FRED PLANT

Ours is a noble profession and you should be proud of the important work you do everyday – delivering the product of the Property & Casualty Insurance Industry in Canada.

One of the many benefits of being National President of the Canadian Independent Adjusters’ Association is access to reach the readers of Claims Canada through this column every two months. Feedback from the last edition confirms that we have many active readers and I very much appreciate your comments, criticisms and encouragement. All of this feedback helps shape the direction of your profession.

You have likely heard the phrase: the only constant is change. That certainly applies to the insurance industry. As adjusters, we have to adapt continuously to change. But there are options. You can be swept up in what seems to be a perpetual tidal wave of change and let it take you where it may – or you can study the cause and determine how to influence its direction. The former is far simpler than the latter. Some go screaming. Others utter not a whimper. What about you?

One of the changes facing adjusters is the reduction of our working day to a handful of “measurables.” What are we doing to influence these forces in our lives? Is it possible or even necessary to reconcile cost and measurables with proper investigation and indemnity? How far will we push the amount to pay on a claim without any proof of anything being furnished? There is a strong sense that the determination of “success” merely means compliance with process.

Simply put, process overtakes purpose.

As a profession, we are somewhat unique in that the people who are in charge of setting the parameters for the measurement of our work (the product) are typically not on the ground delivering it. Often, those who set the price for buying our product are not the people who actually use our product.

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Notre profession est une profession noble; vous devriez être fiers du travail important que vous accomplissez chaque jour, c’est-à-dire d’offrir le produit du secteur de l’assurance de dommages au Canada.

L’un des nombreux avantages d’être président national de l’Association canadienne des experts indépendants est la possibilité de joindre les lecteurs de Claims Canada par l’intermédiaire de cette chronique tous les deux mois. Les commentaires formulés à propos du dernier numéro témoignent du nombre important de lecteurs actifs. Aussi, je vous remercie beaucoup pour vos suggestions, vos critiques et vos encouragements. Ces commentaires contribueront à l’orientation de notre profession.

Vous avez probablement entendu la phrase : la seule constante est le changement. Cette citation s’applique certainement à l’industrie de l’assurance. À titre d’experts en sinistres, il nous incombe de nous adapter au changement.

Mais il existe des choix. Vous pouvez être entraînés par ce qui semble être un raz-de-marée de changement perpétuel et vous le laissez vous emmener où il peut ou vous pouvez analyser la cause et déterminer comment influencer sa direction.

Le premier choix est plus simple que le second. Certains commencent à crier. D’autres ne pleurnichent même pas. Qu’en est-il pour vous?

L’un des changements auxquels font face les experts en sinitres est la réduction de notre journée de travail à une poignée « d’éléments mesurables. » Que faisons-nous pour influencer ces forces motrices de notre vie? Il est possible, ou même nécessaire, de faire concorder les coûts et les éléments mesurables avec une enquête et une indemnité adéquates?

Jusqu’où pouvons-nous défendre le montant à payer pour une réclamation, alors qu’aucune preuve n’a été fournie? On a vraiment l’impression que la détermination de la « réussite » signifie simplement d’être conforme au processus. En d’autres termes, le processus a préséance sur le but. À titre de profession, nous sommes en quelque sorte uniques dans la mesure où les personnes chargées d’établir les paramètres pour mesurer notre travail (le produit) ne sont pas généralement sur le terrain pour mettre en pratique ces paramètres.

Souvent, les personnes qui fixent le prix d’achat de notre produit ne sont pas celles qui utilisent effectivement notre produit. www.claimscanada.ca

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In my view, many of these processes do not factor in the human aspect (people dealing with people) of what we do as adjusters. They also fail to take into account the need for the investigation and claim settlement/payment effort to be open, transparent, evenhanded and appropriate.

The golden thread of good faith is woven into the fabric of the insurance contract. Many of the people increasingly in charge of claims decisions overlook this fact. They are stretching that thread too thin as they, like in so many other industries, attempt to “roboticize” and reduce to “process” all that is involved in a claim from start to finish. That may work in the manufacture of automobiles; it does not work where human interaction is necessary. And personal interaction is absolutely necessary in the claims business.

My final words are reserved for remembrance of a dear friend and colleague, Sharon (nee Myles) Walker, who, on November 26, was taken far too early in life by that scourge called cancer. We were fortunate to have had her for the time we did. She will forever be in our minds and hearts. “Tis better to have loved and lost than never to have loved at all.” Alfred Lord Tennyson n

À mon avis, bon nombre de ces processus ne tiennent pas compte de l’aspect humain (des personnes qui traitent avec d’autres personnes) de ce que nous faisons en tant qu’experts en sinistres. Ils n’arrivent pas non plus à prendre en considération le fait que l’enquête et le règlement ou l’effort de paiement de la réclamation doivent être ouverts, transparents, impartiaux et pertinents.

Le fil d’or de la bonne foi est tissé dans la structure du contrat d’assurance. Ce fait est négligé par beaucoup de personnes qui prennent de plus en plus de décisions sur les réclamations.

Elles abusent de cette situation dans la mesure où elles tentent (comme c’est le cas dans beaucoup d’autres industries) de « robotiser « et de réduire à un « processus » tout ce qui fait partie d’une réclamation, du début jusqu’à la fin. Cela peut fonctionner dans le secteur de la construction d’automobiles, mais ça ne fonctionne pas là où l’interaction humaine est nécessaire. De plus, l’interaction humaine est absolument nécessaire dans le traitement des réclamations.

Je termine en exprimant mon affectueux souvenir pour une chère amie et collègue, Sharon (née Myles) Walker, qui nous a quittés trop tôt le 26 novembre, emportée par ce fléau qu’on appelle le cancer. Nous avons été chanceux de l’avoir avec nous.

Elle restera à jamais dans nos esprits et nos cœurs. « Mieux vaut avoir aimé et perdu ce qu’on aime que de n’avoir jamais connu l’amour.» Alfred Lord Tennyson n

NATIONAL EXECUTIVE 2015 2014 - 2016 2015 President Fred R. Plant, AIIC ClaimsPro 85 Englehart Street Dieppe, NB E1A 8K2 Phone: (506) 853-8507 Fax: (506) 853-8501 E-mail: fred.plant@scm.ca 1st Vice-President Heather Matthews, CIP, CRM Crawford & Company (Canada) Inc. 539 Riverbend Dr. Kitchener, ON N2K 3S3 Phone: (519) 578-5540 Fax: (519) 578-2868 E-mail: Heather.Matthews@crawco.ca 2nd Vice-President Gary Ellis, BBA, FCIP, RF, FCLA, FCIAA, FIFAA AMG Claims Inc. P.O. Box 20102 Sherwood Charlottetown, PE C1A 9E3 Phone: (902) 628-9091 Fax: (902) 628-9093 E-mail: gary.ellis@amgclaims.ca Secretary Monica Kuzyk, FCIP, CRM Curo Claims Services 125 Northfield Dr. W., P.O. Box 218 Waterloo, ON N2J 3Z9 Phone: (866) 952-2876 Fax: (519) 888-9704 E-mail: mkuzyk@curocanada.com

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Treasurer John D. Seyler, CIP Integrated Insurance Resources 5080 Timberlea Blvd., Suite 214 Mississauga, ON L4W 4M2 Phone: (905) 238-4985 Fax: (905) 238-2735 E-mail: jseyler@integrated-ins.ca Past-President 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 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 Paul Feron, FCIP, CRM ClaimsPro 210 – 746 Baseline Rd. East London, ON N6C 5Z2 Phone: (519) 645-6500 Fax: (519) 645-2250 E-mail: paul.feron@scm.ca Director Lorri Frederick ClaimsPro 120 Adelaide St. W., Suite 2401 Toronto, ON M5H 1T1 Phone: (905) 308-6292 Fax: (416) 360-7335 E-mail: lorri.frederick@scm.ca Director James B. Eso, CIP, CIOP Crawford & Company (Canada) Inc. 539 Riverbend Drive Kitchener, ON N2K 3S3 Phone: (519) 578-5540 Fax: (519) 578-2868 E-mail: Jim.Eso@crawco.ca Director E. Grant King, BA, B.Ed., CIP Crawford & Company (Canada) Inc. 120 – 237 Brownlow Avenue Dartmouth, NS B3B 2C7 Phone: (902) 468-7787 Fax: (902) 468-5822 E-mail: Grant.King@crawco.ca

Director John Jones, BA 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: jjones@cl-na.com Director Albert Poon, CIP Cunningham Lindsey Canada Claims Services Ltd. 1102 – 50 Burnhamthorpe Rd. W. Mississauga, ON L5B 3C2 Phone: (905) 896-8181 Fax: (905) 896-3485 E-mail: apoon@cl-na.com Director Marie C. Gallagher, FCIP, CRM Kernaghan Adjusters Limited 602 – 1 St. Paul Street St. Catharines, ON L2R 7L3 Ph: (289) 786-1074 Fax: (289) 723-1979 E-mail: mgallagher@kernaghan.com Director Craig J. Walker, CIP, FCIAA, FIFAA Maltman Group International 3550 Victoria Park Ave., Suite 301 Toronto, ON M2H 2N5 Ph: (416) 492-4411 Fax: (416) 492-5657 E-mail: cwalker@maltmans.com

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• cover story

The Measure of Adjusting

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Insurance company claims departments are using a wide range of metrics to measure adjusting efficiency, such as shelf life, cycle time and service indexes. Independent adjusters are accustomed to being accountable for their work, time and professional expertise through ongoing measurements.

But are these key performance indicators relevant to all aspects of the claims handling process? Are the metrics truly effective at improving claim resolution? And how can adjusters and claims managers agree on the measurements that matter most?

By Craig Harris

“Claims transformation” has become a common catchphrase in the property and casualty insurance industry. Many insurers have come to the realization that antiquated legacy systems (and outmoded processes) are not up to the task when it comes to customer responsiveness, business agility and collaborative man-

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agement. The result has been a wave of investments in new technologies, such as Guidewire ClaimCenter, among others.

The push to a more streamlined claims management structure is typically motivated by cost savings and service commitments. “Based on our experience, 1 to 2 per cent improve-

ment of loss cost can be captured by identifying and measuring key claim areas where adjusters can improve loss results and enable process improvements,” notes a recent publication from Capgemini Consulting and Guidewire called Capturing Operational Efficiency and Sustainable Value through Claims.

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Part and parcel of this transformation is a distinct focus on data collection and “metrics.” With that comes a renewed emphasis on performance management and tracking of key performance indicators (KPIs).

“Determining claims program metrics and key performance indicators is a critical step in the upfront design of claims transformation,” the Capgemini and Guidewire study notes. ”Current state metrics may already be in place and heavily used but they are likely constrained by data availability and legacy systems and limited in connectivity between front-line metrics and management KPIs.”

Performance Scorecards This heightened attention to performance scorecards applies to a wide range of insurance suppliers, such as auto repair shops and property restoration firms. Independent adjusters are along for the ride, whether they like it or not.

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“We have absolutely seen this over the last couple of years,” notes David Riddell, president of Canadian Claims Services. “Many of the new contracts we are entering into now have an entire appendix around KPIs or (the

“Generally, the metrics being measured relate to tracking success on a small number of measurable points during the life of a claim, such as ‘time to first contact’, ‘time to first site visit’ or ‘overall shelf life of claim.‘ ” expectation) that you are going to produce for insurance companies a number of management reports.”

“We have seen a definite increase in the inclusion of KPIs being measured

by insurers on our assignments,” concurs Jim Eso, senior vice president, property & casualty for Crawford and Company (Canada) Inc. “The increase in these measurements has happened primarily in the last 3 or 4 years.”

These emergent metrics cover a wide range of areas for insurance companies keen to understand costs, service and time.

