Claims Canada FebMarch 2013

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February/March 2013

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THY SELF

Official Journal of the Canadian Indeépendent Adjusters’ Association

Adjusters Tap into the Self-Insured Retention Client

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Contents FEBRUARY/MARCH 2013 • VOLUME 7 • NUMBER

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Cover Feature

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12 Know Thy Self Independent adjusters can find an important market in self-insured retention (SIR) clients.

While insurance industry cycles often dictate the appetite for alternative risk transfer, adjusters who persist in this field are discovering that these clients present an avenue of opportunity – and challenge.

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BY CRAIG HARRIS

Spotlight 20 The Mediator Stacey Rose, president of B.C.’s Cornerstone Adjusters, believes an adjuster’s job is all about finding resolution.

BY CRAIG HARRIS

Education Forum 40 Examining the Experts Courts are increasingly scrutinizing the role played by expert witnesses.

News Features 22 The Hybrid Storm A meteorologist offers a Canadian perspective on Superstorm Sandy’s path of devastation.

BY GEOFF COULSON

26 High Stakes Litigation

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The case of Brandiferri v. Wawanesa Mutual Insurance Company shows how a complex case went wrong.

BY GLENN GIBSON

31 Delving into D&O What type of “extrinsic evidence” can be considered on a coverage application?

BY MICHAEL TEITELBAUM AND HYLA KORN

34 Solar Systems Rooftop solar farms represent an emerging claims field that adjusters should understand.

BY DIONE SCHELTUS AND SCOTT BROAD

38 Rethinking Retirement Vocational services are increasingly relevant in today’s aging workforce.

BY FRANK MALITO

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Departments 4 First Notice 42 On The Scene

Columns 10 President’s Message 40 Education Forum

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• first notice FN FSCO lays charges against rehab clinics, individuals The Financial Services Commission of Ontario (FSCO) laid 84 charges under Ontario’s Insurance Act in mid-January against two Toronto rehabilitation clinics and four individuals alleged to have submitted false invoices to auto insurers.

The clinics were each charged with seven counts of knowingly making false or misleading statements to an auto insurer to obtain payment for goods and services provided to an insured, and seven counts of engaging in an unfair or The clinics charged include Fairview Assessment Centre and Pacific Assessment Centre, both located on Finch Ave. West in Toronto. Four individuals charged were Danny Grossi, Alexandre Lobatch, Yaniv Tamsout and Vitali Tourkov.

“When fraudsters falsify accident treatment bills, Ontario drivers take the hit through higher premiums,” Philip Howell, CEO and Superintendent of FSCO noted.

Meanwhile, in mid-December York Regional Police north of Toronto arrested and charged nine individuals in connection with alleged staged collisions. The arrests were made as a result of the second phase of Project Sideswipe, an ongoing investigation into allegedly false auto insurance claims at medical rehabilitation and assessment centres in and near Toronto.

“As of December 13, 2012, nine suspects had been arrested and 41 charges, including participate in criminal organization, possession of proceeds of crime over $5,000 and money laundering have been laid,” York Regional Police announced in December.

The nine people charged were in addition to 51 individuals charged with 201 counts in the first phase of Project Sideswipe. The investigation was originally launched by the Insurance Bureau of Canada (IBC) in August 2010, which subsequently turned over its information to the police. ●

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Survey shows support for improved claims processes Improving the insurance claims process and upgrading or replacing claims systems were among the key focus areas for the majority of insurance claims professionals in the U.S. responding to a survey by Massachusetts-based Trillium Software.

Almost 93% of respondents cite insurance claims process improvement as the top initiative to lower operational costs, notes a statement from Trillium Software, Improving claims process was followed by staff training, software implementation and staff reorganization.

Conducted in the fourth quarter of 2012, the survey aggregated information from approximately 30 insurance claims executives, managers and adjusters across all major lines of business.

Highlights of the survey include the following: • 74% of insurers believe their claims systems will support their operations for less than five years;

• 55.6% of respondents cited disagreements on insurance claims decisions as a key customer issue, which can result from insurance claims process issues and less-than-optimal data utilization; • 40.7% of claims units surveyed do not currently utilize analytics; and • 40.7% of respondents noted new software implementation would be a high priority in order to improve the bottom line.

“Claims professionals are well-aware of the challenges they face in improving their claims processes, reducing costs, enhancing staff performance and decreasing cycle time,” Michael Chochreck, insurance solutions principal consultant at Trillium Software, notes. “It is critical that claims professionals gain insight into the universe of data flowing through their organization, and harness this information to more effectively serve their customers and grow their business.” l

Industry could see more M&A activity The Canadian insurance industry could see more merger and acquisition activity in 2013, in part because of continuing low investment returns, suggests a new outlook report from Aon Risk Solutions.

Overall, the market will remain stable in 2013, and insurers are expected to continue showing underwriting discipline this year, notes the company’s 2013 Canadian Insurance Market Report. However, the current low interest rate environment, which looks set to continue at least in the short term, means insurers must find “better ways to invest and deploy capital,” which could lead to more M&A activity this year, says the report, which provides breakdowns of pricing, coverage and capacity provincially and by several markets.

Last year also saw a moderately low level of natural catastrophes, apart from Hurricane Sandy, from which loss figures aren’t yet finalized.

That has allowed the Canadian market to have strong capital levels, the report notes.

Regulation requirements going forward will also be a key issue this

year, Aon says. “In addition to potential impacts of Solvency II regulation, Canada’s federal insurance regulator, the Office of the Superintendent of Financial Institutions (OSFI), is proposing guidelines that will impact capital assessments as well as the probable maximum loss (PML) calculations for earthquake exposures,” the report notes. These changes will significantly reduce property capacity available for policyholders’ risks, particularly in British Columbia.” l

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• first notice FN Cyber threat top business risk: survey Corporate executives are more concerned about cyber threats than other major business risks, a new survey sponsored by insurance giant AIG suggests.

More than 85% of the 258 executives surveyed said they were very or somewhat concerned about cyber risks to their organizations, compared with the group’s response to six other areas of risk, including income loss (82%), property damage (80%), and securities and investment risk (76%).

Out of executives and insurance brokers, 80% said they find it difficult to keep pace with changing cyber threats, AIG noted. For most executives and brokers (69%), the reputational risk involved with a cyber attack is greater than the financial risk, the company also said.

Other findings from the survey include: More than seven in ten (75%) executives and brokers say legal compliance issues are making companies think more about cyber risks.

The vast majority of brokers and executives (82%) believe hackers are the primary source of cyber threats, though a significant portion of those surveyed (71%) also perceive human error as a significant component of cyber risk. l

Ontario floats regulatory changes to fight fraud The Ontario government is proposing several regulatory amendments, slated to go into effect June 1, as part of ongoing efforts to fight auto insurance fraud in the province.

The regulatory changes include: • Requiring insurers to provide claimants all reasons for denying a claim.

• Giving claimants the right to receive a bi-monthly, detailed statement of benefits paid out on their behalf.

• Increasing the role of claimants in fraud prevention (e.g. require them to confirm attendance at health clinic).

• Making providers subject to sanctions for overcharging insurers for goods and services and banning them from asking consumers to sign blank claim forms.

The changes come in part as a response to the final report from the Auto Insurance Anti-Fraud Task Force. That report outlined about 40 recommendations for fighting fraud, which many in the insurance industry consider a major problem that leads to much higher premiums for all Ontario drivers.

“The importance of our auto insurance reforms and the impact they will have on Ontario drivers cannot be underestimated,” Finance Minister Dwight Duncan noted in a January government statement. “The government will continue to take the necessary steps to

crack down on fraud which will help lower premiums, increase road safety and ensure people hurt in car accidents get the treatment they need.”

The Insurance Brokers Association of Ontario commended the government on its first steps in implementing the report recommendations.

“IBAO is pleased to see that action is being taken with the initial first steps announced today,” IBAO CEO Randy Carroll commented. “However, there is still much more to do in order to tackle the fraud problem in Ontario auto insurance.”

In related news, the ability for the Financial Services Commission of Ontario (FSCO) to impose administrative monetary penalties (AMPs in the province’s insurance sector went into force January 1, a long-considered move that has been applauded by some within the industry.

In the 2012 Ontario Budget, the government announced that it would implement AMPs in the insurance sector as a way for FSCO to promote compliance and address violations of its regulations. l

New Brunswick court orders production of fire documents The New Brunswick Court of Appeal recently upheld a lower court decision requiring a fire insurance claimant to produce records for State Farm Fire & Casualty Insurance.

The appeal court dismissed an appeal from Karen Bennett of an Oct. 2011 decision by Judge Judy Clendening of the Court of Queen’s Bench, which ordered Bennett to produce several documents for State Farm.

According to court records, Bennett was the owner of a property in Nashwaak Village, about 15 km north of Fredericton, which was destroyed by fire on June 19, 2008.

State Farm denied her insurance claims on the grounds that the home had been vacant for more than 30 consecutive days, that there had been “a material misrepresentation regarding the vacancy of the home” and that she “failed to give notice of a material change in the risk when the home became vacant.”

In background information provided with Judge Clendening’s ruling, the Royal Canadian Mounted Police conducted an investigation “because it is suspected that the fire may have been deliberately set.”

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Bennett has argued State Farm should not be allowed to get RCMP documents related to the fire for several reasons. In its Jan. 10 decision, the Court of Appeal essentially rejected all of her arguments.

“Ms. Bennett argues that the documents produced by the RCMP ‘should not be used for parasitic or collateral purposes,’ the appeal court noted in a decision by Judges Marc Richard, Richard Bell and Bradley Green. “She submits that ‘[n]either the police nor the Crown should be coopted into the private proceedings between parties without any limitations,’ on the basis that it is ‘not the role they were created to fulfill.’”

But the appeal court said this argument was not grounds for appeal.

“No compelling argument has been made in support of an overriding public policy reason to shelter relevant documents from disclosure and production in a civil matter simply because these originated or were gathered in the course of a police investigation,” the court noted. “If the documents are not otherwise cloaked by privilege or immunity, and if they are relevant and shed light on the truth, the interests of justice are served by their disclosure, not by their suppression.” l

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• first notice FN Natural perils in 2012 cause $72 billion in insured losses In its recently released annual global climate and catastrophe report, Aon Benfield noted that the costliest catastrophe worldwide in 2012 was Hurricane Sandy, while a hailstorm July 12 in Calgary led to claims exceeding $500 million.

Impact Forecasting, the Aon Benfield unit that develops software and catastrophe models, published the Annual Global Climate and Catastrophe report. It noted there were 295 natural peril events worldwide in 2012, with insured losses of US$72 billion and total economic losses of US$200 billion. The 10-year average for annual insured and economic losses were US$52-billion and US$187 billion respectively, Impact Forecasting reported.

“Hurricane Sandy was the costliest single event of the year causing an estimated US$28.2 billion insured loss for Sandy, combining private insurers and governmentsponsored programs, and approximately US$65 billion in economic losses across the United States, the Caribbean, the Bahamas and Canada,” the report noted. “These losses remain subject to change.”

Worldwide, about two-thirds of insurance losses were from Hurricane Sandy and the drought in the U.S. alone. Of the oth-

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

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

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

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

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

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er eight events that made the list of the top 10 global insured loss events, only one was outside the U.S. Aon Benfield counted two earthquakes in May in Italy as one catastrophe. Economic and insured losses from these were US$15.8 billion and US$1.3 billion respectively.

The Aon Benfield report pegged the insured and economic losses of the year-long drought and heat wave last year in the U.S. at US$20 billion and US$35 billion respectively.

In Calgary, a hailstorm July 12th damaged homes, businesses, trees, vehicles and power lines. “The hardest-hit area of Calgary came in the metro region’s northeast as the Insurance Bureau of Canada reported that claims payouts were in excess of $552 million,” Aon Benfield noted. “Total economic losses were even higher.”

Other events of Canada highlighted in the report included flooding in central and eastern Canada May 25 through 29, which damaged 1,100 homes in Thunder Bay, Ont. and infrastructure in Montreal. Quoting IBC numbers, Aon Benfield noted claims were at least $260 million. l

Claims Canada

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Gary White Production Manager (416) 510-6760

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

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

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Message from the President La Plume du Président JOHN D. SEYLER I think we need to add some days to February. As adjusters, all we sell is time and knowledge; with all that goes on this month, it is much too short.

CIAA’s Mid-Year meeting and the CIAA National Insurance Industry Advisory Board (NIIAB) meeting were held at the start of a very busy week full of events where industry people converge from across Canada.

The CIAA NIIAB was formed to maintain a pro-active national forum working on behalf of Canada’s Claims Professionals to address and resolve mutual and individual issues of concern.

It struck me in the meeting when concern was expressed about publishing fraud indicators as a training aid. Could this potentially be seen as bad faith? While I believe that the majority of adjusters undertake an investigation with the mindset that their objective is to fairly adjudicate claims, they also have distaste for blatant abuse of the insurance system. If something doesn’t pass the “smell test,” it should be pursued and investigated. The thought that training adjusters to protect the insuring public from the criminals committing insurance fraud could be construed as bad faith seems bizarre.

This tied in nicely with this year’s CIAA/CICMA Ontario Joint Conference theme. The organizing committee is to be commended for providing an exceptional education program reminding us all that we are in the business of customer service. The presenters hit home that “attitude” far outweighs “ability” in serving the industry well. Steve Scullion of Granite Claims Solutions suggested that following the natural steps of investigation along with an attitude to adhere to the spirit of the policy are essential for adjusters to avoid allegations of bad faith. When you combine this with Carl Van’s approach to serving our customers, it was clear that this advice will not only make you a better adjuster, but allow you to cope with the constant pressures of our industry. Our affiliation with CICMA and these conferences are really one of the great benefits of membership.

It was my pleasure to see so many new members approved at the CIAA Mid-Year meeting. The majority of the membership applications were from our colleagues at Cunningham Lindsey and we are excited to have them back in our association. In my discussions with Cunningham Lindsey’s management team, it was clear they were impressed with CIAA’s ongoing efforts on behalf of the profession and we look forward to their contributions in this process.

Some of the key areas of recent interest include The Department of Finance’s present review of the current GST/HST tax system within the financial services sector. As one of the stakeholders, CIAA National participated in their assessment of the current status – any future recommendations will be based on improvements Finance feels can be achieved in efficiency, fairness and simplicity of handling GST/HST – essentially value added taxes (VAT). At their request, your executive, with the assistance of Bob Krische of Crawford & Company, have submitted a formal position paper outlining CIAA’s recommendations.

To condense it to one line: independent adjusters should be treated in a similar fashion as insurers to ensure equality in taxation for all in10 Claims Canada

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Je crois que nous devons ajouter quelques jours de plus au mois de février. En tant qu’experts en sinistres, tout ce que nous vendons c’est du temps et des connaissances; et avec tout ce qui se passe ce mois-ci, février est beaucoup trop court.

La réunion de mi-année de l’ACEI et la réunion du Conseil consultatif national de l’industrie de l’assurance de l’ACEI (CCNIA) se sont tenues au début d’une semaine très occupée riche en événements dans le cadre de laquelle des gens de l’industrie de partout au Canada se sont rassemblés.

Le CCNIA de l’ACEI a été formé pour maintenir un forum national proactif qui travaille pour le compte des professionnels en sinistres au Canada afin de traiter et de résoudre leurs problèmes communs et individuels.

Ce qui m’a interloqué lors de la réunion, c’est que la publication des indicateurs de fraude comme aide à la formation est devenue un sujet de préoccupation. Bien que je crois que la majorité des experts entreprennent une enquête en gardant à l’esprit que leur objectif est d’évaluer équitablement les réclamations, ils sont aussi dégoûtés par les abus flagrants du système d’assurance. Si quelque chose « sent mauvais », il faut suivre cette intuition et faire enquête.