“For any type of claim there are four important arenas to consider: customer satisfaction indexing (CSI), loss costs, expenses and compliance,” notes Marilyn VanderLey of Performance Gateway in a December 2014 article in PropertyCasualty 360 publication. “By breaking these arenas down into categories and assigning specific measures with appropriate targets to these categories, one can provide the company with easy-to-interpret results — especially if the individual KPI scores are aggregated to provide an overall category score. When monitored weekly,

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these overall category scores can help avoid the roller coaster effect of balancing customer satisfaction results against the need to control loss costs.”

More specifically for independent adjusters, examples of KPIs include such measurements as contact with the insured, claim site visit, report to principal, reserves, cycle time, shelf life and many others.

“Generally, the metrics being measured relate to tracking success on a small number of measurable points during the life of a claim, such as ‘time to first contact’, ‘time to first site visit’ or ‘overall shelf life of claim,’” notes Eso. “Those metrics that are most effective are the ones we know directly impact client satisfaction, such as overall file shelf life.”

“A key area of opportunity is to improve the service paradigm,” notes Patti Kernaghan, president of Kernaghan Adjusters Ltd. “These basic data elements provide an overview of the performance on an individual

Tracking Data Many adjusters say they welcome the tracking of key data in helping to more effectively manage the entire claims cycle.

claim and once rolled up to the entire portfolio level, they can provide management with tools to assess the adjuster’s performance and the progress of the entire claims portfolio.

p12-19 COVER STORY.indd 15

“If the insurance company client feels there is value in tracking customer service survey results or shelf life or other KPIs, then we’ll do what we can to make sure they are getting the data.”

“Tracking data gives real time opportunities for the claims handler to recognize where they need to apply attention to individual claims; it also provides managers the opportunity to assist adjusters when they see stuck points in the claims handling process,” Kernaghan adds.

“The reality is that if the measurement is important to the customer, then it’s important to us,” says Riddell. “If the insurance company client feels there is value in tracking customer service survey results or shelf life or other KPIs, then we’ll do what we can to make sure they are getting the data.”

Riddell adds that it’s important for adjusters to know not just what insurance companies want to measure, but why.

“We just signed a new contract with one of our bigger clients and they provided a list of reports they want us to produce with some regularity,” Riddell notes. “They asked whether

15-12-16 2:33 PM

we had any issues or concerns with that. My response was: no issues or concerns, but we need to know what you’re hoping to capture, so that if we are not getting that information in our system now, whatever those data fields are, we need to adapt and get them put in. When it comes time to produce these reports, we can then give them something meaningful. It is all fine and good to say you need this measurement and these data

fields and the analytics, but we need to know what data you are trying to capture, and what it will show,” he observes.

No Two Insurers the Same It’s a truism of the p&c industry that no two insurance company measurements or requirements are the same. This requires flexibility and adaptability on the part of independent adjusting firms.

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p12-19 COVER STORY.indd 16

December/January 2016

“Each insurer will have their own set of measurable outcomes based on their own internal processes and their own perception of what items are most important to track,” Eso states. “The challenge is ensuring that the measurables are ones that are or can be measured automatically in our system. The alternative of having to manually track specific metrics is not desirable, so we use different systems such as our own CMS Claims Management System, the insurer’s system or third party vendor systems such as Xactimate to track specific items that can be reported on.”

Riddell agrees that technology is critical for adjusters in adapting to measurement requirements from insurance company clients.

“Most independent adjusting firms now have quite good claims systems that are able to track those measurements with accuracy and efficiency,” Riddell says. “We are able to extract data and produce meaningful management reports, not only for owners of adjuster firms but also for insurance company clients. Our system is very flexible, so we can accommodate virtually any request for data. As time goes on, we want to be sure that the data is what they asked for and what they need, we can even hopefully anticipate some of what they might be looking for.”

However, IAs may require work processes or procedures to adapt to the relatively new world of KPIs, according to Riddell.

“It changes workflow because different insurers require different reports and measurements,” Riddell comments. “That has always been the big challenge from an independent standpoint; that every insurer wants it done just a little bit differently. Now, however, we have to make sure we are checking the right boxes or ensuring the right data fields are populated in the system so that they are able to extract the data they need.”

A crucial challenge for insurers is gathering data and avoiding cumbersome and labour-intensive spreadsheets, according to VanderLey. www.claimscanada.ca

15-12-17 10:58 AM

“Web-based scorecard technology can help improve accuracy and ensure that data gathering and calculations are automatic,” VanderLey writes in PropertyCasualty 360. “The data is available 24/7 in one location and everyone is looking at the same information. Scorecard technology allows users to determine the categories to be measured and the individual measures within those categories.

They should also be able to determine the target scores to be achieved and how the measures will be weighted.

It should also drill down to the estimates/claims that comprise the results and highlight scores that don’t meet target levels to pinpoint problem areas and make an accurate analysis.”

Technology, especially mobile communications, may even make some of the KPIs or metrics less relevant in the future, according to Eso. “Some metrics, such as ‘time to first contact’ have become less important with improved technology around communication,” Eso notes.

“With email, text messaging and telephone contact, the process of receiving a claim and then reaching out to the policy holder is much easier to do, and in many cases is done by us at First Notice of Loss when we receive the claim through our Claims Alert intake centre,” he adds.

Efficiency versus Indemnity?

Some measurements are not emphasized enough at insurance companies, according to several independent adjusters. For example, the proliferation of telephone adjusting can be measured for efficiency, but what about the potential tradeoff in indemnity costs?

“I think one area that has been toned down is the investigation versus the indemnity costs,” Riddell says.

“Insurers are doing more and more claims on a telephone adjusting basis instead of having an adjuster on the scene. I don’t know if I have ever seen a meaningful calculation on the cost savings on telephone adjusting files versus what you spend from an indemnity perspective. You are cutting out that adjusting process, but to www.claimscanada.ca

p12-19 COVER STORY.indd 17

what end? And how do you measure that? What is the cost savings versus indemnity?”

Kernaghan concurs that telephone adjusting is ripe for the kind of metrics and measurements that insurers are applying to all aspects of the claims management process.

“There is an opportunity to compare a telephone claim versus an adjuster attending the loss location,” Kernaghan notes. “There’s an expense

to outsourcing adjustment services; however, there are also opportunities for cost savings through reduced indemnity. The expense can generate claims savings such as: where to cut off repairs; is the damage really caused by the peril being claimed; what the full extent of repairs should be, and so on.”

“When the adjuster attends, there is less likelihood of inflated claims,” she adds. “When a claim is adjusted

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15-12-16 2:33 PM

over the phone from a photograph the insured has taken, human nature tells us that the explanation and photograph could favour the insured’s position. If we don’t measure it, how do we know whether there is a false economy at work with large telephone adjusted claims?”

For Riddell, there is an element of caution that should be applied to the universal use of claims measurements.

“I think the whole data analytics and metrics piece is relatively new and I think companies need to be cautious in how they approach this,” he says.

“It tells part of the story but not the whole story. They need to be able to determine exactly what it is that these measurements are telling you, in what context and then go from there.”

Re-inspection and Audit Process Riddell cites the example of insurance companies relying less on the reinspection or audit process due to a strict reliance on data metrics.

“Some of my clients have told me: ‘for the last several years we have been taking all this data and we know now this is what our average repair cost 18 Claims Canada

p12-19 COVER STORY.indd 18

“I think that with the increased recognition and measurement of policyholder satisfaction as a key driver for growth at the insurance company level, the focus on things like first contact time, total indemnity or estimate accuracy have been replaced by a more focused effort on measuring those things that help the client understand the impact of the claim process on customer satisfaction and retention.” should be. We can now do away with many of the controls in place, such as re-inspections, appraisals or audits,’” Riddell notes. “My response is that the average repair cost may well be

December/January 2016

accurate, but isn’t that number impacted by the very fact that you had controls in place? And that the service providers knew that at any point in time, the process could be re-inspected or audited?”

CIAA president Fred Plant believes that the prevalence of telephone, or remote, adjusting raises broad questions about the effectiveness of standard insurer measurements.

“It is not just about taking pictures and sending them to someone at a desk 1,000 kilometres away,” Plant says. “The service we provide as independent adjusters is difficult to measure; it comes out of our heads. We can tick off all the boxes on the audit or KPI sheet, and say we did a great job on that particular claim. But the claimant could be dissatisfied or we could have overpaid under the policy terms. As long as you followed the process, everything is fine and you get a pat on the back. It’s that old saying: the operation was successful, but the patient died.”

One of the difficulties with standardized measurements is that they may fail to take into account www.claimscanada.ca

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unique claims scenarios, according to Plant.

“Claims are not all the same. Even fender benders or minor fires may seem like routine events, but they are very different, involving different claimants and personalities. You can’t necessarily do the same thing every time and expect it to work exactly the same way, “ he says. “So many business rules and processes have been created that don’t allow adjusters to be agile in the field. If you step out of the process, that is a failure for some insurance company measurements – but that may be exactly what is needed in a certain claim. It may actually be the best thing to get the claim resolved.”

Plant notes that there is nothing wrong with claims efficiency measurement in and of itself. “In the world of big data, measurement is crucial. People want to measure everything,” he says. “It is not that the processes insurance companies employ are ineffective or counterproductive. They are in a competitive business, they want to keep their costs down; I understand that and I agree with it. But you can’t go so far as being focused completely on claims costs at the expense of service.”

Worm Starting to Turn Some adjusters, such as Jim Eso, say the worm is starting to turn when it comes to the measurement of customer service indexes and claimant satisfaction.

“I think that with the increased recognition and measurement of policyholder satisfaction as a key driver for growth at the insurance company level, the focus on things like first contact time, total indemnity or estimate accuracy have been replaced by a more focused effort on measuring those things that help the client understand the impact of the claim process on customer satisfaction and retention,” Eso notes.

“The increased use of satisfaction ratings like Net Promoter Score, combined with the increased use of data analytics that helps the insurer valiA National Network of Independent Law Firms date the impact of positive or negative customer experience, is what will

continue to drive the development of metrics that will be measured on independent adjuster files,” he adds.

“Adjusters need to adapt to these changes in order to remain a relevant part of the insurance claims process.”

Several sources say the world of KPIs, metrics and data analytics is here to stay in the insurance industry – and the broader economy. It will be up to adjusters to cope with this new reality.

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The ARC Legal Reporter v. Crowther and Kelly Case: Winter IssueReported – Article #1 Blyth 2009 NBCA 80 Citation: At Issue:

When is a medical examination considered a second examination under Rule 36 of the New Brunswick Rules of The Court?

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www.claimscanada.ca

“I think we will see a continued focus on data analytics, metrics and measurement in the coming years,” Riddell concludes. “That is the way the world is going. It is not just insurance, but virtually all types of businesses and sports. As a service provider, you have to be prepared to evolve. If you cannot adapt your business, you will be on the outside looking in – which is where nobody wants to be.” 

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When both the plaintiff’s physical and mental condition are in issue in an action, and the plaintiff undergoes a physical examination, will a subsequent application for a psychiatric examination be considered an application for a second medical examination?

Should medical examinations that are ordered as part of the discovery process be characterized as ‘independent’ medical examinations?

Court of Appeal of New Brunswick December/January 2016 Claims Canada 19 October 13, 2009 (Reasons delivered November 2015-02-14 26, 2009) Judgment Rendered: 1:05 PM The plaintiff suffered injuries in a motor vehicle accident and commenced an action Factual Summary: seeking damages. Both the plaintiff’s physical state and mental state were in issue in the action. The plaintiff submitted to a physical examination by the defendant’s expert, but subsequently refused to submit to a psychiatric examination.

Blyth v. Crowther and Kelly 2009 NBCA 80 When both the plaintiff’s physical and mental condition are in issue in an action, and The adefendant made a motion requesting an order that the plaintiff submit to the the plaintiff undergoes a physical examination, will a subsequent application for PM appealed, psychiatric examination. The motions judge granted the15-12-16 order. The2:34 plaintiff psychiatric examination be considered an application for a second medical

• spotlight S

Absolute

Commitment

Moose Jaw, Saskatchewan’s Keith Wright runs Absolute Claims Adjusters – a firm that believes in the value of small town service.