L’idée que la formation des experts en sinistres pour assurer la protection du public contre les criminels qui commettent une fraude d’assurance peut être interprétée comme de la mauvaise foi me semble bizarre.

Ceci s’incorpore naturellement au thème de la conférence commune de l’ACEI et de l’ACDSA en Ontario de cette année. Le comité d’organisation doit être félicité pour avoir fourni un programme de formation exceptionnel qui nous rappelle à tous que nous sommes dans le secteur du service à la clientèle. Les présentateurs avaient vraiment raison de dire que l’« attitude » l’emporte de loin sur la « capacité » pour ce qui est de bien servir l’industrie. Steve Scullion de Granite Claims Solutions a suggéré qu’il est essentiel pour les experts de suivre les étapes naturelles de l’enquête avec l’attitude de respecter l’esprit de la police pour éviter toute allégation de mauvaise foi. Lorsque vous combinez cela à l’approche de Carl Van pour servir nos clients, il était clair qu’en prenant leurs conseils au sérieux, non seulement vous pourrez devenir un meilleur expert en sinistres, mais vous pourrez aussi mieux résister aux pressions constantes de notre industrie.

Notre affiliation avec l’ACDSA et ces conférences sont vraiment l’un des grands avantages de l’adhésion.

C’est un réel bonheur que de voir tant de nouveaux membres approuvés à la réunion de mi-année de l’ACEI. La majorité des demandes d’adhésion proviennent de nos collègues de Cunningham Lindsey et nous sommes ravis de les revoir au sein de notre association. Lors de mes discussions avec les membres de l’équipe de direction de Cunningham Lindsey, il était clair qu’ils étaient impressionnés par les efforts continus déployés par l’ACEI au nom de la profession et nous nous réjouissons de leur contribution à ce processus.

L’un des principaux secteurs d’intérêt consistait en l’examen du régime fiscal actuel de la TPS/TVH dans le secteur des services financiers par le ministère des Finances. En tant qu’intervenant, le bureau national de l’ACEI a participé à l’évaluation de l’état actuel du régime fiscal et toute recommandation future sera basée sur les améliorations qui peuvent être obtenues en efficacité, équité et simplicité du traitement de la TPS/TVH, qui est essentiellement une taxe sur la valeur ajoutée (TVA). À sa demande, votre haute direction, avec l’aide de Bob Krische de Crawford & Company, a présenté un document de position officielle contenant les recommandations de l’ACEI. Les voici condensées en une phrase : les experts en sinistres indépendants doivent être traités de la même façon que les assureurs en vue d’assurer l’égalité fiscale pour tous les participants du secteur de l’industrie. Rassurez-vous; nous allons suivre cela de près et nous tiendrons les membres informés. www.claimscanada.ca

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dustry sector participants. Rest assured, we will follow this closely and keep the membership posted.

Another area of interest is adjuster mobility and a seamless licensing process, particularly in times of emergency. CIAA has been working in conjunction with the Canadian Insurance Services Regulatory Organization (CISRO) to develop an expedited process to ensure adjusters can travel efficiently to best serve the public interest when disaster strikes.

The last event for this marathon week was the OIAA Claims Show, where I worked the CIAA booth with our Executive Director, Pat Battle, and Anna Sonta. I was honoured to be OIAA President Steve DelGreco’s guest at the OIAA Luncheon. This year’s speaker was Joe Roberts, also known as the “Skid Row CEO.” His message was very inspiring and reminded me we really need to try harder to take care of each other and those among us who are less fortunate. If you’re interested, go to www.skidrowceo.com to learn about his fundraising for at risk youth.

It was exciting to see the busloads of students from the various colleges and universities attending the job fair and trade show. They have no idea what a great career lies ahead. They also got a taste of how much fun the social aspects of our industry can be. I think I demonstrated that aspect all too well at the “Big Mingle,” with hosts Jamie Dunn of Blouin Dunn and Chris Giffen of Giffen Koerth following the CIAA/CICMA Joint Conference.

I look forward to the warm western hospitality when attending the Northern Alberta Chapter’s CIAA/CICMA Joint Educational sessions in Edmonton this March.

Finally, I remind you to make sure to join me at this year’s WICC Gala in Toronto. It is going to be a great event with Chantal Kreviazuk as the entertainment. Tickets are on sale now!

Continue to set the standards of excellence CIAA adjusters have come to be known for and enjoy reading this edition of Claims Canada. n

Un autre secteur d’intérêt est la mobilité des experts en sinistres et un processus d’autorisation transparent, en particulier dans les situations d’urgence. L’ACEI a travaillé en collaboration avec les Organismes canadiens de réglementation en assurance (OCRA) quant à la mise au point d’un processus accéléré pour faire en sorte que les experts en sinistres peuvent se déplacer efficacement dans le but de mieux servir l’intérêt public en cas de catastrophe.

Le dernier événement de cette semaine de marathon était le salon des sinistres de l’ACEI, où je travaillais au kiosque de l’ACEI aux côtés de notre directeur général, Pat Battle, et de Anna Sonta. J’ai eu l’honneur d’être l’invité du président de l’ACEI, Steve Delgreco, lors du déjeuner de l’ACEI. L’orateur de cette année était Joe Roberts, également connu sous le nom de « PDG des vagabonds ». Son message était très inspirant et m’a rappelé que nous devons vraiment faire plus d’efforts pour prendre soin de notre prochain et de ceux d’entre nous qui sont moins fortunés. Si vous êtes intéressé, visitez le site www.skidrowceo.com pour en apprendre davantage au sujet de sa collecte de fonds pour les jeunes à risque.

Il était excitant de voir des autobus d’étudiants de plusieurs collèges et universités participer au salon de l’emploi. Ils n’ont aucune idée de la belle carrière qui les attend. Ils ont également eu un aperçu du plaisir que représentent les aspects sociaux de notre industrie. Je crois que j’ai vraiment bien démontré cet aspect lors de la « grande interaction » avec les hôtes, Jamie Dunn de Blouin Dunn et Chris Giffen de Giffen Koerth, après la conférence commune de l’ACEI et de l’ACDSA. J’ai hâte de bénéficier de l’accueil chaleureux de l’Ouest canadien en assistant aux séances de formation conjointes de l’ACEI et de l’ACDSA de la section régionale du nord de l’Alberta à Edmonton en mars.

Enfin, je vous rappelle de vous assurer de vous joindre à moi à l’occasion du gala de la WICC de cette année à Toronto. Ce sera un grand événement : Chantal Kreviazuk est l’artiste invitée et les billets sont en vente dès maintenant!

Continuez à établir les normes d’excellence pour lesquelles les experts en sinistres de l’ACEI sont maintenant reconnus et profitez de la lecture du magazine Claims Canada. n

NATIONAL EXECUTIVE 2012-2013 2011-2011 PRESIDENT John D. Seyler, CIP ProFormance Group Inc. 5080 Timberlea Blvd., Suite 214 Mississauga, ON L4W 4M2 Phone: (905) 238-4985 • Fax: (905) 238-2735 E-mail: jseyler@prospecialty.ca 1ST VICE-PRESIDENT Marie C. Gallagher, FCIP, CRM Granite Claims Solutions 71 King Street, Suite 204 St. Catharines, ON L2R 3H7 Phone: (905) 984-8282 • Fax: (905) 984-8290 E-mail: marie.gallagher@graniteclaims.com 2ND VICE-PRESIDENT E. Grant King, BA, B.Ed., CIP Crawford & Company (Canada) Inc. 120 – 237 Brownlow Avenue Dartmouth, NS B3B 2C7 Phone: (902) 468-7787 • Fax: (902) 468-5822 E-mail: Grant.King@crawco.ca SECRETARY Paul Hancock, B.Sc., CIP Crawford & Company (Canada) Inc. 300 – 123 Front Street West Toronto, ON M5J 2M2 Phone: (416) 867-1188 Fax: (416) 867-1925 E-mail: Paul.Hancock@crawco.ca

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

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

PAST-PRESIDENT Greg G. Merrithew, CIP, FIFAA Arctic West Adjusters Ltd. 201 – 5204 – 50 Ave. Yellowknife, NT X1A 1E2 Phone: (867) 920-2212 Fax: (867) 873-2244 E-mail: gregm@arcticwest.ca

DIRECTOR John Jones, BA Granite Claims Solutions Suite 300, 5915 Airport Road Mississauga, ON L4V 1T1 Phone: (905) 671-3164 Fax: (905) 671-1889 E-mail: john.jones@graniteclaims.com

EXECUTIVE DIRECTOR Patricia M. Battle Canadian Independent Adjusters’ Association/ L’Association Canadienne des Experts Indépendants Centennial Centre, 5401 Eglinton Avenue West, Suite 100 Etobicoke, ON M9C 5K6 Phone: (416) 621-6222 Toll Free: 1-877-255-5589 Fax: (416) 621-7776 E-mail: pbattle@ciaa-adjusters.ca

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

February/March 2013

Claims Canada 11

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CS

• cover story

KNOW

THY SELF Independent adjusters can find an important market in self-insured retention (SIR) clients.

12 Claims Canada

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February/March 2013

www.claimscanada.ca

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Insurance industry cycles often dictate the appetite for alternative risk transfer, particularly during a prolonged soft commercial market with attractive premiums. For those adjusters who persist in this field, SIR clients present an avenue of opportunity – and challenge.

BY CRAIG HARRIS

A

s the property and casualty insurance industry cycle goes, so too does the demand for clients seeking higher self-insured retentions (SIRs) or alternative risk transfer vehicles. Simply put, a soft market means better premiums and relatively good terms for commercial insurance policies. It is when the market hardens that organizations look for alternatives – a higher SIR or more formalized approach such as captives, reciprocals or insurance exchanges.

Along with this ebb and flow, of course, comes the need for adjusters to manage claims beneath that SIR threshold on behalf of clients. For many independents, this area has become a flourishing business representing a significant supplement to their traditional base of insurance companies.

“Whereas before, adjusters were largely an extension of insurers, they are more and more handling risk as www.claimscanada.ca

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an extension of a municipality, manufacturer or professional services firm, for example,” notes George Szypka, vice president, municipal accounts for Granite Claims Solutions. “If an adjuster wants to hone their talents on a particular skill set, there are far more options available these days.”

“The good news for adjusters is that these accounts can represent very stable clients, and a key source of business,” says Greg Merrithew, president of Arctic West Adjusters.

“Adjusters should be aware of what is going on in their local communities and with associations and organizations. There is business out there with SIR clients; in some cases, it is just a matter of finding it.”

“This is an attractive alternative market for many adjusters, but it is not for everyone,” comments Craig Walker, director, Maltman Group International. “You need to have contacts in the risk management com-

munity, understand the issues and see where the opportunities are. It helps for adjusters if they have a niche in which to specialize.”

Control Adjuster or TPA Whether an adjusting firm is acting as a “control” adjuster coordinating other services on a national program or a third party administrator (TPA), sources say the SIR market is evolving rapidly.

Sheri Martinello, vice president, account management global markets for Crawford & Company (Canada) Inc., notes that clients have become more sophisticated in their risk management and requirements for TPAs. Specifically, procurement departments and, in some cases, in-house legal counsel have become more involved in structuring service level agreements with adjusting firms on the outsourcing of claims management processes.

February/March 2013

Claims Canada 13

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The changing face of the SIR sector means that clients could extend to virtually any organization – from a small manufacturing company to large retail or restaurant chains to governmental bodies, such as municipalities, hospitals or school boards.

“(We have seen) new attention on privacy clauses and increased expectations around security, data and compliance,” Martinello says. “There also has been increased focus on the TPA’s performance and metrics.“ While this involves added complexity and a more stringent onus on performance for the adjusting firm/ TPA, it can also create opportunities, according to Martinello.

“There is an opportunity to build a team to dedicate or specialize in a specific type of industry or claim type,” she observes. “TPAs can administer BPO (business processing outsourcing) services such as FNOL, data management, claims handling, litigation management and trust management.”

Other adjusting firms have also seen a rapid evolution in risk management expertise and breadth throughout public and private corporations, as well as government organizations – of all sizes.

“You are seeing more and more small-to-mid-sized businesses entering the TPA market, armed with a great deal of knowledge around how to encompass the SIR into a full enterprise risk management (ERM) 14 Claims Canada

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approach,” notes Josie MacKinnon, senior account manager for Granite Claims Solutions. “From the TPA service side, this means we are now working with more internal risk managers who are in constant consultation with and have a great understanding of the various business units of the company.“

Enterprise Risk Management Heightened expectations from SIR clients pursuing a comprehensive ERM approach may benefit larger national adjusting firms, according to Szypka.

“In the past, a qualified insurance adjuster with a bit of exposure to the risk management function of a corporation could handle a role in a TPA environment,” he says. “However, the market has now shifted to a more complete ERM approach. Corporations have developed complex and extensive approaches to ERM in association with highly professional brokers and often excellent insurer connections.”

The changing face of the SIR sector means that clients could extend to virtually any organization – from a small manufacturing company to large retail or restaurant chains to

governmental bodies, such as municipalities, hospitals or school boards.

How the actual claims management function operates in an SIR environment is also highly dependent on individual needs. A client may want the adjusting firm to investigate and report back, with claims sent in-house to analysts. Other organizations may prefer the adjuster to handle the claim from first notice to settlement, including financial reporting and trust management.

Clearly, one size does not fit all when it comes to the SIR market.

“The needs of SIR clients can be very different, and adjusters have to adapt their service delivery to those clients, “ says Fred Plant, president of Plant Hope Adjusters. “That means several things – understanding the client’s needs, having the right information reporting systems in place and staying on top of communications with the client.”

While this might seem somewhat daunting to smaller to mid-sized adjusters, Plant argues they are up to the task. He notes that SIR clients represent roughly 6-8% of his business.

“I don’t think smaller adjusters should be intimidated by the (SIR www.claimscanada.ca

13-02-20 1:55 PM

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market),” Plant says. “In the past, there may have been some aloofness or lack of understanding of what these kinds of SIR or TPA arrangements were. But more adjusters are developing relationships, understanding the business and adapting to those needs.

The SIR area is a good opportunity not just for national adjusting firms, but for regional adjusters as well.”

To reach the SIR clientele, adjusters have to tap into the right networks, including brokers, managing general agencies (MGAs), Lloyd’s coverholders, risk managers, regional trade groups and public associations.

Merrithew says that meetings, such as the annual RIMS (Risk and Insurance Management Society) Canada conference, are key ways to keep up-to-date on the SIR market. “(RIMS Canada) is good as both an opportunity to meet with risk managers and for product development,” notes Merrithew. “There are lots of trends in self-insured risk and . . . and risk managers often have their own language and dialogue. Adjusters have to stay on top of this business.”

Intangibles of Serving SIR clients In terms of the skill sets required to properly serve SIR clients, many sources say that the fundamentals of claims adjusting don’t change. It’s the intangibles that come to the forefront when dealing with customer needs.

“The core principles are the same when it comes to adjusting claims,” notes Walker. “The big issue is dealing with claims properly under the SIR so that the situation does not deteriorate. Regardless of the size or type of the claim, it should be reported and handled through proper documentation, interviews and investigation.”

Walker cites the hypothetical example of a client with a $50,000 SIR who experiences a minor claim of $5-10,000 that goes unreported. That claim may end up deteriorating over a period of months, until it starts to approach to SIR limit.

“It is much harder to resolve at that point; we don’t have the facts, evidence, interviews, the investigation may not have been done right, “ 16 Claims Canada

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February/March 2013

Walker explains. “So education and awareness are crucial for SIR clients.

They have to report claims right from the outset, and conduct due diligence.

There also may be a risk or set of circumstances that we need to know about for future losses.”

This communication should also apply to insurance companies, who typically act as the excess layer beyond any SIR. “When you act as a TPA or control adjuster, both the client and the insurance company have to be comfort-

To reach the SIR clientele, adjusters have to tap into the right networks, including brokers, managing general agencies (MGAs), Lloyd’s coverholders, risk managers, regional trade groups and public associations.

able with the structure of the SIR,” notes Walker, whose firm works with roughly 15-20 SIR programs. “Does it apply to each claim? Is there an aggregate per year? If an insurer is acting as the financial backstop, they want to be made aware of certain claims, and whether these could possibly move into the next layer.”

For Merrithew, an adjuster working with an SIR client should be aware of the type of work involved, and exercise discretion and diplomacy accordingly. This is particularly true for

large associations or organizations.

His firm, Arctic Adjusters, works with three municipal organizations in northern Canada, including the Government of the Northwest Territories, the Nunavut Association of Municipalities (48 communities) and the Northwest Territories Association of Communities (32 communities).

“There could be a political angle involved if you are dealing with a group of municipalities or an association, “ Merrithew observes. “For example, a person may report a claim, such as a slip and fall, and that person may also be a constituent in that situation. As an independent adjuster we can give an impartial, third party assessment of the facts of the case and the coverage issues. However, a risk manager may report to a board of directors, and that board may be made up of public officials. It is something that adjusters have to be cognizant of – you can’t just go in like a bull in a china shop.”

Technical Know-How In addition to “softer” skills, SIR clients rely on independent adjusters for technical know-how, including professional claims handling, bordereaux reporting, investigation techniques, coverage review and claims information/tracking systems.

Audit functions are often a key requirement for organizations wanting to understand and monitor loss exposures. “For example, a client may want to do a random selection audit of claims or a broad audit of all claims over $25,000,” Merrithew says. “In one case, an SIR client had a huge rash of 1st party auto claims. It was having a significant impact on the plan, so we decided to up the deductible from $1,000 to $5,000.”

Another key area for clients is loss reserves, particularly the need to accurately forecast and set reserves.

“SIRs also have to keep a close eye on claims reporting and values, particularly for reserve setting,” notes Merrithew. “For an insurance company, to be off 10-20% on reserves is not as big a deal as an SIR. When you are dealing with a threshold, being off by that much can be a very big deal.” www.claimscanada.ca

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Martinello agrees that reserve setting is an important function for adjusters.

“The TPA is generally responsible for the reserving of losses and for reporting the losses to the carrier if the claim could breach the SIR reporting threshold,” she says. “Accurate reserving is imperative as late reporting could expose the insured to non-renewal or penalties as well as prejudice the rights of carriers who seek to participate in a negotiation or litigation.”

For comprehensive SIR programs, larger adjusting firms say the issues that come into play could involve litigation, data/financial reporting and trust fund management, to name a few.

“With most assignments handled by independent adjusters, once the file goes into litigation, the carrier takes the claim in-house,” Martinello notes. “The TPA, (however), is going to require skills to direct legal counsel, and manage legal counsel budget and expenses, along with the direction that the legal process will take.”

The same holds true for tracking accurate data related to financial reporting. “For an SIR client, the client is looking to the TPA to manage their claims portfolio, which is illustrated by the data that is used for financial reporting,” Martinello notes. “Claims payments and reserves for future exposures are translated to the company’s profit and loss (P&L) and it is imperative that the financial management of the claims be reported accurately to the client.”

Adjusters may also need to offer trust management expertise for larger SIR programs, according to Martinello.

“The TPA typically manages a trust account on behalf of the SIR client and it is necessary to provide trust management ability and regularly scheduled reconciliation reports,” she says. “In the event that the claim breaches the SIR, payments made to date must be illustrated for the carrier.“

firms that want to successfully perform in the role of a TPA. Their skill sets have to meet the increasingly demanding needs of SIR clients, according to Szypka.

“As a TPA service provider, this. . . has provided us a chance to educate and train our adjusters not just in adjusting claims, but risk management skills and various business and management functions,” Szypka notes “This allows them to make more complete and beneficial decisions for

a company. As adjusters are increasing their knowledge base to better serve the ERM approach, they better understand the various products, markets, and customers a company has.”

Of course, the opportunities that SIRs present for independent adjusters also arrive with a wide array of challenges. These can vary by size and type of programs, as well as the nature and complexity of the business/ public entity at hand.

Raising the Bar An enhanced focus on risk management raises the bar for adjusting www.claimscanada.ca

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“The major challenge is now the adjuster now must acquire a broad technical understanding of the company he or she is handling risk for,” MacKinnon notes. “This takes research into the people that make up the company, understanding the company’s involvement in the community, their contractual obligations, and overall risk tolerance, to name a few.”

Adjusters may also have to take an impartial, measured approach to dealing with SIR clients, particularly smaller programs, according to Walker.

“Sometimes clients may not objectively look at all the facts,” he says.

“We have to go back and say you may not be as lily white in the circumstances as you think you are. What we have to do as TPAs is give them the facts of the case and negotiate the best resolution possible from that independent perspective. For some smaller firms, they can view it as a personalized issue.”

Another potential hurdle adjusters must clear is negotiating a fair agreement on a fee structure with SIR clients.

Negotiating Fee Structures “For adjusters, negotiating fees for a TPA should involve some time and planning,” Merrithew says. “It really depends on the request for proposal (RFP) and what is being asked for in terms of the clients’ level of expertise and demands. Adjusters may have to provide ‘back-channel’ expertise, especially if they are dealing with a department of limited resources and budget.”

This level of negotiation can become even more complex and varied if procurement departments and in-house legal counsel are involved in setting a service level agreement (SLA) with independent adjusters on an SIR program.

“TPAs need to understand the nuances of dealing with procurement departments and ensure that there is a clear understanding of services and costs of services,” Martinello notes. “Negotiation of the SLA can be challenging for the TPA as the in18 Claims Canada

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February/March 2013

house counsel looks to them as a service provider in the same vein as the company that provides their office supplies. Thus, they may not always appreciate the nuances that are required in an SLA, especially around reserving, authority and indemnification.”

For Plant, one of the prime challenges with the SIR client is simple – finding them. “The challenge for the independent adjuster is to adapt to what the marketplace needs from us,” he says. “For smaller regional adjusters like us, we have to find the people

With more clients embracing enterprise risk management and examining their exposures from a broader perspective, some think the higher SIR – and the consequent need for a control adjuster or TPA – is here to stay.

and companies that are looking into this and establish relationships with them, so they come to us.”

The future evolution of SIR clients and alternative risk transfer vehicles will, as in the past, be closely tied to insurance industry market cycles.

Many sources note that harder markets in past years have spawned greater activity in SIRs. “If the market hardens, you will see more SIRs and alternatives to traditional insurance,” Merrithew ob-

serves. “Where the industry cycle is going is anyone’s guess, but we have seen this movement to SIRs in the past. It takes time, resources and money to set up these alternative structures. But once they are up and running, they rarely go back to the regular market.”

Walker concurs that most SIR clients who have made the investment won’t abandon their efforts – but they may adjust their levels according to market conditions.

“I think the market will have to harden at some point, I am just not sure when,” he notes. “When that does happen, we often see SIR clients start to up their retentions. If it is a smaller operation, insurance companies want to ensure that clients can afford that level of retention.”

The trend of higher self-insured retentions may not be a curse for insurance companies, according to Plant.

“I think we are going to see the SIR trend increase over time,” Plant says.

“In some ways, insurance companies are happy to have commercial clients handling smaller claims. An insurer may be charging a client a large premium for commercial coverage but if that premium is eaten up by a lot of smaller claims and administration, it may not be profitable business.”

With more clients embracing enterprise risk management and examining their exposures from a broader perspective, some think the higher SIR – and the consequent need for a control adjuster or TPA – is here to stay.

“Companies that adhere to the SIR model are likely to expand their risk tolerance and spectrum as a better understanding of the more complete ERM approach develops,” concludes Szypka.

“This includes more complex financial risk systems, a better understanding of reputational risk and more complex supply chains that can bear the risk. This will mean that more and more companies will partner with TPAs, brokers, and insurers who closely mirror their values, flexibility, and knowledge set.”  www.claimscanada.ca

13-02-20 1:56 PM

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• spotlight S

the

Mediator

Stacey Rose, president of B.C.’s Cornerstone Adjusters, believes an adjuster’s job is all about finding resolution.

BY CRAIG HARRIS

A

s a self-described “people” person, Stacey Rose brings an open mind and an even-handed approach to the independent adjusting profession. The 24-year veteran of the claims world heads up a small but senior team of six adjusters and one administrator at Cornerstone Adjusters Ltd. With four locations in Vancouver, West Vancouver, Abbotsford and Surrey, the firm has established a leading reputation as a specialist in handling large losses, including catastrophic and brain injury exposures. It covers a wide geographic territory, ranging from the Vancouver downtown core and surrounding Lower Mainland, the Sunshine Coast and Gulf Islands, through the Fraser Valley and into the B.C. Interior and Okanagan.

Rose herself has earned her stripes as an independent adjuster able to step in and deal with complex disputes, including those involving in-depth pre-trial investigation and witness preparation.

“As adjusters, I think we can play a big part in keeping people from getting entrenched in their positions,” Rose says.

“We are hired as an independent service and we often mediate between insurers and third parties. Adjusters can look at the facts, inform people of the insurance process and work towards a resolution.

That is really what we do best.”

It should come as no surprise then that, augmenting her role as an independent adjuster, Rose also offers dispute resolution services. In addition to the CIP, she holds the national designation of Qualified Mediator (Q. Med) granted by the ADR Institute of Cana20 Claims Canada

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da. To boot, Rose also has the designation of Certified Risk Manager (CRM), which affords her added insight into the critical risk-assessment phase of any mediation process.

‘Mediation really spoke to me,” Rose says, noting that alternative dispute resolution is a career path many senior adjusters in B.C. have followed in recent years. “It really dovetails with claims adjusting, but in this case everyone is sitting at the table and getting their views and positions out in the open. It felt like a really good fit.”

As a member in good standing of the B.C. Civil Roster of Mediators, Rose has been active in resolving disputes and “conflict coaching” for the past three years. But she has no plans of abandoning the independent adjusting profession.

“I don’t foresee ever giving up the claims adjusting side of the business,” she says. “It is still too much fun for me.”

The “fun” for Rose started when she was hired into the Insurance Corporation of British Columbia’s (ICBC) training program for junior adjusters in 1989. She spent two years working in vehicle material damage, and then jumped at the chance to do injury work, where she specialized for eight years.

After a few more years spent as a staff adjuster in the private insurance industry, Rose then got the itch to strike out on her own, starting Cornerstone Adjusters in 2006.

“I started out in my garage with just a laptop,” she recalls. “I tended to overwork and bury myself in the first few years. Fluctuating claims volumes are always a concern for adjusters.”

However, Cornerstone Adjusters quickly found its niche in more complex losses, and this has acted as a consistent source of business for the firm. Rose began taking on other veteran adjusters on a gradual basis, and now feels confident about the expertise her firm holds and the client base it has built. Adjusters on the Cornerstone team now include Shelby Vevers, Angela Shears, Catherine Dussault, Evan Miles and recently hired junior adjuster David Boileau, along with administrative point person Helen Atkinson.

“We have a solid team and I have finally found the balance to be busy, but not buried,” Rose explains. “There has been the odd occasion where we have had to say ‘no’ to some good clients in recent years because of the timing or size of a project. Although this is very difficult to do, in the end it is a disservice to you and your client to accept a large assignment you simply cannot handle.

That has been a very hard business lesson for me to learn, but it is important.”

Dealing with larger claims involves a deft touch that includes proper information gathering, communication and negotiation, according to Rose.

“Much of the work we deal with is litigation-driven, and that can pose some challenges,” she says. “As adjusters we play an important role in collecting and verifying information, interviewing witnesses, confirming their perceptions and ensuring that they understand how the information will be used in the insurance process, even at trial. We can help make the insurance process as transparent as possible.” www.claimscanada.ca

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Stacey Rose, president of B.C.’s Cornerstone Adjusters: a “people person.”

Another issue for independent adjusters involves peoples’ perceptions of bias, Rose observes.

“I know that some people think we are simply hired by the insurance company and are not completely objective,” she says. “While we are contracted by insurers, I always try to point out that we bring our professional training, ethics and licensing to bear in every case, to ensure there is proper resolution of a claim. If I, as a recorder of the facts, take a statement, you shouldn’t be able to tell whom I am working for. If it is impartial and professional, that is proof I am doing my job right. The proof really is in the pudding.”

The ability to conduct interviews, gather facts and report back in a timely manner is an ongoing challenge that independent adjusters face, according to Rose.

“I think that the documentation and reporting demands of being an adjuster today are top of mind for me,” she says.

“It is the insurance examiners at various insurance companies who we have to report back to, and they all have their checks and balances for managing claims. We have to make sure our reporting is solid and thorough and delivered in a timely manner – and that can be a tall order.” www.claimscanada.ca

p20-21 SPOTLIGHT.indd 21

Another issue for many smaller independent adjusting firms is hiring younger people and providing proper on-the-job training. Rose says Cornerstone Adjusters is in that educational mode right now with its recently hired junior adjuster.

“As a smaller firm we are busy with our claims files, and we need to carve out time for quality training,” Rose explains. “It is not just a money or time issue; it is how to train properly for this role. It can be a structural challenge, because there is no real training manual for adjusters. Sometimes, you have to be able to work with and listen to a senior adjuster on the phone. You have to pick it up almost through osmosis.”

The value of an association in helping independent adjusters speak with a concerted voice on key issues is not lost on Rose. “I think the CIAA has done a great job on the national level dealing with the many issues that independent adjusters face, such as education, licensing and advocacy,” Rose says. “However, I also think there is a role for regional associations that can speak to the needs of local adjusters.”

B.C’s provincial adjuster association ended its active role four years ago, with Rose actually serving as the final presi-

dent of the group. “People joked that I was the one who sunk the ship,” she laughs. “I still think there is room for localized adjuster groups, even if meetings are held on a more informal basis.”

These local groups can help in not just information sharing and fellowship, but also recruitment and mentoring for young people considering a career in independent claims adjusting. There is, as Rose observes, a need to both bring fresh blood into the adjusting profession and provide a forum for junior and senior adjusters to share knowledge and networking opportunities.

“Whether independent adjusters will survive as a profession is a hot topic,” she says. “I certainly think we will, but we will likely be a smaller, more knowledgeable group. We will continue to make a difference in terms of deeper expertise, broader training and the ability to bring that independent perspective to the insurance claims structure.”

When asked about her vision of the future of the independent adjuster, it’s clear that Rose doesn’t stray far from her roots in mediation. “The role of the independent adjuster moving forward, I think, will be distinguished by technical knowledge, policy interpretation – and dispute resolution,” she concludes.  February/March 2013

Claims Canada 21

13-02-20 2:08 PM

Superstorm Sandy

A Canadian Perspective on the “Hybrid” Hurricane

BY GEOFF COULSON

Superstorm Sandy began its life as a tropical storm approximately 600 kilometres south of Jamaica on October 22, 2012. During the course of the following days it would transition into a hurricane, striking Jamaica, Cuba and the Bahamas. As it moved northwards from the Bahamas, it would begin to exhibit the characteristics of both a hurricane and a midlatitude fall storm.

By the time it made landfall in New Jersey on the evening of Monday, October 29, it had completely transitioned into a mid-latitude fall storm – albeit a massive one, with a diameter in excess of 1,600 kilometres. The combination of Sandy’s winds, rain, storm surge and snow would leave 135 people dead and loss estimates in the United States ranging from $50-$65 billion dollars.

The impacts in Canada, while not on the same scale as those on the U.S. Eastern Seaboard, were still noteworthy: the loss of two lives in Ontario, 150,000-plus homes without power in Ontario at one point, and approximately $100 million in insurable losses in Ontario, Quebec and Atlantic Canada. A good portion of those losses occurred in the Sarnia and Lambton 22 Claims Canada

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County areas; the winds from Sandy came howling from the north right off Lake Huron.