By Craig Harris

20 Claims Canada

p20-21 SPOTLIGHT final2.indd 20

One thing that frustrates Wright is the perception some adjusting firms try to convey that they have “offices in every corner of creation, but it is really just a cell phone.

I get exceedingly perturbed by IAs that profess to have local offices with the best adjusters, but there is nothing there. They are not putting in; they are just taking.”

After many “ years in this business,

I have learned that you have to balance your level of service with what you take on.

“

T

here are city adjusters and then there are country adjusters. Keith Wright happily counts himself in the latter category.

With his adjusting firm in Moose Jaw, he and his wife Bev Wright service a wide swath of Saskatchewan’s southern region, from Davidson in the north to the U.S. border, to Alberta in the west and Manitoba to the east. In between are small towns many people have never heard of – from Gainsborough and Willow Bunch to Shaunavon and Val Marie.

These are just the types of communities Wright feels truly benefit from the service commitment and response of a local adjuster.

“Geography makes a huge difference,” he says. “If you were in a major city, you would go to a client’s house and you would probably have on business attire. When you cross over into a different region, the mentality changes. Here, you show up to a farm with a three-piece suit and the first thought from them is that you must work for the Canada Revenue Agency.”

The ability to handle a smaller number of files while working more closely with clients is a tradeoff Wright gladly made when he moved from Regina to Moose Jaw six years ago with the creation of Absolute Claims Adjusters. He wanted more autonomy, but also craved a more communityfocused experience.

“There is only one independent adjusting company in Moose Jaw and if you are going to operate in a certain area, you should have an office and be licensed and understand that area,” he says. “I carry city licensing; I participate in my town; I try to put back in, rather than just taking out.”

Absolute Claims Adjusters is an alllines adjusting firm that does a large volume of heavy transport and farm business.

Wright has been in the adjusting profession for 33 years, previously “working for a number of the major IAs,” he observes. He also served for 17 years as a firefighter with the town of Moose Jaw. Bev Wright has been a licensed adjuster for six years; before that she was with Halton Regional Police in Ontario as an identification and prisoner transportation officer. In addition to being active as an adjuster, Bev handles all the administrative work of Absolute Claims Adjusters. The firm is also in the process of training and teaching Level 1 adjuster Jackie Crawford.

Despite their small-town focus, both Keith and Bev Wright have traveled extensively in their adjusting lives, including

December/January 2016

stints in Australia, the Caribbean, Fiji and New Zealand. Whether handling catastrophe losses such as floods in Sydney and Brisbane or the aftermath of hurricanes in the Caribbean, Keith Wright notes that: “you learn from everything you do. If you go in with the attitude that you know it all, then you’re done. You can learn something new from every day on the job.”

Even with this international experience, it is the rural communities that have shaped Wright’s philosophy, ethics and approach to business. Being outside of the insurance companies’ urban radius means that the firm gets a considerable amount of regional accounts.

“As a mom and pop operation, we can’t do the big contracts with the largest insurers because we are not a national IA – but we still get business from companies,” Wright says. “If there is a claim in a town like Shaunavon or Val Marie, we are closer than most. These are the places we service on a regular basis for insurers.”

As a smaller adjusting firm, Wright explains that he values the services of a national organization like CIAA. “We have been with the CIAA for a long time; they are phenomenal people,” he says. “It is a very personalized, supportive conversation we can have with CIAA. They keep our interests as a profession front and centre and it makes for a great focal point. Being a small operation, you don’t always have that fallback, and CIAA gives us that support.

With the knowledge base they have, that is an invaluable asset to us.”

When it comes to business practices, Wright notes that his “philosophy is that we have a stated contact time with clients, a stated attendance time. We try very hard to meet those standards and www.claimscanada.ca

15-12-16 2:40 PM

Photo credit: Andy Hamilton Photography

From left: Jackie Crawford, Keith Wright and Bev Wright.

we are able to deliver on those the vast majority of times. We are taking money from insurers to provide a service, and they expect those service standards to be met. Our philosophy is to give the insurer the service they expect and are paying for and give the clients the service they deserve.”

Wherever possible, Wright says he tries to infuse that business approach with respect and consideration to the community in which he is working.

“We always try to make an effort to include and use small town vendors in our process,” Wright observes. “If I go to a small town and there is a local contractor, we will attempt to use that contractor if we can. We are fully functional with Xactimate in our office and we run the scopes – if the local contractor is competitive, then we will make the recommendation to the insurers. It helps keep the community alive. Maybe that idea is wrong or misplaced, but if you don’t support your local communities, they die.”

For Wright, it is that communitybased spirit that defines rural Saskatchwww.claimscanada.ca

p20-21 SPOTLIGHT final2.indd 21

ewan. “They all put something into the pot, that is just the way we are here,” he says. “It is about community. You are assigned a job, you do it the best of your ability, but you also have to have some conscience about the communities you are working in.”

Another key aspect of his business philosophy is taking the time to actually listen to and relate to clients. “One of the things that has been lost in our industry is the ability to listen,” he notes. “A lot of IAs will sit down with clients and only hear what they want to hear; they are not interested in the overall story. However, that story will tell you what you are dealing with. It will give you some context about the loss. You can talk about the person’s situation. In farming, that is easy – you can ask about bushels per acre, what kind of year it was. You are personalizing the situation and taking a lot of the antagonism out of the insurance process.”

The ability to appraise a situation, listen to clients and handle a manageable amount of claims files may be a lost art

in the era of national flat fee contracts.

But Wright says the smaller adjuster can survive quite well with the right business mindset.

“I think the small operator, if he or she does it smart and sets down some guidelines, will survive and keep thriving,” he notes. “The big guys work and rely on volume. When you do that, you make a lot of money, but you don’t always have the time to service what you’re selling. We manage our files on a reasonable basis; that is why we are able to do what we do.”

One of the crucial things Wright has taken away from his years of experience is the importance of finding the right harmony between service and volume.

“After many years in this business, I have learned that you have to balance your level of service with what you take on,” he says.

“If you take on too many files per month, I believe you are setting yourself up for failure. It gets to a point where you have to be able to sustain and fulfill the contracts you make.”

With that said, Wright is a firm believer that the property and casualty insurance industry is bigger than any one adjuster firm. In other words, it takes all types to make the claims world go around.

“The thing I want to impress upon people: there is a place for everyone in this industry and there is more than enough work to go around,” Wright concludes. “The small guys dig just as hard as the big guys, and we let the chips fall where they may. I think we belong to a great industry. We have to maintain our integrity and maintain our respect for each other and for what we do.” 

December/January 2016

Claims Canada 21

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Ontario

Auto Evolution

Upcoming changes to the province’s auto insurance system will come into effect June 2016 – what adjusters need to know.

By Daniel Strigberger

In the 2015 Ontario Budget, the government advised that it was introducing measures to “ensure affordable auto insurance rates.” The Liberals noted that “Ontario’s auto insurance system remains the most generous among Canadian jurisdictions with private marketplace systems” and that the “government’s reforms will continue to ensure the generosity of Ontario’s auto insurance accident benefits.”

On August 26, 2015, the Ontario Legislature filed Bill 251/15, which apparently seeks to achieve the goals set out in the 2015 Budget. For the most part, the amendments apply only to policies issued or renewed on or after June 1, 2016. Existing contracts will remain subject to the current limits until the contract is terminated or renewed.

The most debated/contentious changes are to the catastrophic impairment definitions. There are also significant changes to the non-earner benefits, attendant care benefits, and medical/rehabilitation benefits available under the policy.

What follows is a brief overview of the notable changes and the possible implications the accident benefits and tort industries face with them.

Catastrophic Impairment The catastrophic impairment definition post-June 1, 2016 includes new and/or updated definitions and criteria for traumatic brain injuries for adults and children. The new definition adopts a number of medical tools to categorize these impairments, such as reference to a (bedside) text called “Structured Interviews for the Glasgow Outcome Scale and the Extended Glasgow 22 Claims Canada

p22-23 SAMIS final.indd 22

Outcome Scale: Guidelines for Their Use, Journal of Neurotrauma, Volume 15.” The often-controversial and highly problematic Glasgow Coma Scale category is removed.

The new definition also updates criteria for amputations, ambulatory mobility, loss of vision, and mental and behavioural impairments. Of note, Pastore (Pastore v.

Aviva Canada Inc., 2012 ONCA 642) has been overruled: future catastrophic status for pure mental and behavioural disorders will require marked impairment in three of four aspects of function, or extreme impairment in one aspect, and the person must be precluded from useful function.

Finally, the Desbiens (Desbiens v. Mordini, 2004 CanLII 41166 Ont. Sup. Ct.) and Kusnierz (Kuznierz v. Economical Mutual Insurance Company, 2011 ONCA 823) methods of “combining” physical and mental impairments now must be done with the American Medical Association’s Guides to the Evaluation of Permanent Impairment, 6th edition (as opposed to the 4th edition). The 6th edition provides a specific methodology for assigning a Whole Person Impairment (WPI) to certain mental and behavioural conditions, which the Legislature has adopted for use in conjunction with the 4th edition’s system for rating other impairments.

Catastrophic Limits For catastrophic impairment claims, a new combined medical/rehabilitation and attendant care benefit of $1 million is available. This reduces the potential amount of recovery under the policy significantly from $1 million for medical/ rehabilitation and $1 million for attendant care.

ing period after the accident (onset of disability), up to two years post-accident at a rate of $185/week. If the person continues to meet the disability test after two years, the benefit amount increases to $320/week.

Further, the benefit is available to a claimant who is 16 years of age or older.

As of June 1, 2016, the six-month waiting period is replaced by a four-week waiting period, but the benefit is no longer payable after two years. Therefore, the $320/ week benefit is eliminated and the insurer’s exposure stops at the two-year mark. Finally, the benefit is not payable to anyone who is under 18 years old.

Medical/Rehabilitation and Attendant Care Benefits The new changes significantly water down the non-catastrophic medical/rehabilitation and attendant care benefits. A new standard benefit that combines medical/rehabilitation and attendant care limits these claims to $65,000 (instead of $50,000 for medical/rehabilitation and $36,000 for attendant care).

Most importantly, the non-catastrophic medical/rehabilitation benefits are no longer available after five years post- accident (instead of 10 years). Of course this change may not make much difference in the long term considering how difficult it can (or should) be to make $50,000 last over the course of 10 years. Nevertheless, the insurer’s exposure post- accident for these benefits will stop after five years. The new duration does not apply to children under 18 at the time of the accident.

Non-Earner Benefits

Optional Benefits for Medical/ Rehabilitation and Attendant Care

Under the existing SABS, the non-earner benefits are paid after a six-month wait-

The current optional $100,000 non-catastrophic medical/rehabilitation and $72,000

December/January 2016

www.claimscanada.ca

15-12-16 2:43 PM

attendant care benefit have been eliminated.

Instead, policyholders can purchase a new combined optional medical/rehabilitation and attendant care benefit of $130,000, which doubles the $65,000 standard limit for these benefits. They can also purchase the existing optional $1 million combined medical/rehabilitation and attendant care benefit that is available currently.

For catastrophic impairments, a new optional benefit of up to an additional $1 million for medical/rehabilitation and attendant care will be available. This optional benefit essentially would restore the catastrophic limits to the default catastrophic limits available today (although the medical/rehabilitation benefits would be combined with the attendant care benefits up to $2 million).

should consider advising their customers to purchase enough liability coverage going forward.

about such things as the Spinal Cord Independence Measure and the Snellen Chart.

• We are still waiting to see what the government plans to do with the Ontario Protocol for Traffic Management (OPTIMa) Collaboration. (See more at: http://samislaw.com/wp/2015/10/26/ update-on-the-mig-protocol-project)

One thing we know for sure is that some or all of these changes will be the subject of much debate, at least until the next round of changes occurs. 