Much has already been written about the rare “hybrid” nature of Sandy, and over the coming years the data gathered during Sandy’s life will be analyzed and reanalyzed. Many experts have referred to this event as a “oncein-a-lifetime” storm which combined the elements of a hurricane with those of a massive fall storm.

The storm also renewed debates about the best ways to protect cities near oceans and what role climate change may have played in its creation.

While the answers to these questions are not readily available, Sandy has opened the discussion on how best to adapt to the potential for more storms of this nature in the coming years.

One of the best ways to describe Sandy’s lasting legacy will be the fact that this could be the storm that “launches a thousand dissertations.”

Many Ph.D. theses in the coming years in Atmospheric Science, Climate Science and Emergency Management will be drawn from how Sandy formed, evolved and impacted the U.S. Eastern Seaboard.

Sandy also provided an opportunity to demonstrate just how much weather modelling has improved over the last

couple of decades. The ECMWF (European Centre for Medium-Range Weather Forecasts) prediction model uses a very powerful computer and has been designed to forecast the weather in the 3-to-10-day timeframe. Even as Sandy was in its formative stages on October 23, the ECMWF model was predicting a rare westward turn in Sandy’s track into the northeastern seaboard of the U.S. six days into the future. At this point, the ECMWF model was somewhat unique, with models from Canada, the U.S. and the U.K. indicating a more traditional track for the storm keeping it out over the Atlantic.

Given the skill shown by the ECMWF model in the past, and the fact that its forecast track could potentially impact portions of Ontario, Quebec and Atlantic Canada with strong winds and rain, a preliminary e-mail was sent to key provincial and municipal contacts within Ontario on October 23 mentioning the possibility of significant weather a full six days into the future.

This e-mail represented an example of the type of “early notification” to key clients that Environment Canada would like to develop more fully in the coming years. The form that this early notification may take could change in www.claimscanada.ca

13-02-20 2:11 PM

the coming years, but the main issue is to try to inform key stakeholders about potentially significant weather in the 3-to-7-day timeframe – when forecaster confidence may not be high, but the event is growing in probability. Once forecaster confidence about the event has grown, then formal messaging to the media and general public (i.e., Special Weather Statements, Watches and Warnings) would follow.

As the days went by and other forecast models began to follow the track originally forecast by the ECMWF, and forecaster confidence grew, a Special Weather Statement was issued by the Ontario Storm Prediction Centre on Friday, October 26, for much of Southern Ontario. The statement mentioned the potential of damaging winds and heavy rain from Sandy as it made its anticipated landfall in the northeastern U.S. on Monday, October 29. By Friday, October 26, the Weather Centres in all affected regions (Toronto, Montreal, Dartmouth and Gander) were closely co-ordinating

to ensure common messaging for this event. This co-ordination included internal technical briefings, briefings for key provincial government clients and media briefings.

This image shows Sandy making landfall at around 8 PM on October 29.

The number of isobars around the low indicate just how low its central pressure was; the purple areas denote marine warnings over Canadian waters; and the red shows where wind warnings were in effect.

As Sandy neared the U.S. coast during the early morning hours of Monday, October 29, the forecasters in To-

ronto realized that wind would be the main concern in Southern Ontario.

So, a Wind Warning was issued for this area, mentioning gusts to 90 km/h or more. With the winds forecast to come from the north, the region that was expected to receive the highest gusts was the Lambton County area (as the winds blew in from Lake Huron).

Sandy made landfall at about 8 p.m. on Monday, October 29, bringing with it the various types of damaging weather that had been mentioned in the National Weather Service warnings. Because Sandy hit around the time of high tide, the damage from its storm surge was even more severe.

The storm surge was accompanied by damaging winds, significant rain and, in portions of Ohio and West Virginia, significant amounts of snow as cold air was drawn into the system from the north.

In Ontario, winds began to pick up on the evening of the 29th, with many locations reporting wind gusts of 80 km/h or more into the early morning

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hours of Tuesday the 30th. As anticipated, Lambton County received the highest wind gusts and most significant damage, with gusts as high as 100 km/h. Another impact over the south end of Lake Huron was the creation of 7 metre waves from the strong and persistent winds from the north. This led to direct impacts on Great Lakes shipping as many large lakers had to hold up on the west end of Lake Erie unable to transition up through Lake St Clair and into Lake Huron with waves of this height.

A witness along the shores of western Lake Erie during that Monday evening remarked that it looked like a floating city of lights given the number of lakers waiting for the winds to die down. The strongest gusts diminished over most of Southern Ontario by mid-morning on the 30th except in Lambton County and over southern Lake Huron, where strong gusts continued for much of the day.

Extensive media coverage accompanied the days leading up to, during, and in the aftermath of Sandy’s land-

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fall. In Ontario, more than 200 media requests were handled from Saturday, October 27, through Tuesday, October 30. One of the issues faced by Environment Canada spokespeople concerning this event was attempting to separate the American impacts of Sandy from the Canadian ones. Some Ontario media outlets had assumed there would be greater impacts in Ontario, based on the reports about Sandy coming out of the U.S., and so some time was spent to explain the differences and to provide more context concerning the Ontario impacts.

In summary, Sandy was a very rare storm that combined the ocean-driven energy of a hurricane with those of a massive fall storm system. No storm quite like Sandy had been documented before, but its method of birth and evolution will be a source of research for a number of years to come. It dramatically demonstrated the vulnerabilities of large cities along the U.S. Eastern Seaboard, where approximately 20% of the American population is found. While the worst impacts from Sandy were along the U.S. northeast coast, the storm was so immense that its impacts were felt well into Ontario, Quebec and Atlantic Canada.

The storm also provided evidence of the increased ability for weather models to provide useful guidance a full seven days before an event. This has important ramifications for the ability of weather services like Environment Canada to provide some form of “early notification” well in advance of large-scale events of this nature.

Now that the ability to provide advance notice in this kind of timeframe has been demonstrated, more work needs to be done in the coming years to determine the best avenues to share this type of information with key clients and the general public, and how best to express the uncertainties involved in the forecasting of these events.  Geoff Coulson is a Warning Preparedness Meteorologist with Environment Canada.

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Official Journal of the Canadian Indeépendent Adjusters’ Association

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“High Stakes” LITIGATION How A Complex Property Case Went Wrong

BY GLENN GIBSON

Brandiferri et al v. Wawanesa Mutual Insurance Company (2012) is an example of a long-running case that, in the end, resulted in a punitive damages award against the insurer.

It highlights many issues, including proof of loss, the appraisal mechanism and allegation of fraud (which the court determined was unfounded).

In terms of the facts of the case, on August 8, 2000, a fire started in an attached garage of a dwelling located in Woodbridge, Ontario. The garage and its contents were destroyed. Heavy smoke penetrated the main dwelling.

There was a single limit on the homeowner’s policy of $564,000. The insurer paid $479,029.42 prior to the trial.

The homeowner plaintiff was seeking additional payments and an award for punitive damages. The trial began 12-years after the loss and lasted 14-days. During the trial, the judge made two rulings on expert evidence to be given at the trial. The final judgment took 12-months to write and release.

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This is a very lengthy decision that touches on many issues. It is worthy of a complete read, but several important points are noted in the judge’s decision.

The Dwelling The insurer’s staff adjuster was experienced in handling property claims.

He made immediate arrangements to secure the site using an experienced fire general contractor. Additional steps were taken to engage a fire contents restoration firm who removed soft furniture, clothing etc. from the house. A second firm removed some hard contents from the house.

The adjuster retained two contracting firms to inspect the building damage. Both firms were insurance restorators with experience in repairing fire-damaged buildings. Both had a “preferred” status with the insurer.

The first contractor secured the property and estimated building damages to be $45,000. The second firm was closer to $83,000. This caused the insurer to review the initial scope of damage. This resulted in the first firm revising their repair price upward to about $69,000.

The insured’s had the choice of choosing which contracting firm to engage. They chose the firm with the higher initial pricing. A customer authorization was signed on Sept. 20, 2000. The trial judge ruled this authorization established a contract between the insured and the contracting firm.

Five months into the repairs the contractor increased their estimate to $249,000. Ten months post-loss, the price increased again to $352,500.

Clearly, as repairs unfolded, substantially more damage to the dwelling was discovered.

During the repair process, the adjuster attended the scene many times to inspect further damages and to mediate disputes between the policyholder and contractor. Without doubt, the insured was intimately involved with every step of the repair process. The judge found that it was: “…entirely appropriate for the Brandiferri’s to monitor the work, and, where it was incomplete, to demand more work; it was entirely appropriate for them to demand the correction of deficient work….. ….in general terms, the Wawanesa www.claimscanada.ca

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adjuster, was sympathetic to the Brandiferri’s and approved changes to the (contractors) scope of work as necessary, although he eventually balked, especially regarding repairs that he saw as extras.”

The judge described the relationship between the adjuster and the insured as “typical of the to-and-fro that would occur on any construction project.”

The original contractor left the job site 15 ½ months after the fire. A deficiencies list was provided prior to this date in November 2001 and the firm felt the only outstanding matter was brickwork, which they indicated they would complete the following spring.

The insured clearly did not agree with the contractor’s position.

requested a re-consideration, but was refused.

This is an important point because, at trial, the insurer took the position that the damage issues had to go to Appraisal pursuant to the terms and conditions of the Insurance Act. However, in light of what took place, the trial judge found that the insurer, through its counsel, had “…waived its right to insist on an appraisal, in writing, and therefore cannot now insist that it is a

condition precedent to the plaintiffs’ right to recovery in this action.”

Election to Repair Statutory Condition #13 is an election the insurer can take to repair a property. Rarely is this condition invoked. In this case, the plaintiff lawyer argued that the manner in which the initial contractor was hired and the insurer’s conduct in how they managed the process was an implied election.

Appraisal At the 10-month mark, the adjuster spoke to the insurance broker and raised the prospect that the insurer would invoke appraisal to resolve the issues in dispute. The adjuster subsequently used the broker to communicate an “all-in” offer. It was refused.

A lawyer was retained by the insured 11 months after the fire. The adjuster wrote to the lawyer that if they could not resolve matters they would go to appraisal.

The lawyer took the letter as a request to begin the appraisal process.

He responded by appointing an engineer as their appraiser. Within short order, however, a new lawyer took over carriage of the file and expressed the view that, “….Appraisal, at this point might not be the best way to address the issue of quality repair work, as opposed to value.”

Both sides backed away from the Appraisal process and normal litigation ensued, with Examination for Discoveries taking place in March 2004. It was at Discovery that plaintiff’s counsel proposed Appraisal as he felt that the damage issues had been narrowed down. He proposed postponing further Discoveries until the Appraisal process was concluded.

The insurer’s lawyer responded in writing that the insurer took the position that, “…your client is not entitled to an appraisal.” Plaintiff’s counsel www.claimscanada.ca

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The plaintiff lawyer raised some good arguments but the judge eventually ruled that the customer authorization signed by the insured and the contractor was a contract although the language did contemplate the insurer being involved with a direction to pay proceeds to the contractor.

The insurer had built itself into a middle position by controlling the cash flow and having the adjuster involved in the reconstruction process, according to the judge. The contractor refused to work without the adjuster’s authorization. But the trial judge did not feel their conduct was sufficient to amount to an election under Statutory Condition #13.

The judge ruled the insurer did become an agent of the insureds for the purpose of paying the initial contractor. The insureds had withdrawn their authorization to make the final payment to the contracting firm but the insurer concedes they moved forward with payment. In light of this, the trial judge ruled that if the insureds could not make full recovery from the contracting firm, the insurer was going to

have to stand good for it.

The judge gave the insurer and contractor 30-days post judgment to sort out remaining issues.

Personal Property There were a variety of issues on this front. The insured’s daughter catalogued much of the loss outlining at trial the process she followed with assistance from a public adjuster. Reference was also made to the fact that some of the clothing that had been removed for cleaning had subsequently been destroyed in a fire at the cleaning contractor’s shop. And, the insurer had dropped the ball in not advising the insureds of this issue until 3-years later. Further commentary on this portion of the loss came from the trial judge’s views on the insurer’s strategy to “….cast doubt on some of the (content) figures without offering alternative evidence.”

Eventually, the argument was raised that the insureds were only entitled to the actual cash value of the contents loss unless they had replaced the item.

The plaintiff lawyer argued that a form

of equitable estoppel had been created.

The insured did not have the money to replace goods. It was pointed out that the insurer only dropped a counterclaim of $600,000 against the insureds on the eve of trial.

The judge found that in removing the insured’s content items from the home, the insurer had taken on the role of a bailee. The contractors who removed items were sub-bailees of the insurer. It was required of the insurer to return the goods directly to the insureds. This did not happen.

The judge ruled on several interesting points: 1. The insurer was responsible for the items destroyed in the cleaner’s fire.

The judge used the insured’s replacement cost numbers but applied a 40% depreciation rate across the board. The insured had applied a 30% rate.

2. The insured had rejected content items returned from a second firm.

The judge accepted their opinion and likewise applied an additional 10% of depreciation.

3. Another batch of content items was

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returned to the insured on the eve of the trial. There was not adequate time for inspection. The judge ordered the insured and insurer into appraisal to determine repair or replacement.

Fraud on the Proof of Loss The first formal proof of loss was filed on August 31, 2001—over one year post-fire. It concluded with a claim totaling $623,137.99.

There was considerable evidence at trial on how the insureds arrived at this claim. The insured’s daughter was the key person putting this document together. The plaintiff lawyer argued that…. “….(the daughter), who put together the proofs of loss, did so systematically but not correctly and certainly not fraudulently.

The goods were largely available for inspection post-loss. The adjuster who gave evidence conceded in cross-examination, “….I don’t know if we were actually misled.” The adjuster went on to agree that they had not rejected the proof of loss that was filed.

Further concessions were made that the first time “fraud” was brought up by the insurer was in a counter-claim that the insurer made against their policyholder.

This judgment outlines many of the precedent cases where an allegation of fraud is made against a policyholder.

In his decision, the judge noted: 1. A claim that might be seen as exaggerated is not automatically a fraud.

It might simply be an “opening for negotiations.”

2. The amount claimed might be the opening salvo in negotiating how much an insured will get under the policy.

3. There must be an intention to mislead or deceive.

4. There must be strong evidence to support a finding of fraud.

5. Does the approach of the policyholder seem reasonable under the circumstances?

At trial, the insured’s daughter was intelligent, well-spoken and able to articulate what she did and why. Her testimony was credible and as described by the judge as being “plausible, sensible

and reasonable.” She had an honest belief in the fairness of how she had evaluated and submitted her parent’s claim.

The judge was very critical of the “…late breaking allegation of fraud.”

He found it “opportunistic” as the allegation first appeared in filing the Statement of Defence. He determined that no fraud had been committed.

Punitive and Aggravated Damages The insurer owes the insured the duty of “utmost good faith” in their investigation, evaluation and settlement of any claim.

The plaintiff lawyer sought $350,000 in punitive damages and another $50,000 for aggravated damages on the basis that: 1. The insurer’s defence of fraud was revealed for the first time with the filing of their Statement of Defence.

2. The insurer made a counter-claim of $600,000. The judge described this tactic as putting a gun to the head of the insured. The insurer withdrew their counter claim on the eve of trial.

Restoration Industry

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3. The insurer breached its duty to their insured by making a final building payment to their approved contractor.

4. The insurer failed to advise the insured’s for three years that some of their goods had been destroyed in a fire at the storage facility 5. This insurer was a repeat offender.

Lawyers for the insurer argued that there was evidence at trial that the original adjuster had “…acted fairly and promptly in the circumstances.”

The trial judge focused his attention on the litigation strategy. Heavy attention was paid to the late breaking fraud allegation. The judge found this to be “…a high stakes litigation strategy” that in his mind clearly failed.

The judge noted the insurer to be a repeat offender and fixed punitive damages at $100,000. He declined to award aggravated damages.

Case Summary A property adjuster in our profession for any length of time will face this type of loss situation. The claim issues in this loss are not unique. There are however, a few things to learn from this case.

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Both sides backed away from the process when the insured’s lawyer suggested that the issue involved the “…quality of repair work, as opposed to value.”

1. The proof of loss can be a difficult form to properly explain to insureds. Schedule of Loss forms usually accompany the form. It should be a sworn document. It is THE critical document in a property claim.

The presentation of the sworn Proof of Loss represents the insured’s official claim. This demands that claims professionals not only treat receipt of the Proof of Loss seriously, but also demonstrate that the insured(s) knew exactly the process they should be following to complete the form.

2. Be very careful of using the “Fword.” You are alleging a criminal act on the part of your insured. The burden of proof required to prove fraud is much higher than normal civil standard of the balance of probabilities. This burden is closer to that required by a criminal court – beyond a reasonable doubt.

3. The appraisal mechanism is part of the Insurance Act for a reason. It is a cost-effective, timely method to settle damage and value matters in dispute.

4. It was very interesting to see the trial judge order a portion of this case into the appraisal process to resolve quantum.

5. The initial adjuster assigned to this loss had the right thought in mind when seeking to trigger the appraisal mechanism. But both sides backed away from the process when the insured’s lawyer suggested that the issue involved the “…quality of repair work, as opposed to value.”  Glenn Gibson, CIP, CLA, FCIAA, CFE, CFEI, CFII-c, is Chief Executive Officer, Crawford & Company Consulting (Canada). www.claimscanada.ca

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Delving Into

D&O

What type of “extrinsic evidence” can be considered on a coverage application?

BY MICHAEL S. TEITELBAUM AND HYLA KORN

In Lloyds Syndicate 1221 (Millenium Syndicate) v. Coventree Inc., 2012 ONCA 341, the Court of Appeal affirmed the Application Judge’s decision that, based on the policy language and the circumstances underlying the negotiation and issuance of the policy, the current directors’ and officers’ policy afforded coverage for a claim although notice of the potential for that claim had been given to a previous insurer.

Coventree was a major participant in the asset-backed commercial paper market in Canada. In August 2007, there was a severe disruption in this market and share prices dropped significantly. When this disruption occurred, Coventree was insured under a D&O policy by the Great American Insurance Company. Great American advised that this policy would not be renewed after it expired on October 17, 2007. The Great American policy included coverage for claims made after the expiration of the policy so long as notice of the potential claims was given during the policy period. On October 16, 2007, Coventree provided notice to Great American of all potential claims it could envision due to the market collapse.

Coventree obtained extended coverage from Great American for $1 milwww.claimscanada.ca

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lion for claims made between October 17, 2007 and October 17, 2008, which were based upon acts alleged to have occurred prior to October 17, 2007.

Coventree also obtained a new D&O policy from Lloyds Syndicate for the period October 17, 2007 to October 17, 2008 which provided coverage in the amount of $10 million. The Lloyds Syndicate policy excluded “prior acts coverage” for any claim based upon an alleged wrongful act that occurred before October 17, 2007.

On September 18, 2008, Coventree applied to Lloyds for coverage for the period beginning on October 17, 2008.

Lloyds issued a policy in the amount of $10 million effective from October 17, 2008 to April 17, 2010. This policy was a claims-made policy, with the exclusion for prior acts coverage removed.

In July 2009, the Ontario Securities Commission issued a notice of hearing and statement of allegations against Coventree and two of its senior officers, raising matters for which Coventree gave notice to Great American on October 16, 2007. Coventree and its two senior officers incurred $12 million in legal costs. Great American responded to the claim and paid its limits of $1 million. Coventree claimed against Lloyds for reimbursement of defence costs under the Lloyds 2008-10 policy.

Lloyds denied coverage.

In Coventree’s policy application to Lloyds, it affirmatively answered that it had given notice of claims to its prior insurer, and responded in the negative to a question whether it had knowl-

edge of any acts that might give rise to a claim. The application contained a “carve-out” provision with the purported intention to not afford coverage for any such claims. Lloyds’ agent then sent a document to Coventree’s broker, which waived the answers to these questions and was subject to Lloyds accepting an application “with original signature.” The agent then issued a temporary binder providing coverage and waiving the answers to the questions. This was followed by Coventree’s broker sending Lloyds’ agent a new application bearing an original signature, and with the questions unanswered.

Lloyds ultimately issued a policy that included an endorsement which appeared to provide that $5 million of the $10 million limits applied to the “prior acts.”

Extrinsic Evidence: the Court’s Comments The Court applied the general principles used to interpret insurance policies in its decision that the Lloyds policy provided coverage for the “prior acts” referred to in the October 16, 2007 notice to the extent of the first $5 million of the $10 million policy limits.

The Court noted that the purpose of interpreting an insurance contract is to determine the intentions of the parties viewed objectively at the time the contract was entered into. To do so, one must complete an analysis of the written insurance policy. The Court stated, “contracts are not to be looked at in a vacuum” and recognized that it may be February/March 2013

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The Court’s search for the intention of the parties may be aided by reference to the surrounding circumstances or factual matrix at the time of the negotiation and execution of the contract, as viewed objectively by a reasonable person.

necessary and proper to look at the surrounding circumstances to determine the intentions of the parties. However, the Court limited the surrounding circumstances it examined and relied upon those known to both parties at the time of execution of the contract.

The Court stated: The court’s search for the intention of the parties may be aided by reference to the surrounding circumstances or factual matrix at the time of the negotiation and execution of the contract, as viewed objectively by a reasonable person.

In addition to the insurance contract, the Court looked at all e-mail correspondence between the parties, the applications submitted on behalf of Coventree by its agent, and the quotes, binders and proposals issued by Lloyds.

Examining such items, the Court determined that it was the intention of the parties that Lloyds policy cover prior acts referred to in the October 16, 2007 notice up to the first $5 million of the $10 million limits.

Lloyds’ Argument on the Policy’s Carve-Out Provision Lloyds relied on the carve-out provision included in its application for insurance to deny coverage to Coventree.

The carve-out provision read: it is understood and agreed that if any such claims exist, or any such facts or circumstances exist which could give rise to a claim, then those claims aris32 Claims Canada

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ing from such facts or circumstances are excluded from the proposed insurance.

Because Lloyds had a copy of the October 16, 2007 notice, Coventree, through its broker, made it clear it wanted “full prior act coverage” and Lloyds issued a temporary binder which provided temporary coverage in which it waived answers to questions relating to prior knowledge, both the application judge and the Court of Appeal found that this evidence supported a finding that Lloyds had waived the carve-out provisions. In these circumstances, it was illogical for Lloyds to have intended to exclude coverage and waive the answers to the questions, especially after Coventree’s October 16, 2008 express request for full prior acts coverage.

The Court held that as of October 17, 2008, a reasonable person objectively viewing these circumstances would have concluded that Lloyds intended to provide full prior acts coverage of $5 million for matters included in the October 16, 2007 notice. With respect to the temporary binder issued by Lloyds on October 17, 2008, the Court noted that although the temporary binder is “not part of the final policy of insurance when issued… [it] is part of the factual matrix and is therefore relevant to what the objectively viewed intention of the parties was as they proceeded.”

Some time after October 17, 2008, Coventree submitted three further applications to Lloyds electronically and

on each application answered the giving of prior notice question in the affirmative. Lloyds issued the 2008 policy on November 20, 2008, a term of which was that Coventree’s application for insurance formed part of the policy. In addition, Lloyds appended a copy of Coventree’s application with this question answered in the affirmative but it did not append a copy of the October 16, 2007 notice. As a result, Lloyds argued that because it included a copy of the application with the affirmativelyanswered question, the-carve out provision applied. The Court did not accept this argument stating, “it would be more than a little surprising if once Coventree obtained a temporary binder to cover the prior acts referred to in the October 17, 2007 notice, it then forewent that coverage in submitting the further applications.”

On November 21, 2008, after Lloyds issued the policy, Coventree’s broker e-mailed the Lloyds’ agent for Lloyds regarding the endorsement which excluded coverage for prior acts from the first $5 million. Coventree’s broker said it understood that coverage would be excluded from the second $5 million, but re-affirmed Coventree’s position that it was purchasing full prior acts coverage. Lloyds did not take issue with this assertion.

On December 10, 2008, Coventree’s broker forwarded to Lloyds’ agent a new application with the prior knowledge questions unanswered. This application www.claimscanada.ca

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had an original signature as required by the October 17, 2008 binder. In 2009, Lloyds issued the final version of the endorsement dealing with prior acts coverage, which amended the exclusion provisions of the policy by adding: “based upon, arising out of, relating to, directly or indirectly resulting from or in consequence of, or in any way involving any Wrongful Acts or related Wrongful Acts where all or any part of such acts were committed, attempted or allegedly committed or attempted prior to October 17, 2007, applies only to the $5,000,000 excess of $5,000,000 limit of liability”.

The effect of this endorsement was that the second $5 million of the $10 million coverage does not apply to acts committed prior to October 17, 2007.

This implied that the first $5 million does apply to acts committed prior to October 17, 2007. If Lloyds had intended to exclude coverage for the acts referred to in the October 16, 2007 notice it would have been “logical” to have done so in this endorsement.

Lloyds’ additional arguments to exclude coverage Lloyds also argued, albeit unsuccessfully, that section VI.B of the 2008 policy operated to exclude coverage for acts referred to in the October 16, 2007 notice. Section VI.B stated: “More than one Claim involving the same Wrongful Act or Related Wrongful Acts of one or more Insureds shall be considered a single Claim, and only one Retention shall be applicable to such single Claim. All such Claims constituting a single Claim shall be deemed to have been made on the earlier of the following dates: (1) the earliest date on which any such Claim was first made or (2) the earliest date on which any such Wrongful Act or Related Wrongful Act was reported under this Policy or any other policy providing similar coverage”.

The Court did not accept Lloyds’ argument stating that section VI.B deals with the subject of retention (“the amount of loss the insured is responsible for before the insurer has to begin paying up to the policy limits”).

Furthermore, this section did not exclude coverage for claims that would www.claimscanada.ca

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otherwise be covered under the policy.

Having already found that the parties intended the policy to cover prior acts referred to in the October 16, 2007 notice, the Court held that section VI.B does not alter the agreement relating to coverage.

Lloyds also argued that section IV.B excludes coverage of matters referred to in the October 16, 2007 notice. This section is a general exclusion clause for claims for which notice was previously given to another insurer and states:

In light of this case, the need for insurers to take care in respect of the language used in policy-related documents and what is stated in correspondence between the parties is re-emphasized.

“The Insurer shall not be liable to make any payment for Loss for any Claim made against any Insured based upon, arising out, relating to, directly or indirectly resulting, in consequence of, in any way involving, or in connection with: B. any Wrongful Act or related Wrongful Act or any fact, circumstance

or situation which has been the subject of any notice of Claim given under any other policy of which this Policy is a renewal or replacement.”

Lloyds argued that the October 2008 policy was a renewal or replacement of the Great American Policy and that this section applies to exclude coverage. The Court did not find it was necessary to resolve this issue and agreed with the application judge that once the parties intended to make the October 2008 policy cover matters referred to in the October 16, 2007 notice, it would not make sense to interpret the general exclusion clause as intending to refer to matters set out in that notice. In fact, to interpret the general exclusion clause this broadly, would go against the Supreme Court of Canada’s interpretation principle as set out in its Reid Crowther decision – which holds that exclusion clauses are to be construed narrowly.

Conclusion The Coventree decision differs from other cases that discuss the use of extrinsic/parol evidence. It suggests that a court can look at documentary evidence to discern the factual matrix and glean the objective intent of the parties in order to ascertain what the coverage was as long as no ambiguity is revealed by this analysis. Thus, it does not necessitate going as far as receiving parol evidence (as in Chilton v. Co-operators, [1997] O.J. No. 579) to determine the parties’ subjective intent which is required because there is ambiguity in the policy language.

In light of this case, the need for insurers to take care in respect of the language used in policy-related documents and what is stated in correspondence between the parties is re-emphasized.

This case illustrates that such material may be considered the type of extrinsic evidence that is open to a court’s scrutiny in determining the intention of the parties. It also emphasizes that to exclude coverage for prior acts, the insurer must do so clearly and unambiguously.  Michael S. Teitelbaum is a partner with Hughes Amys LLP and Hyla Korn is an associate with Hughes Amys LLP (A member firm of the ARC Group Canada).

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Solar Photovoltaic Systems

An Emerging Claims Field that Adjusters Should Understand

BY DIONE SCHELTUS AND SCOTT BROAD

The practical use of solar energy is not new. All systems and entities on earth are, or have been, touched by solar energy in one form or another. Photovoltaic (PV) technology is merely a simple method of concentrating the sun’s energy (radiation) and directly converting that solar radiation into an easily useable form of energy: electricity.

A rising market for solar PV systems means Canada is reducing its reliance on non-renewable sources of energy and creating investment opportunities and jobs. But what are the other, often unexpected, consequences of the explosion in the popularity of this technology? What happens when the systems are not manufactured or installed correctly and losses occur? And what are the relevant issues that face the insurance industry?

Overview of a PV System PV systems function by converting energy from the sun and other light sources into electricity using PV modules (or solar panels). The light excites the molecular structure of the material from which the cells within a module are made, creating direct current (DC), which is the type of electricity found in batteries. This is in contrast to electricity in the form of alternating current (AC), the type provided through the electricity grid to your home.

The most common type of PV module used in Canada for commercial installations is the crystalline silicon module. This module is covered with tempered glass on top and ethylene vinyl acetate (EVA) on the back. The glass and EVA completely enclose the module to protect it from moisture, and the EVA provides a tough material on the back. An important feature of the crystalline module is that with every 1°C over 25°C, the module reduces in efficiency by 0.5%.

A commercial rooftop PV system generally comprises a few key components: the PV modules, the string combiner boxes, the array combiner box, the inverter (allowing the system to be connected to the grid), transformer and the electical wires connecting the components.

When a PV system is ready to be installed on a roof, the modules arrive prefabricated. Electricians put together the

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frames to hold the modules at the required angle to the sun, secure the frames to the roof either by direct attachment or by weighing them down (ballasting), and then insert and secure the modules in the frames. The wiring is also completed by the installing electricians.

A small commercial PV array on the roof of a building or warehouse might comprise 1200 panels, 8 string combiner boxes and output approximately 250 kW of power. With approximately 2.5 wire connections per panel, over 3000 connections need to be created by the installing electricians.

Political and Industrial Context According to CanSIA (Canadian Solar Industries Association), Canada’s solar PV market rose by 289 MW in 2011, an amazing 270% increase over 2010. This growth was mainly driven by the construction of PV systems in Ontario, where 91% of the capacity was installed. By 2016, the total installed PV capacity is estimated to be between 3,200 and 4,300 MW – an 11 fold increase over 2011.

A new policy environment in several provinces means that local and international companies are seeking opportunities in the Canadian solar PV market. While the installation of small residential rooftop mounted systems represents 100 MWDC of the market (with 11,000 installations), we are also starting to see very large roof-mounted PV systems connected directly into the grid.

Each Canadian province is approaching the promotion of renewable energy in a different way. Quebec has a solar assistance program focused on replacing fossil fuel use by commerce and industry; Alberta is providing grants for PV systems of up to 10 kW; and, British Columbia passed its Clean Energy Act in 2010 which promotes renewable energy technologies and proposes the introduction of a Feed-in Tariff (FIT).

In May 2009, the Ontario government passed the Green Energy Act as part of its broader plan for a green economy and, within this framework, the FIT program was initiated.