• The Licensing Appeal Tribunal, which currently reviews matters such as fishing and gaming licenses, will have to learn

Daniel Strigberger is a partner with Samis & Company and provides litigation services to many of Canada’s leading property and casualty insurers.

Other Changes — Attendant Care The amendments have tweaked the attendant care benefit claim by confining entitlement to actual losses when an attendant care provider performs the services at a cost that is less than the actual amount stipulated on the Form 1 (“Assessment of Attendant Care Needs”).

What Does this Mean?

• The next six to 12 months will be very interesting for Ontario auto insurance stakeholders: • The new changes present a number of challenges for insurers and claimants alike. Insurance adjusters will have to wrap their heads around the several new tools/texts that have been inserted in the new catastrophic definition, which could make responding to these claims difficult for the next while.

• It is not clear whether claimants and insurers will be pushing for full and final settlements of their claims, now that the standard medical/rehabilitation benefits have been capped at five years post accident.

• It will be interesting to see whether motorists start purchasing some of the optional benefits available to protect themselves and their families. Of course doing so would also increase the cost of auto insurance for the insured who wants that protection.

• Tort adjusters should also expect to see more claims with higher exposures now that the standard and catastrophic medical/rehabilitation limits have been significantly reduced. Direct writers/brokers www.claimscanada.ca

p22-23 SAMIS final.indd 23

December/January 2016

Claims Canada 23

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CIAA Members are dedicated to fair practice and integrity on all claims-related services” Giannini Group Ltd. Toronto Hanselman Claims Inc. Milton Integrated Insurance Resources Mississauga E.R. Jones General Insurance Adjusters Ltd. Thunder Bay Kellow & Associates Inc. Claims Consultants & Insurance Adjusters Inc. Mississauga Orangeville Kernaghan Adjusters Limited Kenora Orangeville Oshawa St. Catharines Toronto Lander-Spiers Insurance Adjusters Ltd. Toronto Leading Edge Claims Services Inc. Fonthill Lennox & Company Insurance Adjusters Inc. Burlington Lethbridge Adjusting Limited Mississauga Maltman Group International Toronto Maximum Insurance Adjusters Inc. Mississauga McKeon & Associates Adjusting Company Mississauga MGB Claims Consultants Inc. Toronto NSA Claims Inc. Mississauga OZA Adjusting Ltd. Grimsby Patterson Insurance Adjusters Inc. Collingwood

P.C.A. Adjusters Limited Belleville Kingston Ottawa R. Ian Pepper Insurance Adjusters Inc. Lindsay Picano Claims Adjusters Fort Erie Pinnacle Adjusters Group Inc. Toronto Whitby ProFormance Group Insurance Solutions Inc. Toronto Resource Adjusters Group Toronto G. Rocca & Associates Consulting Inc. Sudbury David A. Roy Adjusters Ltd. Ottawa SCS Insurance Adjusters Ltd. North Bay Sault Ste. Marie Sudbury Thunder Bay Timmins Sedgwick CMS Canada Inc. Toronto D.R. Siegel Insurance Adjusters Limited Pembroke G.R. South & Associates Insurance Adjusters Inc. Orillia TC Insurance Adjusters Ltd. Exeter London Thomson Insurance Adjusters Inc. Collingwood Orangeville Toronto Upright Claims Services Ltd. Ottawa Williams Adjusting Inc. Sunderland

For more information about membership in CIAA, our professional standards, goals and objectives: Canadian Independent Adjusters’ Association 5401 Eglinton Avenue West, Suite 100, Etobicoke, ON M9C 5K6 Phone: (416) 621-6222 Fax: (416) 621-7776 E-mail: info@ciaa-adjusters.ca Website: www.ciaa-adjusters.ca

For a complete listing of all CIAA Professional Members – www.ciaa-adjusters.ca/find.asp

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Expanding the Pollution Exclusion

A recent court case may broaden the application of the pollution exclusion in commercial liability coverage.

By Michael S. Teitelbaum and Yulia Pesin

The “absolute pollution exclusion” is a standard exclusion clause commonly found in Commercial General Liability (“CGL”) policies. It purports to preclude coverage for losses arising out of the discharge or escape of pollutants at or from an insured’s premises.

The term “pollutant” is commonly defined in CGL policies as including “any solid, liquid, gaseous or thermal irritant or contaminant, including smoke, vapour, soot, fumes, acids, alkalis, chemicals and waste. Waste includes materials to be recycled, reconditioned or reclaimed”.

Recently, the British Columbia Court of Appeal, in Precision Plating Ltd. v. Axa Pacific Insurance Co (BCCA 277, 2015), considered the leading case law on this provision, and appears to have broadened the approach to determining its application.

By way of background, in Zurich Insurance Co. v. 686234 Ontario Ltd, (O.J. No.4496, 2002) the Ontario Court of Appeal was the first Canadian court to formulate an approach to the interpretation of this pollution clause. In Zurich, the issue before the Court of Appeal was the scope of the absolute pollution exclusion.

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Given the lack of Canadian jurisprudence at the time, the court undertook a comprehensive analysis of the history and purpose of the exclusion clause, including a review of relevant American case law and academic writing. In doing so, the court cited the view of American professor J.W. Stempel, who concluded that the pollution exclusion was meant to bar “coverage for classic environmental degradation pollution and not tort claims previously conceded to be within the scope of standard CGL coverage.”

The court also summarized two divergent lines of American jurisprudence on the interpretation of the absolute pollution exclusion. In the first, the American courts adopted what the Court of Appeal referred to as a “hyperliteral” interpretation of the wording of the exclusion. This approach often resulted in excluding claims arising from common hazards that were not normally viewed as pollution.

The second line of cases applied a contextual interpretation to the exclusion clause, taking into account the context of the insurance policy, the drafting history and the purpose of the exclusion, as well as the presence of any ambiguity in the wording of the clause.

The court in Zurich found the second line of American cases more persuasive and, accordingly, adopted what it referred to as a “connotative contextual construction” approach. In applying this approach, the court found that the pollution exclusion in Zurich’s

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policy was overtly broad as its literal dictionary interpretation would render carbon monoxide a “pollutant.”

The court therefore held that the exclusion clause was ambiguous and that the ambiguity was to be resolved in favour of the insured. Further, given the historical context of the exclusion, the court concluded that its purpose was to exclude “active industrial polluters of the natural environment” and not coverage for claims such as carbon monoxide emission from a faulty furnace of a residential landlord.

In the result, the court held that Zurich had both a duty to defend the claim and to indemnify the insured for any damages found against it.

In Precision, the British Columbia Court of Appeal appears to have further expanded the scope of the pollution exclusion clause. In the case, the insured was in the business of electroplating. It was sued by several tenants of the commercial strata building in which it was located for damages resulting from chemical solutions that seeped from the insured’s vats into the neighbouring businesses. The seepage of the chemical solutions was caused by a fire that broke out in the insured’s premises resulting in the activation of its sprinkler system which in turn caused its chemical vats to overf low.

The insured held a CGL policy with Axa: however, Axa denied coverage based on the absolute pollution exclusion found in its policy.

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The British Columbia Court of Appeal overturned the lower court decision and found that the pollution exclusion in Axa’s CGL policy excluded damages caused by the release of the insured’s toxic chemicals, which itself was partially caused by the fire. The court reaffirmed the connotative contextual interpretative approach espoused in Zurich. However, it qualified the application of this approach by stating that it was necessary only when the literal dictionary interpretation of the exclusion clause would fail to result in a commercially sensible interpretation of the policy. Specifically, the court took the following approach: “A strict and literal interpretation of the CGL Policy would exclude coverage for liability arising out of a release of the chemicals stored by Precision. I understand Zurich… to suggest that a contextual examination of the policy is appropriate where a literal interpretation may lead to a result that is inconsistent with the insured’s reasonable expectations or is inconsistent with the main purpose of the insurance coverage.”

The court found that the trial judge erred in his analysis by framing the issue “as a question of causation of the damages, rather than causation of the liability.” Specifically, the Court explained that the CGL policy, read with the exclusion, afforded coverage for the insured’s source of liability as alleged in the pleadings and not for the potential damages of the plaintiff.

The distinction between the cause of the damage versus the source of the liability was also emphasized in Zurich, where the court held that “it is necessary to understand that the exclusion focuses on the act of pollution, rather than the resulting personal injury or property damage.”

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In Zurich, for instance, the source of the insured’s liability was the faulty maintenance of its furnace, which is not an act of pollution. The cause of the damages alleged by the plaintiffs, however, was the escape of carbon monoxide, which under a literal dictionary interpretation of the absolute pollution exclusion clause could be classified as pollution.

In contrast, in Precision, both the source of the insured’s liability and the cause of the damage to the plaintiffs was the escape of toxic chemicals from the insured’s property, which according to the court, clearly fell within the common sense meaning of the pollution exclusion.

In both cases, the courts emphasized that the application of the absolute pollution exclusion is strongly dependent on the actual business activities of the insured.

With respect to the absolute pollution exclusion, several general principles can be derived from the case law. The courts’ paramount concern appears to be to ensure that the application of the exclusion clause leads to commercially reasonable results.

Where a reasonable application of the exclusion cannot be achieved, the courts favour a contextual, or in the words of the Zurich decision, a “connotative contextual construction” approach. Thus, the exclusion’s wording and its historical objective are relevant

to the coverage analysis. However, it appears that the ultimate outcome will turn on the nature of the business that causes the pollution exposure.

In Zurich, despite the fact that the language of the pollution exclusion supported a broad application of the clause, the court declined a “hyperliteral” interpretation of the exclusion.

Instead, it introduced a connotative contextual approach and appeared to limit the scope of the exclusion to “active industrial polluters.”

In Precision, the British Columbia Court of Appeal continued to espouse the connotative contextual construction approach. However, the court highlighted the importance of framing the analysis in terms of the source of the insured’s liability rather than the cause of the plaintiff ’s damage. In doing so, it held that a literal interpretation of the exclusion clause can be applied in instances where it would lead to a commercially sensible interpretation of the policy.

Arguably, the British Columbia Court of Appeal has simply added another layer to the analysis by saying that a literal approach can be taken in the appropriate case but, if not, the contextual approach should be used. More importantly, in both cases, the courts emphasized that the application of the absolute pollution exclusion is strongly dependent on the actual business activities of the insured. Given this most recent development, we await with interest how the absolute pollution exclusion will be applied in future cases.

Michael S. Teitelbaum is a partner with Hughes Amys LLP. Yulia Pesin is an associate with Hughes Amys LLP. Hughes Amys is a member firm of The ARC Group of Canada, a network of independent law firms across Canada. 

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Cyber Challenges

What recent American developments reveal about the potential future of cyber liability in Canada.

By Anne Juntunen While the availability of standalone cyber insurance policies in Canada has increased, the field is still in its infancy.

This article reviews recent development in the U.S. while offering a perspective on the uniquely Canadian factors that may affect how cyber insurance claims will develop in this country.

Introduction to Cyber Insurance Standalone cyber liability policies are principally aimed at covering insureds for losses resulting from unknown third parties hacking into the insured’s computer systems and accessing, deleting, or publishing data.

Cyber policies often include both third-party coverage (i.e., defence costs and indemnity in the event of a customer’s claim for damages arising from the insured’s failure to adequately protect the customer’s data) and first-party coverage (i.e., reimbursement for loss arising from the insured’s costs to respond to breaches, such as IT support and public relations specialists).

This straddling of the third-party/firstparty divide is a singular feature of cyber insurance. This has the potential to create challenges as insurers consider whether certain claimed damages fall more appropriately under one or the other – an important question, as many cyber policies provide different limits for each side.

Although data breaches are often the first risk when considering cyber insurance, they are not the only exposures. Depending on the policy, cyber insurance can also cover claims involving defamation, infringement of intellectual property rights and ransom payments associated with cyber extortion threats. Some cyber policies have borrowed coverages usually found in fidelity policies, such as computer fraud and funds transfer fraud coverages.

One challenge of this new line of insurance is the lack of common wording. Unlike older areas of insurance, such as CGL or professional liability, there is no standard “form” cyber policy or wording. The Insur28 Claims Canada

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ance Services Offices has now published a standalone cyber policy that may eventually serve as an industry standard, but for now, the coverage and wordings available under cyber policies are as varied as the number of insurers that underwrite these policies.

Case Law Interpreting Cyber Policies To date, there are no Canadian decisions interpreting the scope of standalone cyber liability coverage. In the U.S. there have been only two issued actions involving coverage under cyber insurance policies.

The first was Travelers v. Federal Recovery Services Inc. (No. 2:14-CV-170-TS D.Utah May 11, 2015), in which the insured, a payment processing company, had been sued by its client for refusing to return certain credit card and bank information belonging to the client’s customers. The court held that the insurer had no duty to defend because the client alleged that the insured had intentionally breached a contract, not acted negligently. This decision simply confirmed that cyber liability policies will be treated like traditional liability policies for purposes of assessing whether the insurer has a duty to defend.

In the second action, Columbia Casualty v. Cottage Health Systems (No. 2:15CV-3432 C.D.Cal., filed May 7, 2015), the insurer sought a declaratory judgment that its standalone cyber policy did not provide coverage for an in insured health care provider’s data breach. The insurer’s position was based on an exclusion for failing to maintain appropriate encryption and other cybersecurity measures. Under the exclusion, coverage was unavailable for any loss arising out of the insured’s failure to “continuously implement the procedures and risk controls” identified in the insured’s coverage application. Unfortunately for the many cyber insurance practitioners anxiously awaiting the court’s analysis, the case was dismissed in July 2015 because the insured had not exhausted the policy’s alternative dispute resolution requirements.

While it provided no answers, Columbia Casualty highlighted a question that is likely to arise again: what are the minimum

December/January 2016

standards required for insureds under cyber policies that contain such exclusions? And, might the benchmark be different for differing types of companies (i.e., a hospital versus a retail store)?

Although Travelers and Columbia Casualty may provide some glimpse into the future of cyber insurance litigation, they provide little guidance as to how cyber policies will be interpreted north of the border.

In fact, most recent developments have involved the prospect of coverage for data breaches under non-cyber policies. For example, in Eyeblaster, the court suggested that a CGL policy could potentially cover claims by a third party alleging that the insured had frozen and rendered the third party’s computer inoperable (Eyeblaster, Inc. v. Federal Insurance Co., 613 F.3d 797 8th Cir. 2010).

This decision is notable in that U.S. courts have generally held that CGL policies do not respond to data breaches. In addition, shareholder litigation in the wake of the widely-publicized Target and Neiman Marcus data breaches has led to speculation about a new wave of litigation against directors and officers who fail to adequately prevent and respond to breaches, with questions about the extent to which D&O coverage may be called upon to respond.

Although cases decided in the CGL and D&O contexts are not directly applicable to cyber coverage, judges are wrestling with similar challenges that cyber insurers will inevitably face. One such challenge involves causation and damages: has the insured’s customer suffered a loss simply because her personal information has been compromised, notwithstanding that no stolen-identity loss has yet occurred? And if a customer does eventually suffer an identity-theft loss, how can this be traced to a particular data breach? If cyber policies respond to liability for damages resulting from data breaches, this can significantly affect the magnitude of the risk insured.

The Seventh Circuit Court of Appeals recently touched on causation in a class action brought by customers whose credit card information had been compromised as part of the 2013 Neiman Marcus data breach. In Remijas v. Neiman Marcus ( WL 4394814 7th www.claimscanada.ca

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Cir. July 20, 2015), the court held that the class plaintiffs may pursue their action notwithstanding that they had not yet suffered identity theft as a result of the breach. The court held that there was an objectively substantial likelihood of the plaintiffs suffering that result.

Cyber Breaches in the Canadian Context As the cyber insurance market grows throughout North America, some uniquely Canadian factors are likely to influence the development of cyber coverage here. One is the deeply ingrained value of privacy as an element of the individual’s right to autonomy. Academics have posited that, unlike Americans who tend to view privacy as a matter of protecting one’s liberty from government intrusion, Canadians view privacy as a matter of protecting one’s dignity, which includes shielding one’s personal information from misuse by corporations and other individuals. This may be one reason why the scope of a private right of action for privacy-related torts is showing signs of expanding.

The Ontario Court of Appeal first recognized the tort of intrusion upon seclusion in 2012 (Jones v. Tsige, 2012 ONCA 32). More recently, in Hopkins v. Kay (2015 ONCA 112), the Ontario Court of Appeal held that individual claimants may issue private actions against health care providers who breach their privacy by failing to adequately protect claimants’ information. Under Hopkins, a health care provider’s privacy breach may lead not only to sanctions by the Privacy Commissioner, but also to claims by individual plaintiffs or even class actions by plaintiffs. The broadening of individual rights of action for disclosure of, or failure to protect, private information has the potential to increase the number of claims made under cyber policies.

New regulatory requirements are also likely to change the risk that could be covered under cyber policies. Currently, Alberta is the only province with mandatory privacy breach notification for non-health carerelated organizations. However, under the new Digital Privacy Act, PIPEDA has been amended to add mandatory data breach notification. The mandatory notification provisions will require companies to notify the Privacy Commissioner and possibly also the individuals whenever there is a breach that presents a “real risk” of harm such as identity theft or reputational damage. While these provisions are not yet in force, they are widely expected to increase the uptake of cyber insurance policies as companies recwww.claimscanada.ca

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ognize the risk of penalties for failure to report and the inevitable claims that will come when a breach becomes public.

Conclusion The uptake of cyber insurance policies in Canada is expected to increase as media coverage of highly-publicized breaches continues to keep the risk visible, particularly as mandatory data breach reporting requirements come into effect. While we wait for the first Canadian cyber claim to wend its way into and through court, claims professionals

would be wise to keep one eye turned southward for a preview of what’s to come.  Anne Juntunen is an associate at Halfnight McKinlay P.C. in Toronto and a member of Canadian Defence Lawyers.

Her practice includes coverage advice and litigation in fidelity and other commercial insurance matters. The author thanks Madeleine Dinnissen, Specialty Claims Examiner at Chubb Insurance Company of Canada, for her input into the issues surrounding cyber policies in Canada.

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December/January 2016

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Liability Notice In Lloyd’s Underwriters v.

Blue Mountain Log Sales Ltd., a B.C. court wrestled with the issue of pre-tender defense costs.

By Todd Davies and Scott Harcus

For obvious reasons, liability insurers want to receive prompt notice of claims and suits that may be covered under their policies. To accomplish this end, notice provisions are included in the standard CGL wording.

The notice provisions typically require the insured to report an accident or occurrence “as soon as practical” and to forward to the insurer any demand or notice “immediately,” once a claim or suit is brought. Despite these stipulations, delay on the part of the insured in reporting will not always relieve an insurer of its obligations under the policy.

On many occasions, Canadian courts have concluded that the notice provisions of the standard CGL policy are terms of the policy, rather than condition precedents for coverage. Courts have found that late reporting constitutes “imperfect compliance” with the policy, and have allowed insureds relief from forfeiture where an insurer has denied a claim due to late reporting, but cannot identify any prejudice caused by the delay.

In the recent case of Lloyd’s Underwriters v. Blue Mountain Log Sales Ltd. 2015 BCSC 630, Mr. Justice McEwan considered whether the insurer, Lloyd’s, was required to reimburse their insured, Blue Mountain, for costs expended by Blue Mountain to defend a claim prior to the claim being reported to Lloyd’s – referred to as pretender defense costs.

The claim related to six lawsuits commenced against Blue Mountain in Washington State. Blue Mountain reported the 30 Claims Canada

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claims to its American insurer, but did not appreciate that the lawsuits could trigger the Lloyd’s polices issued in British Columbia. While the American insurers were put on notice in September 2012, Lloyd’s was not given notice until April 2014. In the interim, significant costs had been incurred defending the claims.

Upon receiving notice, Lloyd’s accepted the claim and sought a determination as to whether the policy covered pre-tender defense costs. Lloyd’s sought to distinguish cases where courts had granted relief from forfeiture due to late reporting, given a lack of prejudice. Lloyd’s pointed out that it had not denied coverage. Rather, at issue, was the proper interpretation of the policy.

Lloyd’s relied not only on the “notice” provision but also the “no voluntary payment” clause in the policy, which read: The Insured shall not, except at his own cost, voluntarily make any payment, assume any obligation or incur any expenses other than for first aid or other medical dental or surgical relief to others at the time of accident.

Lloyd’s argued that the “no voluntary payment” clause had the effect of rendering any pre-tender defence costs the responsibility of the insured. Lloyd’s relied upon a recent American decision from Oregon, which canvassed the case law in the United States and concluded that the balance of authority supported the view that pre-tender defence costs were not recoverable.

Ultimately, McEwan J. refused to follow the majority view in the United States and opted to follow two Canadian decisions: Kelowna (City) v. Royal Insurance Co. of Canada, 1992 CanLII 858 (BCSC) and International Comfort Products Corp.

(Canada) v. Royal Insurance Co. of Canada, [2000] O.J. No. 893.

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In Kelowna (City), the City failed to notify the insurer of the claim until shortly before the trial. The insurer denied the claim because in its opinion the allegations did not fall within the scope of coverage.

The City defended the claim at trial and obtained a dismissal. The City then commenced an action seeking recovery of its defence costs under the policy. The court concluded that there was no prejudice suffered by the insurer because the City had successfully defended the claim. The court also pointed out that when the insurer was eventually notified of the claim it denied the claim on grounds other than the late reporting and that there was no reason to believe it would not have denied the claim had it been reported at the outset. In such circumstances, the court noted that the usual practice would have been for the City of Kelowna to defend the claim and seek to be indemnified at the end. Having found that the grounds of denial were without merit, the court ordered the insurer to pay all of the defense costs.

In International Comfort, the insurer received notice after the case settled. The insured had not contributed to the settlement, but had incurred defense costs of approximately $100,000. As in Kelowna (City), the insurer denied the claim on grounds other than the late reporting. In particular, it was the insurer’s position that various policies were triggered by the claim and that the total deductible payable was in excess of the amount of the defense costs.

The court agreed that a number of policies were triggered by the claim, but disagreed with the insured’s application of the deductibles, such that approximately $40,000 was still payable after the deductibles were taken into account. After resolving the deductible issue, the court considered the issue of late reporting, noting that the inwww.claimscanada.ca

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surer had admitted that no prejudice had been suffered: I note that Royal initially denied coverage on the basis of the deductible exceeding the defence costs. That being the case, it can hardly say it was prejudiced due to late notice. In the circumstances, I exercise my discretion under s. 129 and relieve against forfeiture.

As stated above, Lloyd’s sought to distinguish Kelowna (City) and International Comfort on the basis that it had not denied Blue Mountain’s claim. Rather, it had accepted there was coverage and was only seeking a determination on whether pretender defense costs were recoverable. On this point, McEwan J. concluded: Accordingly, while I appreciate the petitioner’s submission that it has taken no adverse position against the respondents, other than to rely on the notice provision, and that it cannot be said to have declared the respondents in breach, I am of the view that, in the absence of identified prejudice, the respondents may be relieved from the negative consequences asserted by the petitioner. The petitioner is, therefore, not entitled to a declaration that it has

no liability for pre-tender defence costs.

Put in positive terms, the petitioner may not avoid pre-tender defence costs on the basis of the respondents’ failure to give more timely notice.

Lloyd’s argued that the “no voluntary payment” clause had the effect of rendering any pre-tender defence costs the responsibility of the insured.