The FIT program provides a guaranteed pricing structure for the production of electricity using renewable sources including PV, biomass, biogas, on-shore wind and hydropower. Within 12 months of the initiation of the FIT program, applications for 15,000 MW of renewable supply were sub-

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mitted, which is equivalent to 43% of Ontario’s electricity generating capacity.

The result of these policy programs is that Canada’s solar industry is moving rapidly towards becoming market competitive, with the cost of PV projects forecast to drop by more than 50% by 2025 to between 14.6 - 20.0 cents per kilowatt-hour (c/kWh), and the establishment of over 3,000 jobs in the solar industry in Canada.

Observations in PV Installations We have been involved in a number of direct insurance events relating to rooftop PV systems. We have also provided inspection, testing and commissioning services for over 50 MW of rooftop PV installations (217,391 modules). In doing so, we have made several observations regarding the process as it currently exists in Ontario.

Because PV modules have no moving parts, they are relatively robust and long-lasting. So robust, in fact, that many PV module manufacturers offer guarantees of up to 20 years.

Yet PV modules are still subject to environmental, mechanical, thermal and manufacturing anomalies that can shorten their lifespan or rated power output. These anomalies are usually related to water ingress or overheating.

Most PV array installations operate unattended for extended periods and few receive scheduled re-commissioning or maintenance checks. In addition, although some PV inverters do have remote monitoring capabilities, those ca-

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pabilities are more focused on the power output of the array and the general condition of the inverter itself. They cannot be monitored remotely to detect the presence of an anomalous condition or pending failure, which usually results in anomalies being discovered hours or days later after they occur.

The recent “gold rush-like” increase in PV projects in Ontario has led to an expedited process of manufacturing and installing PV modules. This has yielded many, often systemic, mechanical and electrical failure mechanisms that could (and have) resulted in catastrophic failures, with installation deficiencies as the primary culprit. Further, the development of applicable regulations, standards, existing infrastructure and installation has not kept pace with the expansion of the industry.

PV modules are unique in that the electrical output is DC and not the typical AC provided by the local electrical grid. The vast majority of the codes and standards for power generation and distribution were designed for AC power, since that was what rotational generation methods such as hydro-electric, coal-heated steam turbines and wind turbines generated. Large-scale passive DC generation is relatively new to Canada and, as such, codes and standards for DC power generation and distribution are not as detailed as they are for AC power.

Furthermore, electrical trades and engineers who are more familiar with AC power do not always appreciate the

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Issues for Insurers to Consider Insurers of buildings onto which PV systems are to be installed may not be consulted prior to the installation and hence may not be provided with the opportunity to consider the risks in advance. This may obviously cause issues if a claim occurs. Regardless, issues to be considered by the building insurer prior to installation include: • Has the existing roof structure been analyzed and approved by a structural engineer for the additional loads of the PV system? Note that issues like the increased potenPotential Risks for the Insurance Industry tial for snow drifts and the related additional snow loads Underwriting PV systems can be tricky for two main are among many impacts that should be considered. reasons: the technology is relatively new (yielding a short • Has the existing electrical system been fully vetted by history of operational data) and there are fewer installations an electrical engineer familiar with the requirements of relative to other technology deployments. Further complexa large DC power generation system? ity is added because PV installations typically involve many • Has the entire PV array been fully commissioned and parties including installers, developers, investors, lenders verified by a qualified firm? and insurance companies. PV systems are typically con• Have building staff been educated about the hazards asnected to buildings owned and insured by different parties. sociated with the PV system?

Insurers that may be impacted by the loss involving a PV • Has the overall risk profile of the building been re-evalusystem are not only those that insure ated to take into account the additional the PV installation projects themselves, fire, water, and wind damage potential? but also those that insure the buildings From the Canadian • How would building business interon which the PV system is mounted. ruption relating to a loss associated with (and global) policy While determining which insurer may the PV system be accounted for? environment in place carry the risk is obviously dependent Issues to be considered by the insurer upon the specific policy wording and of the PV system include many of the today, we predict that leasing details, the following are some above considerations, plus: the number of of the potential risks that we have iden• What agreements are in place governinstallations of large, tified to date: ing maintenance of the system and are • Property damage to the PV instalthey adequate to minimize damage to rooftop commercial lation from typical weather sourcthe PV system and ensure the maxiPV systems is only es such as storm and snow/ice; mum energy output? The latter point is • Property damage to the building, going to increase. particularly valid if there is any insurprimarily the roof structure and ance coverage for poor energy output roof covering, arising during the in(i.e. failure to meet a certain perforstallation and/or ongoing maintenance of the PV system; mance specification).

• Property damage to the building due to failures of the • What agreements are in place governing protection of PV system, including fire, water and electrical system the PV system during building rooftop maintenance of damage (as the existing building electrical distribution the roofing system, HVAC systems, roof anchors, etc., system is directly connected to the PV system); and what risks may be incurred by such maintenance?

• Liability for property damage and/or injuries resulting From the Canadian (and global) policy environment in from PV system components blowing off the roof; place today, we predict that the number of installations of • Damage to the PV system by building personnel during large, rooftop commercial PV systems is only going to inbuilding maintenance (often inadvertently); crease. This presents an altered risk and loss scenario for • The high cost of roof replacement if a PV system is in insurers which may not, yet, be fully appreciated. Insurers, place (and consideration of whether the property policy brokers and adjusters should become familiar with this relpremium reflects this); atively new risk and adjust their underwriting and claims • The possible nullification of the roofing contractor’s processes accordingly.  and roofing manufacturer’s warranties if panels are installed over an existing roof without the contractor’s or Scott Broad is Principal of the Fire and Electrical Group at manufacturer’s permission; Giffin Koerth, which is involved in solar commissioning and • Financial losses to the business that operates in the other renewable energy technologies including wind turbine building due to fires or other property damage from the and geothermal systems.

PV system loss; and, Dione Scheltus is an Account Manager at Giffin Koerth and • Issues arising during firefighting on a roof with an elec- is currently undertaking her Master of Engineering, specialtrical system that cannot be turned off. izing in renewable energy technologies. important differences between AC and DC. Compounding this issue is the fact that, unlike most other power generation methods, PV systems are difficult to “shut off.” That is, while a typical building can be disconnected from the electrical grid by shutting off the incoming electrical feed (thereby de-energizing all the wiring), in a PV system all of the wiring connected to the modules will almost always contain energy, even at night (due to light emitted from other sources including thermal radiation).

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Rethinking

Retirement

Vocational services are increasingly relevant in today’s aging workforce

BY FRANK MALITO

Remember Freedom 55? If you’re old enough to remember the Freedom 55 concept—that we could somehow hatch a plan that resulted in retirement at just 55 years old—then you are also likely old enough to realize that these days, Freedom 55 is more dream than reality. Just like 60 is the new 40, it seems that today, Freedom 55 is more like Freedom 75.

For most of us, the reality is that we will be staying in the workforce longer than previous generations. But what does this mean for your motor vehicle accident (MVA) clients who are 50+ years of age? It means that whether just 50 or approaching 55 or 65, and in some cases, even 75, vocational services are becoming increasingly relevant for the 50+ client population.

Retiring the idea of retirement Not only is the Canadian population aging, we’re working longer into what were previously considered “retirement years.” Staying in the workforce longer is a positive trend for society overall in that, although life expectancy rates are increasing, the birth rate is decreasing so we need labour power. For instance, the federal government recognizes that Canada’s labour market and economy need to adapt to an aging society to remain strong and as a result, the government is making policy changes that reflect societal trends: The Government of Canada, in Budget 2012, introduced measures to gradually change the eligibility age for the Old Age Security (OAS) program over six years, starting in April 2023.

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The eligibility age for the OAS pension and the Guaranteed Income Supplement (GIS) will increase from 65 to 67.

It also introduced a voluntary deferral of the OAS pension, starting in July 2013, to provide more flexibility and choice for Canadians so they can make decisions that are right for them when preparing for the transition from work to retirement.”

Staying in the workforce longer is also a positive trend for many “older adults” who are to some degree increasingly not psychologically ready, combined with some degree of not financially ready. Regardless of the motivation, as our society ages, work continues to play a big part of day-to-day life for most people. Whether full time, part time or periodic contract work— these days many in the 50+ population want and need to continue to work.

Vocational services front and centre As Canada’s population continues to age and your caseload increasingly includes clients 50+ years of age, in turn you will find yourself increasingly involved with vocational services. Gone are the days when file management for those 50+ focused primarily on postaccident physical and psychological impairments with vocational services a secondary issue, or sometimes not required at all. For today’s 50+ client, vocational issues will increasingly be viewed as a “must have.” Fortunately, depending on your 50+ client’s pre-accident employment situation and their post-accident abilities and limitations, there are a range of vocational services that can help you facilitate your client’s transition back to work.

Determining the return-towork goal For all client populations, regardless of age, there are a range of possible work scenarios to consider like modified job/same employer, different job/ same employer, different job/different employer, and same job/different employer, as well as the possibility of retraining or self- employment. Now add to the mix all of the numerous agerelated issues that may be affecting your 50+ client, and it’s clear that your best starting point for selecting the most appropriate vocational services is to have a solid return-to-work goal. Based on the goal, consider using the following overview as a guideline regarding which vocational services would be most helpful for your client.

When the return-to-work goal is: • To assess your 50+ client’s abilities and limitations in performing a specific job so that you can develop an effective return-to-work plan to resolve any identified issues = Job Site Analysis/Work Site Evaluation • To assess your 50+ client’s existing job = Physical Demands Analysis (breaks the job down into specific tasks and then measures your client’s ability to successfully complete the tasks, including physical, environmental, organizational components, and cognitive demands).

• To assess your 50+ client’s ability to perform tasks that could be related to a range of different jobs = Functional Abilities Evaluation (measures, records, and analyzes your client’s ability to safely perform a number of job-related functions providing critical baseline data).

• To ensure your 50+ client is properly positioned in the work environment www.claimscanada.ca

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to alleviate current symptoms, to prevent symptoms from getting worse, or to avoid new symptoms from developing = Ergonomic Assessment (includes work demands analysis, work environment measurements, postural analysis and modifications, education and demonstrations, and equipment recommendations and follow-up training of equipment use).

• To identify potential new vocations for your 50+ client and provide recommendations of suitable alternative jobs/occupations = Transferable Skills Analysis (identifies transferable skills by taking into consideration your 50+ client’s work history and special skills; however, it does not include psychometric tests so information about aptitude and interests is not included).

• To investigate employment options either via your 50+ client directly entering a new type of work or formal re-training = Vocational Assessment To survey potential employers specifically related to your client’s identified job/occupation = Labour Market Survey (includes outreach via databases, the Internet, and employment periodicals about potential employers, job availability in desired geographic region(s), and salary information to provide a comprehensive overview of the job market specific to your client’s identified job/ occupation).

• To educate your 50+ client regarding job search skills = Job Search Training Programs (include developing a resume and networking, contacting potential employers, and learning interview skills. Depending on your client’s specific issues and needs, programs can be on an individual or group basis).

• To help your 50+ client secure and maintain employment by direct contact with potential employers = Job Placement Services (includes placement and then follow-up with both the client and employer to monitor progress and enhance job success).

Client-centred takes on a whole new meaning In keeping what could be considered one of the most important prinwww.claimscanada.ca

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ciples of rehabilitation, the diversity of the 50+ client population couldn’t be a better example of why it’s critical to take a client-centred approach.

Although some post-accident situations faced by your 50+ client may be similar, they are rarely identical; diverse situations are the norm rather than the exception. Similarly, to meet their diverse needs, vocational services for the 50+ population are

increasingly the norm rather than the exception.  Frank Malito is National Director of Government & Vocational Services, Sibley & Associates. Additional information about this topic is available through the Sibley Resource Library and Complimentary Educational Training Seminars.

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EF

• education forum

A SERIES OF ARTICLES PROVIDED BY THE INSURANCE INSTITUTE OF CANADA

Examining

the Experts

F

or years, courts have expressed concern about the trend of “hired gun” expert witnesses retained by plaintiff or defendant lawyers. Some courts are now applying a higher level of judicial scrutiny to the role of expert witnesses, particularly in cases involving medical diagnoses.

Claims examiners and insurers need to be cautious when retaining experts and make sure that their processes will stand up to review.

Although only a few claims reach the courtroom, adjusters and insurers must anticipate that any file may be subject to judicial review. At court, admissible evidence is used to inform a judge – and sometimes a jury – about the true facts of a case. Judges and juries are not specialists in technical matters such as medical or psychiatric conditions, so experts are relied upon to clarify the issues.

Basic principles In any claim situation, an expert should be reputable, stable and properly qualified in a relevant field to provide an analysis or opinion regarding a point in question. If a case is litigated, the credentials of experts will be scrutinized, so the experts selected should be ones whose credentials are relevant to the claims file under review. The organization an expert works for may also be assessed as to its stability and reliability in its field of expertise and how it values training and development.

To avoid any possible conflict of interest, a person who is hired to do work on an insurance claim should not have any stake in the claim or in any property which is the subject of the investigation. In principle, the professional 40 Claims Canada

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should not make any profit other than fees or salary; and the opinion provided should be impartial.

Judges and juries are sometimes faced with divergent and conflicting assessments, particularly in cases involving health-related claims. The adversarial nature of the legal system, combined with the fact that experts are retained and paid by the respective parties, has arguably contributed to a culture of “opinions for sale” in some quarters.

Recently, however, signs of a shift have been emerging.

New emphasis In Ontario, the Rules of Civil Procedure were changed in January 2010 to include revamped duties of experts.

These revised rules introduced several enhanced requirements: • Experts must sign an explicit acknowledgement of their duty to the court and must attach it to their reports. This acknowledgement states

that experts are expected to provide evidence that is related only to matters within their area of expertise and “to provide opinion evidence that is fair, objective and non-partisan.” The form emphasizes that the expert’s duty to the court “prevails over any obligation which I may owe to any party by whom or on whose behalf I am engaged.”

• Every expert report must include certain standard items, such as the expert’s area of expertise, qualifications, employment and educational experience.

• The expert must disclose any background research, documentation and “foundational material” that led to the opinion given in the report.

• The expert must also disclose any instructions about the proceeding that they received from lawyers or clients.

All instructions and correspondence between lawyers and expert witnesses are producible before or at trial.

In other words, any attempt to in-

Expert Examples Although judicial scrutiny of the expert role has focused in particular on medical experts, many other professionals are also called upon to provide opinions to the court, and they may be subject to scrutiny as well. For example: • Engineers who are involved in automobile accident reconstruction, fire origin and cause determination, investigations of equipment failures, construction issues and more.

• Forensic accountants retained to analyze financial evidence, investigate suspected improprieties or quantify damages related to income and other losses.

• Appraisers who estimate the cost, value or cost of repair of an insured item.

Most focus on automobile damage, inspecting damaged vehicles after an accident and estimating the cost of repairs.

• Property restoration contractors who repair fire, smoke and water damage, and who may specialize in particular areas like mould remediation or contents restoration.

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fluence or conceal the opinion of an expert witness – whether by counsel or by a party, including an insurer – can be revealed at court, potentially jeopardizing the case.

Legal decisions issued since the introduction of the revised rules suggests that courts have begun showing an increased awareness of possible bias and advocacy in expert witness reports and testimony. And although the new rules currently apply specifically to cases litigated in Ontario, they address concerns that have been felt in other jurisdictions as well.

pert, establish lack of causation, etc.

• Review the professional standing, reputation, technical expertise and past courtroom experience of an expert before making a selection. Evidence of a professional disciplinary action or an unfavourable comment by a judge in a past case could be signs of trouble to come.

• Evaluate timing considerations such as the sequencing of experts and reports.

• Instruct experts clearly and impartially about their role and responsibilities.

Experts also need to be given adequate time to educate themselves about the case. Providing lots of time and an organized case file can help reduce costs and improve the likelihood of getting a balanced and comprehensive report.