In coming to this conclusion, McEwan J. stated that to find otherwise would result in the insurer avoiding “an expense for which it has received a premium from the insured, effectively getting something for nothing.” In the authors’ opinion, this concern seems misplaced. The insurer was not “getting something for nothing”.

Indeed, Lloyd’s had agreed to defend the matter going forward, and thus would be earning its premium. It was Lloyd’s that did not get what it bargained for, given the

clear wording of the “no voluntary payment” clause.

It is also unfortunate that our courts have adopted a very narrow view of prejudice, focusing only on prejudice in investigating and defending the claim in question, rather than the general prejudice to an insurer in operating its insurance business. Issues concerning the effect late reporting has on properly setting reserves and financial reporting are ignored by the courts, in favour of a myopic analysis of what the insurer would have done differently with the particular claim.

Lloyds Underwriters v. Blue Mountain Log Sales Ltd. is presently under appeal. It is expected that the appeal will be heard in the spring of 2016.  Todd Davies is a partner with Alexander Holburn Beaudin LLP and a member of the firm’s Insurance and Motor Vehicle Practice Groups.

Scott Harcus is an associate with Alexander Holburn Beaudin and a member of the firm’s Insurance, Construction/Engineering, Environmental, Defamation/Reputation Risk Management, and Insolvency/Restructuring Practices. Alexander Holburn Beaudin LLP is a member firm of The ARC Group of Canada, a network of independent law firms across Canada.

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• on the scene OTS Cunningham Lindsey Canada Claims Services Ltd. (“Cunningham Lindsey”) announced the appointment of Dan Burns, CIP, as Branch Manager, inTrust Toronto branch. inTrust, a division of Cunningham Lindsey Canada, offers customized TPA service and cost-effective solutions across multiple disciplines, covering commercial and personal lines, Dan Burns property and casualty, automobile, major and complex losses and transportation fleet including services offered to Lloyd’s of London clientele. l DSB Claims announced its expanded service territory along with an all-new corporate website and updated company logo. Headquartered in Brampton ON, and a leader in the independent claims adjusting market, DSB Claims now serves clients from seven offices spanning the Greater Toronto and Ontario Area. With claims adjusters in Brampton; Kitchener; Hamilton; Oshawa; Peterborough; Belleville; and Muskoka, DSB Claims can continue to hone the stellar service reputation for which it has become known. “Fast claim response time facilitates a better policyholder experience and a more thorough investigation. In most cases, we can be onsite within 60 to 120 minutes, which is a huge advantage for our clients,” says DSB President, Dara Banga. l Pario Engineering and Environmental Sciences (Pario), one of Canada’s top providers of engineering and environmental services, announced that it has appointed Tara Morissette as Director of Business Development. l

Tara Morissette The Board of Directors and Senior Management team at AssessMed Inc. welcome Dr. Max Kleinman, physiatrist, to its experienced team of specialists in British Columbia.

AssessMed is CARF-accredited and a true national provider of high quality IME services with strategically located regional offices in BC, Alberta, Ontario, Quebec and Atlantic Canada. l

Jérémie MailletLeBlanc

CEP Ottawa is pleased to welcome Jérémie Maillet-LeBlanc, EIT, a new Civil / Structural Engineering Forensic Investigator. Founded in 1972, CEP has grown to a company of over 70 employees covering all fields of Forensic Engineering and Sciences. CEP provides service across Canada with 4 offices strategically located in Laval (Montreal), Quebec City, Oshawa (Toronto) and Ottawa l

STRONE is pleased to announce several recent appointments in the development of its team across Canada. Graham Goodwin - Branch Manager – STRONE Calgary Graham has over 17 years of experience including business ownership. Daniel Ottenbrite - Branch Manager – STRONE East GTA Dan brings over 30 years of experience in the restoration industry. Thomas Stewart – Senior Project Manager – STRONE Ottawa and James Picken – Project Manager – STRONE Ottawa Both Thomas and Jim have worked in different parts of Canada and have now returned to the Ottawa area. Frederik Bonneau - Business Development Representative – STRONE Montreal and Ottawa Frederik comes to STRONE with 10 years of business development experience, notably in the textile restoration and disaster damage restoration industries. l Crawford & Company, the Atlanta, Georgia-based independent provider of claims management solutions to insurance companies and self-insured entities, recently announced a “new simplified operating structure.” The new structure is designed to capitalize on Crawford’s competitive position, enhance the firm’s profitability and align with the global market for insurance companies, reinsurers, brokers, Lloyd’s and the London market as well as self-insured corporations, Crawford & Company said in a statement. Effective immediately, the company’s business segments are: U.S. Property & Casualty, International operations, Broadspire and Garden City Group. “The restructuring allows each operating division to adapt to changing market needs with greater speed and flexibility while ensuring our CEOs are able to devote more time to meeting our many clients’ needs in a competitive claims environment,” said Harsha V. Agadi, Crawford interim president and CEO. l

On Side Restoration is pleased to announce that effective October 19th 2015, James Greenan has been promoted to Branch Manager, Vancouver, On Side’s corporate head office. In other company news, On Side also announced that Peter Duhault is assuming the Abbotsford Branch Management position, in addition to his role as Surrey Branch Manager, effective November 2nd, 2015. l

James Greenan 32 Claims Canada

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Peter Duhault December/January 2016

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APPOINTMENT

Mehran A. Wancho Mehran holds an Honours Bachelor of Arts degree in Criminology from York University, where he graduated Summa Cum Laude.

Mehran received his Juris Doctor from the University of Ottawa’s Faculty of Law, where he graduated Cum Laude. Mehran was the recipient of numerous academic awards during undergrad and law school.

Prior to obtaining his J.D., Mehran worked in the area of personal injury law as a licensed Paralegal with the Law Society of Upper Canada. While in law school, he interned at two esteemed boutique personal injury firms in Toronto. Mehran’s exposure to the personal injury bar provides him with a unique perspective which he incorporates when serving his clients’ needs.

Mehran articled with Blouin, Dunn LLP and was hired back as an associate after being called to the Ontario Bar in 2015. During his articles, Mehran successfully argued a number of opposed motions at the Superior Court of Justice.

Mehran’s practice focuses exclusively on insurance defence litigation and he has had extensive exposure to different aspects of defence work, including personal injury, motor vehicle liability, statutory accident benefits and property damage disputes.

Mehran is a member in good standing with the Law Society of Upper Canada and is also a member of the Canadian Defence Lawyers and Toronto Lawyers Association.

Mehran’s contact information is: mwancho@blouindunn.com (416) 365-7888 ext. 176

• on the scene OTS As of Nov. 17, Canadian insurance brokers will be able to offer policies covering fresh water flooding written by RSA Canada to some homeowners purchasing sewer backup coverage, a senior RSA Canada official recently announced. A new RSA Canada endorsement, called Waterproof, will include a limited sewer backup endorsement plus “enhanced protection for damage caused by fresh water flooding and damage that is also caused by eaves and downspouts and drains, so it is a much more comprehensive coverage,” said Donna Ince, RSA Canada’s senior vice president for personal lines. RSA will launch Waterproof for application of new business Nov. 17 and for renewals Jan. 17. Waterproof will be available across Canada, except for Quebec, Saskatchewan and the territories. l Vehicle collisions in Alberta, New Brunswick, Nova Scotia and Ontario are on the rise, with a 7.3% increase in frequency rate from last year, according to the seventh annual Allstate Insurance Company of Canada Safe Driving Study released in November. The study – which uses Allstate data to track collision frequency among Allstate Canada consumers in Alberta, New Brunswick, Nova Scotia and Ontario – found that the frequency of collisions rose nationally from 5.19% in the previous study to 5.57% this year. [click image below to enlarge] Using their data, Allstate – which provides home and auto insurance products, including usage-based insurance – was able to rank 81 cities across the country based on collision frequency, with Spruce Grove, Alta. being rated the safest with a collision frequency of 3.43%. The community with the highest frequency in collisions was Halifax at 7.12%, Allstate noted in a press release. l Manitoba has witnessed a 42% hike in road fatalities in the province over the last three months compared to the average number of fatalities over the same time period in the previous five years, Manitoba Public Insurance (MPI) reported in late November. Since Sept. 1, MPI notes that 34 people have been killed in vehicle collisions compared to 24 fatalities on average in the previous five years. The deaths since Sept. 1 – almost 50% of this year’s total – bring Manitoba’s 2015 total to 71 people who have died as a result of collisions on public roadways. That is already more than the total number of fatalities recorded for all of 2014 last year. l Saskatchewan Government Insurance recently announced several changes to its safe driver recognition program, which provides discounts to safe drivers and increases premiums for drivers with incidents or convictions. SGI said in a press release the province has approved recommendations put forward by SGI, the government’s monopoly auto insurance carrier. For premiums, SGI has neutral, penalty and safety zones. In the new system that will be implemented in mid 2016, a driver in the “safety zone” will be rated either as a good driver, great driver or safest driver. Those in the neutral zone will continue to be charged the base premium. With the new program, financial penalties will double from $25 to $50 per point for drivers in the penalty zone. l

Blouin Dunn is one of Ontario’s leading insurance defence firms whose members have been providing quality legal support to the insurance community for over 30 years. We offer services in Ontario to property and casualty insurers throughout North America, at all levels of experience, at appropriate and competitive rates.

More than 50 insurers globally are now offering standalone cyber coverage, in addition to other carriers that provide cyber-related endorsements to commercial general liability or multi-peril policies, according to a report released in November

by Moody’s Investors Service, Inc. Along with these cyber policies, a number of insurers are offering valuable loss avoidance and risk mitigation services, Moody’s said in a statement. In the United States, where the largest share of standalone cyber insurance policies are in effect, the segment still remains a niche market within the commercial property and casualty sector, generating a few billion dollars of premiums annually, Moody’s reported. l

www.blouindunn.com

Vancouver-based Square One Insurance Services Inc. has found that the majority of Canadians are not aware of a common home insurance condition that, if not met, eliminates coverage for damage from frozen pipes. Square One Insurance recently conducted a survey and found that 91% of the 1,200 people surveyed were not aware of the condition. The condition requires homeowners who are away for more than a few days to turn off water at the home’s main source and drain all pipes or arrange for someone to enter the home daily and ensure that heat is maintained. l

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December/January 2016

www.claimscanada.ca

15-12-16 2:58 PM

FIRST GENERAL ANNOUNCES NEW OWNERSHIP FRANK AND ADRIAN MIRABELLI HAVE SUCCESSFULLY ACQUIRED ALL OUTSTANDING SHARES OF FIRST GENERAL

Michael Flatt and Lou Abbruzzese are pleased to announce the sale of First General to Frank and Adrian Mirabelli of Mirabelli Corporation.

This transaction marks the completion of the succession strategy developed and managed by all parties. Over the last three years, the executive team has focused on successfully redefining the First General brand and enhancing the value it offers to its clients and network of restoration professionals. First General is proud of our accomplishments, our team and our network and are excited about the opportunities that lie ahead.

Frank Mirabelli, CEO, states: “First General’s market position and growth prospects are greater now than at any time in our history. The restoration environment is evolving rapidly and we have a strong foundation for sustained growth through new and innovative services. We will enhance our brand by continuing to deliver on the needs of our clients and strengthening industry partnerships. The executive team and I look forward to expanding our service offering and the number of First General offices in Canada, the United States and abroad.

We look forward to the continued partnership of every First General office as we become the global premier restoration brand.”

Michael Flatt will continue to consult the executive team at First General for the next five years. Lou Abbruzzese will pursue new interests.

Michael Flatt, former CEO, states: “This announcement marks the beginning of an exciting new chapter for First General. The new executive team has demonstrated a real understanding of our business and I am absolutely convinced that First General is in very good hands.”

Mirabelli Corporation provides Complete North American Facility Service to the worlds most successful Retailers and Commercial Landlords. Our service suite is customized to meet every clients unique service requirements.

First General has been the leading choice for property damage restoration. With over 80 offices across North America we service property owners, insurance companies, policyholders and property managers during times of crisis. First General members honor their commitment to you, our customer, because meeting your expectations and restoring promptly and professionally is what matters.

At this time, First General would also like to acknowledge the contribution of Michael Flatt and Lou Abbruzzese after more than 30 years with First General. Michael Flatt will continue to support the company in a consulting capacity, and we wish the best for Michael and Lou and their families in the future.

Enquiries may be directed to Frank Mirabelli at 416-522-3833

ad right size copy.indd 1

15-10-07 10:19 AM

• on the scene OTS CIAA New Members ClaimsPro Bob Leckie Brent Campbell Carrie Esopenko Craig Mackay Dale Smith Denise E. Alberti Dineen King Eleanor Friesen Glenn Hillgren Greg Burgess Howard Friesen Jeff Kowalchuk John McInnes Josh Friesen Keith Germscheid Kelly Poole Kevin Hengstler Kirsten Rose Lewis Moorman Mark Condic Oscar Castro Pat Bratz Pennie McInnes Scott Boles Scott Burgess Scott Douglass Sharon Colby Teena Thomas Terry Lineger Tim Hauck Brittany Johnston Jennifer Myette Kayla Smith Stephanie Wells Michael Buzzeo Steven Hardy Jennifer MacAulay Amber Bamford Andy Chuchmuch Brenda Burak Bryan Meier Cal Hotchkiss Camille Wilde Celeste Hand Charlene Huynh Craig Gauthier Daryl Doiron Dave Skinner Debby Nickerson Donna Martineau Eric Anthony Erin Wright

Calgary, AB Calgary, AB Calgary, AB Calgary, AB Calgary, AB Calgary, AB Calgary, AB Calgary, AB Calgary, AB Calgary, AB Calgary, AB Calgary, AB Calgary, AB Calgary, AB Calgary, AB Calgary, AB Calgary, AB Calgary, AB Calgary, AB Calgary, AB Calgary, AB Calgary, AB Calgary, AB Calgary, AB Calgary, AB Calgary, AB Calgary, AB Calgary, AB Calgary, AB Calgary, AB Calgary, AB Calgary, AB Calgary, AB Calgary, AB Calgary, AB Calgary, AB Canmore, AB Edmonton, AB Edmonton, AB Edmonton, AB Edmonton, AB Edmonton, AB Edmonton, AB Edmonton, AB Edmonton, AB Edmonton, AB Edmonton, AB Edmonton, AB Edmonton, AB Edmonton, AB Edmonton, AB Edmonton, AB

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

Jeff Jones Julie Hoy Kelly Chipman Kimberly Bailey Leanne Campbell Lloyd Skelly Luke Smith Lynn Fleming Maureen Clarke Michael Lee Mike Stelter Myron Zaharia Nadair Dale Paul Kam Riley Wolfe Sarah Hirst Scott Hamilton Sue Manuel Tyler Norsworthy Umar Walusimbi Janelle Ryerse Darrell Portz Renee Chevalier Rosa Doyle Dale Vey John Lee Michael Moorman Yuvinder Chauhan Craig Mackay Franklin Lawrence Bobby-Lyn Hanton Braidie Rule Carla Buck Crystal Wells Kyler Moore Roger Leclerc Trent Hill Bill Craig Bangu Ntaisi Scott McMullen Francisco Zabala Jenny Morton Shane Christensen Wanda Mackay Brenda Hamilton Brittany Rhodes Luc Turcotte Myles Zajic Jo Dyson Lorne Kastrukoff Troy Fitzpatrick Kari Armella Rachelle Krupinski

Edmonton, AB Edmonton, AB Edmonton, AB Edmonton, AB Edmonton, AB Edmonton, AB Edmonton, AB Edmonton, AB Edmonton, AB Edmonton, AB Edmonton, AB Edmonton, AB Edmonton, AB Edmonton, AB Edmonton, AB Edmonton, AB Edmonton, AB Edmonton, AB Edmonton, AB Edmonton, AB Edmonton, AB Edmonton, AB Edmonton, AB Edmonton, AB Fort McMurray, AB Fort McMurray, AB Fort McMurray, AB Fort McMurray, AB Fort McMurray, AB Fort McMurray, AB Grande Prairie, AB Grande Prairie, AB Grande Prairie, AB Grande Prairie, AB Grande Prairie, AB Grande Prairie, AB Grande Prairie, AB Grande Prairie, AB Hinton, AB Hinton, AB Lethbridge, AB Lethbridge, AB Lethbridge, AB Lethbridge, AB Lethbridge, AB Lloydminster, AB Lloydminster, AB Lloydminster, AB Medicine Hat, AB Medicine Hat, AB Medicine Hat, AB Peace River, AB Peace River, AB

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

To be continued in the February March 2016 issue of Claims Canada.

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December/January 2016

www.claimscanada.ca

15-12-17 3:36 PM

APPOINTMENT

The Government of Alberta announced in late October that it will pump almost $450 million into funding flood protection measures along the Bow and Elbow Rivers around the Calgary area. Insurance Bureau of Canada (IBC) noted in a statement that the move shows Alberta’s “commitment to building resilient communities.” IBC welcomed the decision to provide $297 million to ensure communities along the Elbow River are protected and $150 million to the City of Calgary over 10 years for local projects through the Alberta Community Resilience Program. The funding is meant to help prevent a repeat of the damage and devastation experienced in parts of Calgary and upstream communities during the severe flooding in June 2013, Alberta environment and parks minister Shannon Phillips says. The flooding in southern Alberta two years ago was the costliest natural disaster in Canadian history, resulting in insured losses of about $2 billion. In total, “more than $6 billion in damage was inflicted on our infrastructure and economy,” Phillips says. The government of Alberta also announced in November that it is providing grants totaling nearly $3 million to 12 organizations to help improve the flood and drought resiliency of communities across the province. The grants, through the Watershed Resiliency and Restoration Program, include one grant of $750,000 to The City of Calgary – Water Resources for restoration of riparian areas that were severely damaged by the 2013 flood. Another grant of $749,000 is for the Alberta Birds of Prey Foundation for restoration of wetland features and creation of a 16.2 hectare wetland in a flood sensitive area. l A class action lawsuit for breach of privacy against British Columbia’s government auto insurer, arising from an employee’s access of clients’ personal information, can proceed, but the province’s appeal court does not recognize a common law tort of invasion of privacy. In a decision released Nov.16, the B.C. Court of Appeal upheld a Supreme Court of B.C. ruling, released July 22, 2013, that denied an application from Insurance Corporation of BC (ICBC) to have a lawsuit against the insurer struck in its entirety. Madam Justice Loryl Russell ruled in 2013 that the plaintiff’s claim, of vicarious liability on the part of ICBC, “is a ‘merits-based’ argument which ought to not be determined on an application to strike pleadings.” However, Justice Russell struck the plaintiff’s claim of negligent protection of privacy (based on the province’s Freedom of Information and Protection of Privacy Act) and the plaintiff’s claim of breach of privacy pursuant to common law. Ufuk Ari filed the statement of claim against ICBC on behalf of himself and a proposed class of persons with similar claims. Ari alleges that in or about 2010 and 2011, Ari and at least 65 other individuals had their personal information “wilfully and without a claim of right” accessed by an ICBC employee for “an unauthorized purpose.”. l A total of 59% of Canadian businesses are making data analytics a strategic priority and 31% of Canadian executives already feel that analytics has better prepared their organizations to meet today’s competitive challenges, according to a new Forbes Insights report in cooperation with Ernst & Young (EY). The 2015 EY/Forbes Insights Data & Analytics Impact Index: Don’t Forget the Human Element report said that 31% of Canadian executives feel that analytics has better prepared their organizations to meet today’s competitive challenges, compared to 20% of their counterparts in the United States and 26% globally. Canadian companies are also more willing to reward employees for using analytics in their work, according to the report. Forty percent are willing to help employees expand their opportunities for advancement through the use of data analytics on the job, versus 27% of their counterparts in the U.S. and 33% globally. The global study consisted of a survey and qualitative interviews with 564 senior C-level executives, of whom 11% of chief executives or presidents of their organization. Nearly one-third (32%) of the executives are based in the Asia/Pacific Rim region, 40% are in the Americas and 28% are in Europe, the Middle East and Africa. Industries represented include technology, energy, pharmaceuticals, healthcare, financial services, manufacturing, consumer products and government. l

www.claimscanada.ca

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Mercédes C. Marin Mercédes obtained her Bachelors in Civil Law (LL.L.) from the University of Ottawa in 2013. She made it on to the Dean’s list for the 2012/2013 academic year. She graduated from the National Program, Juris Doctor (J.D.) in 2014.

Mercédes completed her articles at Blouin, Dunn LLP and was hired back as an associate in 2015 after being called to the Ontario Bar. Her practice focuses on insurance defence litigation, including motor vehicle accidents, occupier’s liability, construction claims and WSIB matters. Mercédes has appeared as counsel in interlocutory proceedings and at trials, as second chair, at both the Ontario Superior Court of Justice and Small Claims Court levels.

Prior to practicing law, Mercédes worked in the claims department for a managing insurance agent in the areas of professional liability, construction and environmental law.

Mercédes is fluently bilingual (French and English) and is able to practice in both languages.

Mercédes is a member in good standing with the Law Society of Upper Canada.

Mercédes’ contact information is: mmarin@blouindunn.com 416) 365-7888 ext. 169 Blouin Dunn is one of Ontario’s leading insurance defence firms whose members have been providing quality legal support to the insurance community for over 30 years. We offer services in Ontario to property and casualty insurers throughout North America, at all levels of experience, at appropriate and competitive rates.

www.blouindunn.com

December/January 2016

Claims Canada 37

15-12-16 3:03 PM

• on the scene OTS Toronto insurance and commercial litigation boutique Gilbertson Davis LLP hosted its Annual Fall Reception at the Albany Club on September 10. Industry friends and colleagues enjoyed an evening of fine conversa­tion and cuisine, with background musical accompaniment provided by the Variante Harp & Flute Duo. Guests at the reception included, among others, claims representa­ tives, adjusters, engineers, accoun­tants and other ser­ vice providers. l

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December/January 2016

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15-12-16 3:05 PM

Canadian Independent Adjusters’ Association

32nd Annual General Meeting and Conference September 22 – 25, 2016 The Algonquin Resort, located in New Brunswick’s charming town of St. Andrews by-the-Sea, is one of Canada’s most luxurious and legendary resorts.

Known for its majestic presence, maritime hospitality, and invigorating seaside allure this destination truly offers the best of the past with contemporary amenities.

SAVE THE DATE CIAA New Brunswick ad.indd 1

15-12-14 4:34 PM

• on the scene OTS As a warm-up for the 2015 RIMS Canada Conference, which took place this year in Quebec City, Crawford and Company (Canada) Inc. held its annual RIMS Canada Conference dinner on September 26 at Il Bello Ristorante. l

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December/January 2016

www.claimscanada.ca

15-12-16 3:09 PM

CIAA REGIONAL PRESIDENTS 2015 – 2016 Newfoundland & Labrador TBA

Nova Scotia Michael Connolly, BA, CFEI, CIP ClaimsPro 30 Damascus Rd., Suite 220 Halifax, NS B4A 0C1 Phone: (902) 835-5065 Fax: (902) 835-0848 E-mail: michael.connolly@scm.ca

New Brunswick & Prince Edward Island Greg Potten, BPE, CIP, CFEI AMG Claims Inc. 212 Queen Street, Unit 308 Fredericton, NB E3B 1A8 Phone: (506) 458-9000 Fax: (506) 458-9595 E-mail: greg.potten@amgclaims.ca

Quebec/AESIQ Denis Duchesne Cunningham Lindsey Canada Claims Services Ltd. 1250 rue Guy, bureau 1000 Montreal, QC H3H 2T4 Phone: (514) 938-5400 Fax: (514) 938-5445 E-mail: dduchesne@cl-na.com

Ontario Maria Joshua, FCIP Sedgwick CMS Canada Inc. 21 Four Seasons Place, Suite 100 Toronto, ON M9B 6J8 Phone: (416) 695-5100 Fax: (416) 695-5120 E-mail: maria.joshua@sedgwickcms.ca

Manitoba Craig Shanks, BA, CIP Network Adjusters Ltd. 64 Regent Cres.