While some parties may be tempted to assume that the old rules of finding the right “advocate” for personal injury cases still apply, proactive adjusters and insurers will benefit from reviewing their processes and keeping them aligned with evolving judicial expectations.

Retention routines Insurers, claims professionals and counsel need to be aware of this potential for a finding of bias and be diligent when selecting experts. In any jurisdiction, factors to consider when retaining a medical expert include the following: • Identify the specific purpose for which expert advice is needed – for example, to rebut the plaintiff’s ex-

Educating the experts That last step in retaining an expert is an important one: educating the expert about their role and responsibilities. Simply gathering up the expert’s signed procedural paperwork is not enough; it’s critical to ensure that the professional understands his or her duty and the implications of acting as an expert witness under the rules that apply in the jurisdiction.

This article is based on excerpts from ADVANTAGE Monthly, a series of topical papers on emerging trends and issues provided to members of the CIP Society.

The Chartered Insurance Professionals’ (CIP) Society is the professional organization representing more than 16,000 graduates of the Insurance Institute’s Fellow Chartered Insurance Professional (FCIP) and Chartered Insurance Professional (CIP) programs. 

24HR

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• on the scene OTS PAUL DAVIS SYSTEMS CANADA, LTD. (PDSC) has added Ralph Gottschalk as the newest franchisee to its network. Ralph will be operating the Paul Davis Systems of Peterborough & Kawartha Lakes franchise providing restoration services to the Peterborough community and surrounding area. l

As of early February, Australian general insurers had already received more than 65,000 claims, with insurance losses conservatively estimated at $674 million, from four catastrophes declared by the Insurance Council of Australia (ICA) in three states over the past few months. The majority of those claims have come from the state of Queensland, which has been affected by severe flooding and cyclone storm damage. More claims are expected over the next months, the ICA noted. l

Ralph Gottschalk Property and casualty insurance firms in Canada need to focus on recruiting aboriginal and internationally-trained professionals, and on flexible work arrangements to retain workers in their 30s, according to a recent report. The Insurance Institute of Canada published the study, dubbed Demographic Analysis of the Property & Casualty Insurance Industry in Canada 2012 - 2022. An executive report is available on the Insurance Institute web site. Written by R.A.L. Consulting Ltd. president Richard Loreto, the report is based on surveys of human resources professionals and of employees in the industry. It also uses information from a demographic analysis of the P&C industry workforce, based on data both from individual companies and from provincial regulators. l Audatex, a provider of information data, technology software, and services for the automobile and insurance claims processing industry, has appointed Darcy Gorchynski as Director of Business Development (Western Canada) for its Insurance Claims Services division. l Darcy Gorchynski Crawford & Company (Canada) Inc. has once again been selected as one of the Top 15 Employers in the Waterloo Region in an announcement that was made in a special editorial feature of The Waterloo Record newspaper in November 202. The list recognizes exceptional employers that offer excellent career prospects to their employees. l STRONE, an emergency, restoration and remediation company headquartered in Oakville, Ontario, has acquired TCR of Muskoka, with its full scope of restoration services.

With this acquisition, STRONE also adds soft contents restoration to its service line-up, gaining the Esporta wash system, offered by TCR. l Cunningham Lindsey Canada has launched a new division, Cunningham Lindsey Research Services Inc (Research Services), offering investigative, surveillance and information services to the insurance industry. The new division is geared toward the Canadian insurance industry but also services the needs of corporations, lawyers and private individuals, the company says. l

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Property and casualty insurer RSA has appointed Paul Lucarelli as vice president of its Large Commercial and Specialty business in the Ontario Region. In this new role, Lucarelli will also lead the company’s Large Commercial and Speciality upper Mid-Market business in Ontario. l Paul Lucarelli

PThere were more than 90,000 impaired driving incidents in Canada in 2011, about 3,000 more than the previous year, Statistics Canada reported in January in an analysis of its latest figures, but fewer of those people charged went to jail. “The rate of impaired driving was 262 per 100,000 population, 2% higher than in 2010 and the fourth increase in five years,” StatsCan stated in an article on its websites. Until 2007, the impaired driving rate in Canada had been steadily declining since the 1980s, the agency noted. In 2011, impaired driving-related deaths, however, were the lowest in 25 years. During the year, police reported 121 incidents of impaired driving causing death, and 839 causing bodily harm, StatsCan said. l

The Traffic Injury Research Foundation (TIRF) and the Toyota Canada Foundation have launched a new education program to teach the public more about vehicle safety features, as the groups suggest that only a third of Canadians understand how such features really work.

“Cars today are equipped with more safety features than ever before. Knowing more about them is an important part of making the most of your car’s safety features,” Stephen Beatty, director of the Toyota Canada Foundation noted in a public statement. “We want to empower Canadians to learn more about how their cars work and to use that knowledge every time they get behind the wheel.”

Known as Brain on Board, the program includes a website that aims to dispel myths about safety features and teach Canadians more about them, in the hopes of reducing collisions overall. The site uses tools such as plain language descriptions of common safety features, details about the human factors that contribute to safe driving, and other educational materials. l

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competitors, CIAA’s volunteers set competition aside and are dedicated to working together for the advancement and preservation of the independent adjusting profession. This significant increase in resources and expertise will be of considerable benefit for all members.”

Rob Seal, President of Cunningham Lindsey, stated “We believe there are some positive initiatives underway and have come to an agreement to rejoin the CIAA. We want to take an active role in pushing these initiatives and look forward to participating.”

Since 1952, CIAA has been providing leadership for Canada’s Independent Adjusters through advocacy, education and recognized standards of professionalism through a defined code of ethics and fair practice policies. l

John Seyler, National President of the Canadian Independent Adjusters’ Association (CIAA) is pleased to announce Cunningham Lindsey Canada’s recent choice to participate and support the ideals and values of the association.

“We are very excited to welcome Cunningham Lindsey back into the fold. CIAA members make a real difference to the industry through their strong belief in corporate social responsibility as a source of opportunity and innovation. Although

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• on the scene OTS CIAA New Members — February 2013 CORPORATE MEMBERSHIP Hansen Labelle Adjusters Ltd. — Calgary, AB Thomson Insurance Adjusters Inc. — Orangeville, ON Cunningham Lindsey Canada Claims Services Ltd. — Mississauga, ON INDIVIDUAL MEMBERSHIP Crawford & Company (Canada) Inc. Christine Giles Nanaimo, BC Mike Zarowny Calgary, AB Sandra Bellrose Medicine Hat, AB David Coy Fredericton, NB Linda Fitzgerald Pickering, ON Ross Greene Mount Pearl, NL

Level 2 Level 1 Level 1 Level 3 Level 3 Level 2

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Markham, ON

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Townsend & Leedham Adjusters Ltd. Kristen Dasilva Edmonton, AB

Level 1

AMG Claims Inc Gary Ellis

Level 3

Charlottetown, PE

Thomson Insurance Adjusters Inc. of Orangeville, ON George Thomson Orangeville, ON Level 3 Hansen Labelle Adjusters Ltd Ole Hansen Calgary, AB Glenn Labelle Calgary, AB Robert Pearson Calgary, AB

Level 3 Level 3 Level 3

Cunningham Lindsey Canada Claims Services Ltd. Ryan Zavitz Sault Ste. Marie, ON Level 3 Anne Tang Vancouver, BC Level 1 Matthew Crisp Barrie, ON Level 3 Hector Palma Barrie, ON Level 3 Krystine Wolochatiuk Barrie, ON Level 1 Lee Butcher Bellville, ON Level 3 Barry McNeil Brampton, ON Level 3 Deanna Milanese Brampton, ON Level 2 Michael Roche Brampton, ON Level 3 Robert Clark Brantford, ON Level 2 Terry O’Reilly Brantford, ON Level 3 Alan Gallagher Brockville, ON Level 3 Margaret McCarthy Burlington, ON Level 3 Walter Panasdir Burlington, ON Level 3 Kevin Quinlan Brampton, ON Level 3 Murray Cook Calgary, AB Level 3 Tara Dempster Calgary, AB Level 1 Joanne Gilbert Calgary, AB Level 3 Coralee Harder Calgary, AB Level 3 Matthew Comiskey Chatham, ON Level 3 Garry Wilson Chatham, ON Level 3 Greg Chaytor Corner Brook, NL Level 3 Terrence Loder Corner Brook, NL Level 3 Kevin LaPierre Dartmouth, NS Level 3 Stephen Topple Dartmouth, NS Level 3 Pieter Heydenrych Dartmouth, NS Level 2 Wanita Publicover Dartmouth, NS Level 3 Carly Gullison Dieppe, NB Level 2 Guy Fournier Edmundston, NB Level 3 Daniel Poitras Edmundston, NB Level 3 Allan Miller Grand Falls, NL Level 2 David Dykeman Hamilton, ON Level 3 Jonathan Kirshenblat Hamilton, ON Level 1 Michael Mixer Hamilton, ON Level 3 Lori Pichenluk Hamilton, ON Level 2

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Adam Tollis Edward O’Hearn Peter Doublard Nicola Young Bradley Wilson Colin Smith Dale Stuart Andrew Walls Eric Renteria Jennifer Jory Luc Turcotte Jeffrey Norman Michael Washington Jamie McGinnis Gary Dalton Michael Morris Albert Poon Michael Alwyn Scott Marsh Rodney Greyling Lorri Frederick Robert Mackay Troy Skinner Kenea Wright Stephen Cordery Brian McCulloch CathyLynne McDonough Eric Burgar Trevor Crowe Christopher Fawcett Dennis Ferris Steve Gibb Jordan Legg Dan McKean Tyler Rafter Greg Waller Scott McLaren Mary Campbell Joseph Murison Leah Wood Marc Doiron Caitlin Enns Nathan Rivard David Atkinson Trevor Black Michael Ragona Robert Hanrahan Brad Arnold Terry Zanetti Trycia Boucher Sean Forgie Pamela Allan Michael Green Eric Gunnell Lee Powell Dale Reid Nick Tucci Vincent Umbrio Vince Chiarelli Jeffrey Bodkin Michael Jobson David Guyader James Dowie Jacqueline Desrochers Norman French

Hamilton, ON Hamilton, ON Kelowna, BC Kentville, NS Kingston, ON Kitchener, ON Kitchener, ON Kitchener, ON Langley, BC Lloydminster, SK Lloydminster, SK London, ON London, ON Milton, ON Mississauga, ON Mississauga, ON Mississauga, ON Mississauga, ON Mississauga, ON Mississauga, ON Mississauga, ON New Glasgow, NS New Glasgow, NS New Glasgow, NS Oshawa, ON Oshawa, ON Oshawa, ON Ottawa, ON Ottawa, ON Ottawa, ON Ottawa, ON Ottawa, ON Ottawa, ON Ottawa, ON Ottawa, ON Owen Sound Penticton, BC Peterborough Peterborough Port Moody, BC Saint John, NB Saskatoon, SK Saskatoon, SK St. Catharines, ON StCatharines, ON St. Catharines, ON St. John’s, NL Stratford, ON Sudbury, ON Sudbury, ON Richmond Hill, ON Richmond Hill, ON Richmond Hill, ON Richmond Hill, ON Richmond Hill, ON Richmond Hill, ON Richmond Hill, ON Richmond Hill, ON Richmond Hill, ON Vancouver, BC Vancouver, BC Victoria, BC Windsor, ON Winnipeg, MB Winnipeg, MB

Level 1 Level 3 Level 3 Level 2 Level 3 Level 2 Level 1 Level 3 Level 3 Level 2 Level 3 Level 2 Level 3 Level 2 Level 3 Level 3 Level 3 Level 3 Level 3 Level 3 Level 3 Level 3 Level 3 Level 2 Level 3 Level 3 Level 3 Level 3 Level 3 Level 2 Level 3 Level 3 Level 2 Level 3 Level 1 Level 2 Level 3 Level 3 Level 1 Level 3 Level 2 Level 1 Level 2 Level 3 Level 3 Level 3 Level 3 Level 3 Level 3 Level 3 Level 3 Level 3 Level 3 Level 3 Level 3 Level 3 Level 3 Level 3 Level 1 Level 3 Level 3 Level 3 Level 3 Level 3 Level 3

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National CICMA Executive at the Annual General Meeting in September 2012 in Fredericton, New Brunswick • First Row: John Russell (Treasurer, British Columbia), Lynn Ross (President, Nova Scotia), Lynn Prescott (Secretary, New Brunswick) • Second Row: Patrick O’Hara (Northern Alberta), Robert Lepine (Quebec), Sharon Clark (Vice President, Ontario), Lyndon Friesen (Manitoba) • Last Row: Robert Hertner (Past President, Ottawa), Hall Noble (Southern Alberta), Dan Langer (Ontario), Wes Moroziuk (Saskatchewan), Alex Lethbridge (Newfoundland) l Robert Hertner, (Past) President of CICMA Ottawa Chapter, on behalf of the Ottawa Chapter presenting awards at the Insurance Institute on November 16, 2012:

ALBERTA APPOINTMENT

Fawn Mah

1

2

1. Nathaniel McPhee receives 1st runner up to Top Local CIP Grad Award.

2. Suzanne Muise receives Top 1st Year FCIP Student Award.

CICMA Ontario Chapter Executive for the 2012-2013 membership year. (From left to right): Dan Langer (Treasurer and Website), Alex Walker (Vice President), John Mendezcuria (Arbitration), Sharon Clark (Communications), Cathy Wismer (Secretary), Mavis Haws (Past President), Jo-Ann Eccleston (President), Teresa Drijber (Program Director), Kevin Chasty (Licensing) and Keith Dyson (Membership) Marsh Adjustment Ltd. is pleased to introduce their New Brunswick claims team Réclamation Marsh Adjustment.

The Marsh Group welcome Pierre Ouellette and MarcAndre Arsenault as their newest staff members. Both Pierre and Marc-Andre are residents of the Bathurst area and bring a wealth of experience and knowledge to the Marsh team.

Together with Dan Laforest’s team in Moncton, Marsh Adjustment now provides claims services to eastern, central and L to R: Pierre Ouellette, Marc-Andre Arsenault, northern New Brunswick. l Monique Chamberlain, Julien Leger, Dan Laforest

Craig Smith, Vice President, Sales and Marketing of ISB Canada is pleased to introduce Fawn Mah as the newest Customer Relationship Manager for Alberta and Western Canada.

Fawn has over 18 years of experience within the insurance industry. She has worked as a business development specialist and marketing representative, a personal lines underwriter in field operations and as an insurance broker.

Fawn will work with Claims Adjusters and Branch Managers to train them on maximizing productivity and efficiency in identifying fraudulent claims through the procurement of source documents.

Fawn can be reached in Calgary at 587-227-4668 or fmah@isbc.ca ISB Canada is your trusted partner for source document retrieval. Documents such as Police Reports, Driver Insurance Histories, Statement of Claim Searches, Land Title Searches, Lien Information and much more are all available. Spend your time analyzing information, not looking for it.

WWW.ISBC.CA www.claimscanada.ca

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• on the scene OTS MDD Forensic Accountants hosted their Annual American Thanksgiving Open House on November 22, 2012 at Real Sports Bar & Grill in Toronto. The event also served as a fundraiser for the Starlight Children’s Foundation. l

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Friends of Hughes Amys LLP gathered at the Irish Embassy in Toronto for the firm’s annual Holiday Cocktail Party on November 29. Attendees enjoyed hors d’ouevres while listening to music and talking to colleagues. l

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APPOINTMENT

The Ontario Pond of the Honourable Order of the Blue Goose hosted its annual Christmas party entitled “Galabration” at the Malaparte at the TIFF Bell Lightbox in Toronto on December 5, 2012. More than 100 ganders and guests attended an elegant evening of fellowship and dining in the true spirit of the season. l

Andrew Papadimitropoulos Claude Blouin and Jamie Dunn, Partners at Blouin Dunn LLP, are extremely pleased to announce that Andrew Papadimitropoulos has joined the firm as an associate lawyer.