Brandon, MB R7B 2W9 Phone: (204) 725-7436 Fax: (204) 725-7437 E-mail: craig.shanks@mymts.net

Saskatchewan Justin Braaten, FCIP, CRM, XAT Capital Claims Adjusters Limited 3500 – 13th Avenue Regina, SK S4T 1P9 Phone: 1 866 550-0516 Fax: 1 866 725-4794 E-mail: justin@capitalclaims.ca

Western M. Doreen Lennon, CIP Townsend & Leedham Adjusters Ltd. 200, 4245 - 97 Street Edmonton, AB T6E 5Y7 Phone: (780) 463-7776 Fax: (780) 462-1280 E-mail: dlennon@tladjusters.com

PACIFIC TBA

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National Standing Committees 2015-2016 ADVISORY Heather Matthews, CIP, CRM Crawford & Company (Canada) Inc. 539 Riverbend Dr. Kitchener, ON N2K 3S3 Phone: (519) 578-5540 Fax: (519) 578-2868 E-mail: Heather.Matthews@crawco.ca Gary Ellis, BBA, FCIP, RF, FCLA, FCIAA, FIFAA AMG Claims Inc. P.O. Box 20102 Sherwood Charlottetown, PE C1A 9E3 Phone: (902) 628-9091 Fax: (902) 628-9093 E-mail: gary.ellis@amgclaims.ca Albert Poon, CIP Cunningham Lindsey Canada Claims Services Ltd. 1102 – 50 Burnhamthorpe Rd. W. Mississauga, ON L5B 3C2 Phone: (905) 896-8181 Fax: (905) 896-3485 E-mail: apoon@cl-na.com Paul Feron, FCIP, CRM ClaimsPro 210 – 746 Baseline Rd. East London, ON N6C 5Z2 Phone: (519) 645-6500 Fax: (519) 645-2250 E-mail: paul.feron@scm.ca Lorri Frederick ClaimsPro 120 Adelaide St. W., Suite 2401 Toronto, ON M5H 1T1 Phone: (905) 308-6292 Fax: (416) 360-7335 E-mail: lorri.frederick@scm.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 E. Grant King, BA, B.Ed., CIP Crawford & Company (Canada) Inc. 120 – 237 Brownlow Avenue Dartmouth, NS B3B 2C7 Phone: (902) 468-7787 Fax: (902) 468-5822 E-mail: Grant.King@crawco.ca John Jones, BA 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: jjones@cl-na.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 Marie C. Gallagher, FCIP, CRM Kernaghan Adjusters Limited 602 – 1 St. Paul Street St. Catharines, ON L2R 7L3 Phone: (289) 786-1074 Fax: (289) 723-1979 E-mail: mgallagher@kernaghan.com Craig J. Walker, CIP, FCIAA, FIFAA Maltman Group International 3550 Victoria Park Ave., Suite 301 Toronto, ON M2H 2N5 Phone: (416) 492-4411 Fax: (416) 492-5657 E-mail: cwalker@maltmans.com CIAA NATIONAL INSURANCE INDUSTRY ADVISORY BOARD Patti M. Kernaghan, FCIP, CRM Kernaghan Adjusters Limited 300 - 1575 West Georgia Street Vancouver, BC V6G 2V3 Phone: 1-800-387-5677 Fax: 1-800-387-5644 E-mail: pkernaghan@kernaghan.com Fred R. Plant, AIIC ClaimsPro 85 Englehart Street Dieppe, NB E1A 8K2 Phone: (506) 853-8507 Fax: (506) 853-8501 E-mail: fred.plant@scm.ca

Heather Matthews, CIP, CRM Crawford & Company (Canada) Inc. 539 Riverbend Dr. Kitchener, ON N2K 3S3 Phone: (519) 578-5540 Fax: (519) 578-2868 E-mail: Heather.Matthews@crawco.ca Monica Kuzyk, FCIP, CRM Curo Claims Services 125 Northfield Dr. W., P.O. Box 218 Waterloo, ON N2J 3Z9 Phone: (866) 952-2876 Fax: (519) 888-9704 E-mail: mkuzyk@curocanada.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 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

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 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 John D. Seyler, CIP Integrated Insurance Resources 5080 Timberlea Blvd., Suite 214 Mississauga, ON L4W 4M2 Phone: (905) 238-4985 Fax: (905) 238-2735 E-mail: jseyler@integrated-ins.ca Fred R. Plant, AIIC ClaimsPro 85 Englehart Street Dieppe, NB E1A 8K2 Phone: (506) 853-8507 Fax: (506) 853-8501 E-mail: fred.plant@scm.ca CONSTITUTION & RULES Paul Feron, FCIP, CRM ClaimsPro 210 – 746 Baseline Rd. East London, ON N6C 5Z2 Phone: (519) 645-6500 Fax: (519) 645-2250 E-mail: paul.feron@scm.ca

Marie C. Gallagher, FCIP, CRM Kernaghan Adjusters Limited 602 – 1 St. Paul Street St. Catharines, ON L2R 7L3 Phone: (289) 786-1074 CONVENTION Fax: (289) 723-1979 TBA E-mail: mgallagher@kernaghan.com DESIGNATION Paul W. Greening, CLA, FCIAA Craig J. Walker, CIP, FCIAA, FIFAA Greening Aviation Claims Inc. Maltman Group International 26C Palliser Park, Box 190 River3550 Victoria Park Ave., Suite 301 hurst, SK S0H 3P0 Toronto, ON M2H 2N5 Phone: (306) 353-2000 Phone: (416) 492-4411 Fax: (306) 353-2200 E-mail: pgreening@sasktel.net Fax: (416) 492-5657 E-mail: cwalker@maltmans.com E. Brian Gough, FCIP, CLA, FCIAA Marsh Adjustment Limited Sasha Alexander 1550 Bedford Highway, Suite 711 University of Guelph Bedford, NS B4A 1E6 Alexander Hall Phone: (902) 469-3537 50 Stone Road East Fax: (902) 469-2396 Guelph, ON N1G 2W2 E-mail: ebgough@marshadj.com Phone: (519) 824-4120 Fax: (519) 824-0364 Robert V. Pearson, CLA, FCIAA E-mail: sasha@uoguelph.ca CIAA Honorary Life Member c/o CIAA National Office 5401 Eglinton Ave. W., Suite 100 Tim Guernsey Etobicoke, ON M9C 5K6 RSA Canada Phone: (416) 621-6222 18 York Street, Suite 800 Fax: (416) 621-7776 Toronto, ON M5J 2T8 E-mail: info@ciaa-adjusters.ca Phone: (416) 366-7511 Fax: (416) 367-9869 EDITORIAL E-mail: tim.guernsey@rsagroup.ca Mary Charman, CIP Crawford & Company (Canada) Inc. Peter Hohman 1 – 120 Mulock Dr. Insurance Institute of Canada Newmarket, ON L3Y 7C5 18 King Street East, 6th Floor Phone: (905) 898-0008 Toronto, ON M5C 1C4 Fax: (905) 898-1705 Phone: E-mail: Mary.Charman@crawco.ca Fax: E-mail: phohman@insuranceinstitute.ca Dan Langer TD Insurance 3650 Victoria Park Ave. North York,, ON M2H 3P7 Phone: (416) 774-3712 Fax: (416) 774-3120 E-mail: dan.langer@tdinsurance.com Justin MacGregor Highgate Insurance Brokers Inc. 151 Rose Glen Rd. Port Hope, ON L1A 3V6 Phone: (905) 885-1551 E-mail: justinmacgregor@highgateinsurance.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 Mark Weir Intact Financial Corporation 700 University Avenue, 13th Floor Toronto, ON M5G 0A1 Phone: (416) 341-1464 Fax: (416) 217-0562 E-mail: mark.weir@intact.net

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 EDUCATION Gary Ellis, BBA, FCIP, RF, FCLA, FCIAA, FIFAA AMG Claims Inc. P.O. Box 20102 Sherwood Charlottetown, PE C1A 9E3 Phone: (902) 628-9091 Fax: (902) 628-9093 E-mail: gary.ellis@amgclaims.ca EMERGENCY MEASURES Richard Van Horne Action Investigations Inc. 2 Catelina Court Dartmouth, NS B2X 3G9 Phone: (902) 462-1222 Fax: (902) 462-3688 E-mail: richardvanhorne@actioninvestigations.ca FINANCE John D. Seyler, CIP Integrated Insurance Resources 5080 Timberlea Blvd., Suite 214 Mississauga, ON L4W 4M2 Phone: (905) 238-4985 Fax: (905) 238-2735 E-mail: jseyler@integrated-ins.ca

December/January 2016

Fred R. Plant, AIIC ClaimsPro 85 Englehart Street Dieppe, NB E1A 8K2 Phone: (506) 853-8507 Fax: (506) 853-8501 E-mail: fred.plant@scm.ca Albert Poon, CIP Cunningham Lindsey Canada Claims Services Ltd. 1102 – 50 Burnhamthorpe Rd. W. Mississauga, ON L5B 3C2 Phone: (905) 896-8181 Fax: (905) 896-3485 E-mail: apoon@cl-na.com IBC: LIAISON, LEGISLATIVE & FORMS Paul Hancock, B.Sc., CIP Crawford & Company (Canada) Inc. 300 – 123 Front Street West Toronto, ON M5J 2M2 Phone: (416) 867-1188 Fax: (416) 867-1925 E-mail: Paul.Hancock@crawco.ca LICENSING J. Miles O. Barber, B.Comm. (Hons.), FCIP, CRM Network Adjusters Ltd. 67 Folkestone Blvd.

Winnipeg, MB R3P 0B4 Phone: (204) 897-5793 Fax: (204) 897-5797 E-mail: mbarber@mts.net MEMBERSHIP & QUALIFICATIONS Marie C. Gallagher, FCIP, CRM Kernaghan Adjusters Limited 602 – 1 St. Paul Street St. Catharines, ON L2R 7L3 Phone: (289) 786-1074 Fax: (289) 723-1979 E-mail: mgallagher@kernaghan.com NOMINATING 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 Fred R. Plant, AIIC ClaimsPro 85 Englehart Street Dieppe, NB E1A 8K2 Phone: (506) 853-8507 Fax: (506) 853-8501 E-mail: fred.plant@scm.ca Lorri Frederick ClaimsPro 120 Adelaide St. W., Suite 2401 Toronto, ON M5H 1T1 Phone: (905) 308-6292 Fax: (416) 360-7335 E-mail: lorri.frederick@scm.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 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 ClaimsPro 120 Adelaide St. W., Suite 2401 Toronto, ON M5H 1T1 Phone: (416) 777-4479 Fax: (416) 360-7335 E-mail: keith.edwards@scm.ca PROFESSIONAL PRACTICES 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

Claims Canada 41

15-12-16 3:37 PM

• on the scene OTS To help kick off the 2015 RIMS Canada Conference, in Quebec City, SCM Insurance Services hosted its annual RIMS Canada Cocktail Party at the Musée de la Civilisation on September 26. l

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December/January 2016

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• on the scene OTS More than 60 companies and organi­ zations providing products and services filled the Exhibit Hall at the 2015 RIMS Canada Conference in Quebec City, held September 27 to 30.l

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• on the scene OTS ARC Group Canada hosted a cocktail party at the 2015 RIMS Canada Conference in Quebec City at Savini Restobar on September 28. Guests enjoyed hors d’oeuvres and network­ing with fellow conference delegates and attendees. l

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