Andrew received his Bachelor of Science degree from the University of Toronto in 2004, after which he attended the University of Manchester, where he obtained his law degree in 2007. He obtained his Certification of Qualification from the National Committee on Accreditation in 2008 and subsequently articled at a mid-sized Toronto full service firm with an emphasis on insurance defence work.

After Andrew was called to the bar in 2010, he worked as in-house counsel for a major insurance company and a boutique insurance defence firm.

Andrew’s practice focuses on insurance defence litigation, including first and third party claims, occupiers liability claims and property damage disputes.

Andrew is a member in good standing of the Law Society of Upper Canada, the Canadian and Ontario Bar Association and The Advocates’ Society.

Outside of work, Andrew’s interests include golf, mountain biking and skiing.

Andrew’s contact information is: apapadimitropoulos@blouindunn.com (416) 365-7888 ext. 123 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

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National Standing Committees 2012-2013 ADVISORY Marie C. Gallagher, FCIP, CRM Granite Claims Solutions 71 King Street, Suite 204 St. Catharines, ON L2R 3H7 Phone: (905) 984-8282 Fax: (905) 984-8290 E-mail: marie.gallagher@graniteclaims.com E. Grant King, BA, B.Ed., CIP Crawford & Company (Canada) Inc. 120 – 237 Brownlow Avenue Dartmouth, NS B3B 2C7 Phone: (902) 468-7787 Fax: (902) 468-5822 E-mail: Grant.King@crawco.ca Greg G. Merrithew, CIP, FIFAA Arctic West Adjusters Ltd. 201 – 5204 – 50 Ave. Yellowknife, NT X1A 1E2 Phone: (867) 920-2212 Fax: (867) 873-2244 E-mail: gregm@arcticwest.ca James B. Eso, BA, CIP Crawford & Company (Canada) Inc. 539 Riverbend Drive Kitchener, ON N2K 3S3 Phone: (519) 578-5540 Fax: (519) 578-2868 E-mail: Jim.Eso@crawco.ca John Jones, BA Granite Claims Solutions Suite 300, 5915 Airport Road Mississauga, ON L4V 1T1 Phone: (905) 671-3164 Fax: (905) 671-1889 E-mail: john.jones@graniteclaims.com Craig J. Walker, CIP, FCIAA, FIFAA Maltman Group International 3550 Victoria Park Ave., Suite 301 Toronto, ON M2H 2N5 Phone: (416) 492-4411 Fax: (416) 492-5657 E-mail: cwalker@maltmans.com CIAA NATIONAL INSURANCE INDUSTRY ADVISORY BOARD Patti M. Kernaghan, FCIP, CRM Kernaghan Adjusters Limited 300 - 1575 West Georgia Street Vancouver, BC V6G 2V3 Phone: 1-800-387-5677 Fax: 1-800-387-5644 E-mail: pkernaghan@kernaghan.com John D. Seyler, CIP ProFormance Group 5080 Timberlea Blvd., Suite 214 Mississauga, ON L4W 4M2 Phone: (905) 238-4985 Fax: (905) 238-2735 E-mail: jseyler@prospecialty.ca Marie C. Gallagher, FCIP, CRM Granite Claims Solutions 71 King Street, Suite 204 St. Catharines, ON L2R 3H7 Phone: (905) 984-8282 Fax: (905) 984-8290 E-mail: marie.gallagher@graniteclaims.com Greg G. Merrithew, CIP, FIFAA Arctic West Adjusters Ltd. 201 – 5204 – 50 Ave. Yellowknife, NT X1A 1E2 Phone: (867) 920-2212 Fax: (867) 873-2244 E-mail: gregm@arcticwest.ca Craig J. Walker, CIP, FCIAA, FIFAA Maltman Group International 3550 Victoria Park Ave., Suite 301 Toronto, ON M2H 2N5 Phone: (416) 492-4411 Fax: (416) 492-5657 E-mail: cwalker@maltmans.com Patricia M. Battle Canadian Independent Adjusters’ Association/L’Association Canadienne des Experts Indépendants 5401 Eglinton Ave. West, Suite 100 Etobicoke, ON M9C 5K6 Phone: (416) 621-6222 Toll Free: 1-877-255-5589 Fax: (416) 621-7776 E-mail: pbattle@ciaa-adjusters.ca

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John M. Sharoun, FIIC, CFE, FCIAA Crawford & Company (Canada) Inc. 300 – 123 Front Street West Toronto, ON M5J 2M2 Phone: (416) 867-1188 Fax: (416) 867-1925 E-mail: John.Sharoun@crawco.ca Dennis N. Schembri, CIP, CFEI Granite Global Solutions 133 King Street East, 3rd Floor Toronto, ON M5C 1G6 Phone: (647) 789-2438 Fax: (647) 789-2449 E-mail: dennis.schembri@graniteglobalsolutions.com Jo-Ann Eccleston, CIP Aviva Canada Inc. 2206 Eglinton Ave. East Toronto, ON M1L 4S8 Phone: (416) 689-3328 Fax: 1-866-805-8585 E-mail: jo-ann_eccleston@avivacanada.com Bob Grouchy, BA, FCIP, CRM Allianz Global 1600 – 130 Adelaide Street West Toronto, ON M5H 3P5 Phone: (416) 915-4247 Fax: (416) 849-4555 E-mail: bob.grouchy@agr.allianz.ca Carol Jardine, FCIP, CRM TD Insurance 2161 Yonge Street, 4th Floor Toronto, ON M4S 3A6 Phone: (416) 486-2507 Fax: (416) 545-6022 E-mail: Carol.Jardine@tdinsurance.com Justin J. MacGregor Martin Merry & Reid Limited 3 Church Street, Suite 404 Toronto, ON M5E 1M2 Phone: (416) 366-3333 Fax: (416) 366-0730 E-mail: jmacgregor@mmr.ca Mark Stewardson, FCIP Royal & SunAlliance 2225 Erin Mills Parkway, Suite 1000 Mississauga, ON L5K 2S9 Phone: (905) 403-2333 Fax: (905) 403-2326 E-mail: Mark.Stewardson@rsagroup.ca Mark Weir Intact Financial Corporation 700 University Avenue, 13th Floor Toronto, ON M5G 0A1 Phone: (416) 341-1464 Fax: (416) 217-0562 E-mail: mark.weir@intact.net Peggy Wong, CIP The Economical Insurance Group 111 Westmount Road South Waterloo, ON N2J 4S4 Phone: (519) 570-8500 Fax: (519) 570-8690 E-mail: Peggy.Wong@teig.com CAREER RECRUITMENT PLANNING Richard Swierczynski, BA, CIP AZ Claims Services Inc. 1500 Upper Middle Rd., Unit #3 P.O. Box 76041 Oakville, ON L6M 3G3 Phone: (905) 825-0027 Fax: (905) 825-5543 E-mail: Richard@azclaims.ca COMMUNICATIONS Teresa Mitchell, FCIP, CRM, FCLA, FCIAA, FIFAA Crawford & Company (Canada) Inc. 14 – 431 Bayview Drive Barrie, ON L4N 8Y2 Phone: (705) 728-5597 Fax: (705) 728-2167 E-mail: Teresa.Mitchell@crawco.ca CONSTITUTION & RULES John Jones, BA Granite Claims Solutions Suite 300, 5915 Airport Road Mississauga, ON L4V 1T1 Phone: (905) 671-3164 Fax: (905) 671-1889 E-mail: john.jones@graniteclaims.com

CONVENTION David S. Riddell, FCIP, CRM Canadian Claims Services 17958 – 106 Avenue Edmonton, AB T5S 1V4 Phone: (780) 443-1185 Fax: (780) 443-1893 E-mail: driddell@canclaims.com DESIGNATION Paul W. Greening, CLA, FCIAA Greening Aviation Claims Inc. 26C Palliser Park, Box 190 Riverhurst, SK S0H 3P0 Phone: (306) 353-2000 Fax: (306) 353-2200 E-mail: pgreening@sasktel.net E. Brian Gough, FCIP, CLA, FCIAA Marsh Adjustment Limited 1550 Bedford Highway, Suite 711 Bedford, NS B4A 1E6 Phone: (902) 469-3537 Fax: (902) 469-2396 E-mail: ebgough@marshadj.com Robert V. Pearson, CLA, FCIAA Hansen Labelle Adjusters Ltd. 1328 17th Avenue N.W. Calgary, AB T2M 0R1 Phone: (403) 284-2211 Fax: (403) 284-2299 E-mail: bob@hansenlabelle.ca DISCIPLINE Greg G. Merrithew, CIP, FIFAA Arctic West Adjusters Ltd. 201 – 5204 – 50 Ave. Yellowknife, NT X1A 1E2 Phone: (867) 920-2212 Fax: (867) 873-2244 E-mail: gregm@arcticwest.ca EDITORIAL Mary Charman, CIP Crawford & Company (Canada) Inc. 14 & 15 – 431 Bayview Drive Barrie, ON L4N 8Y2 Phone: (705) 728-5597 Fax: (705) 728-2167 E-mail: Mary.Charman@crawco.ca John M. Sharoun, FIIC, CFE, FCIAA Crawford & Company (Canada) Inc. 300 – 123 Front Street West Toronto, ON M5J 2M2 Phone: (416) 867-1188 Fax: (416) 867-1925 E-mail: John.Sharoun@crawco.ca EDUCATION Santo Carbone, CRM, FCIAA Crawford & Company (Canada) Inc. 300-123 Front Street West Toronto, ON M5J 2M2 Phone: (416) 364-6341 Fax: (416) 435-0546 E-mail: Santo.Carbone@crawco.ca EMERGENCY MEASURES Richard Van Horne Action Investigations Inc. 2 Catelina Court Dartmouth, NS B2X 3G9 Phone: (902) 462- 1222 Fax: (902) 462-3688 E-mail: richardvanhorne@actioninvestigations.ca FINANCE Russell Fitzgerald, CIP Kernaghan Adjusters Limited 203 – 4246 97 Street N.W. Edmonton, AB T6E 5Z9 Phone: (780) 488-2371 Fax: (780) 488-0243 E-mail: rfitzgerald@kernaghan.com John D. Seyler, CIP ProFormance Group Inc. 5080 Timberlea Blvd., Suite 214 Mississauga, ON L4W 4M2 Phone: (905) 238-4985 Fax: (905) 238-2735 E-mail: jseyler@prospecialty.ca Greg G. Merrithew, CIP, FIFAA Arctic West Adjusters Ltd. 201 – 5204 – 50 Ave. Yellowknife, NT X1A 1E2 Phone: (867) 920-2212 Fax: (867) 873-2244 E-mail: gregm@arcticwest.ca

IBC: LIAISON, LEGISLATIVE & FORMS Paul Hancock, B.Sc., CIP Crawford & Company (Canada) Inc. 300 – 123 Front Street West Toronto, ON M5J 2M2 Phone: (416) 867-1188 Fax: (416) 867-1925 E-mail: Paul.Hancock@crawco.ca LICENSING J. Miles O. Barber, B.Comm. (Hons.), FCIP, CRM Network Adjusters Ltd. 67 Folkestone Blvd.

Winnipeg, MB R3P 0B4 Phone: (204) 897-5793 Fax: (204) 897-5797 E-mail: mbarber@mts.net MEMBERSHIP & QUALIFICATIONS Georgiana Chen, CIP ProFormance Group Inc. 1101 Kingston Rd., Suite 280 Pickering, ON L1V 1B5 Phone: (877) 539-3111 Fax: (905) 554-3776 E-mail: gchen@proadjusting.ca NOMINATING Greg G. Merrithew, CIP, FIFAA Arctic West Adjusters Ltd. 201 – 5204 – 50 Ave. Yellowknife, NT X1A 1E2 Phone: (867) 920-2212 Fax: (867) 873-2244 E-mail: gregm@arcticwest.ca John D. Seyler, CIP ProFormance Group Inc. 5080 Timberlea Blvd., Suite 214 Mississauga, ON L4W 4M2 Phone: (905) 238-4985 Fax: (905) 238-2735 E-mail: jseyler@prospecialty.ca James B. Eso, BA, CIP Crawford & Company (Canada) Inc. 539 Riverbend Drive Kitchener, ON N2K 3S3 Phone: (519) 578-5540 Fax: (519) 578-2868 E-mail: Jim.Eso@crawco.ca Craig J. Walker, CIP, FCIAA, FIFAA Maltman Group International 3550 Victoria Park Ave., Suite 301 Toronto, ON M2H 2N5 Phone: (416) 492-4411 Fax: (416) 492-5657 E-mail: cwalker@maltmans.com PRIVACY James B. Eso, BA, CIP Crawford & Company (Canada) Inc. 539 Riverbend Drive Kitchener, ON N2K 3S3 Phone: (519) 578-5540 Fax: (519) 578-2868 E-mail: Jim.Eso@crawco.ca Keith P. Edwards, FCILA, CLA, FUEDI-ELAE CIAA Honorary Life Member c/o CIAA National Office 5401 Eglinton Ave. W., Suite 100 Etobicoke, ON M9C 5K6 Phone: (416) 621-6222 Fax: (416) 621-7776 E-mail: info@ciaa-adjusters.ca

CIAA REGIONAL PRESIDENTS 2012 – 2013 NEWFOUNDLAND & LABRADOR Christopher Goodwin Crawford & Company (Canada) Inc. 96 Clyde Avenue, Suite 100 Mount Pearl, NL A1N 4S2 Phone: (709) 753-6351 Fax: (709) 753-6129 E-mail: Christopher.Goodwin@crawco.ca NOVA SCOTIA E. Grant King, BA, B.Ed., CIP Crawford & Company (Canada) Inc. 120 – 237 Brownlow Avenue Dartmouth, NS B3B 2C7 Phone: (902) 468-7787 Fax: (902) 468-5822 E-mail: Grant.King@crawco.ca NEW BRUNSWICK & PRINCE EDWARD ISLAND Luc Aucoin, BBA, FCIP Plant Hope Adjusters Ltd. 85 Englehart Street Dieppe, NB E1A 8K2 Phone: (506) 853-8500 Fax: (506) 853-8501 E-mail: laucoin@planthope.com QUEBEC/AESIQ Charles A. Berthiaume Reclamations C. Berthiaume 44, Chemin d’Oka Saint-Eustache, QC J7R 1K5 Phone: (450) 491-6165 Fax: (450) 491-6230 E-mail: rcb@reclamationscberthiaume.ca ONTARIO Teresa Mitchell, FCIP, CRM, FCLA, FCIAA, FIFAA Crawford & Company (Canada) Inc. 14 – 431 Bayview Drive Barrie, ON L4N 8Y2 Phone: (705) 728-5597 Fax: (705) 728-2167 E-mail: Teresa.Mitchell@crawco.ca MANITOBA Timothy W. Bromley J.P. Hamilton Adjusters Ltd. 125 Enfield Crescent Winnipeg, MB R2H 1A8 Phone: (204) 944-1057 Fax: (204) 944-1606 E-mail: tbromley@mts.net SASKATCHEWAN Cheryl Hanson Crawford & Company (Canada) Inc. 210 – 227 Primrose Drive Saskatoon, SK S7K 5E4 Phone: (306) 931-1999 Fax: (306) 931-2212 E-mail: Cheryl.Hanson@crawco.ca WESTERN Russell Fitzgerald, CIP Kernaghan Adjusters Limited 203 – 4246 97 Street N.W. Edmonton, AB T6E 5Z9 Phone: (780) 488-2371 Fax: (780) 488-0243 E-mail: rfitzgerald@kernaghan.com PACIFIC David Porter, LL.B., FCIP, CRM Granite Claims Solutions 400-4370 Dominion Street Burnaby, BC V5G 4L7 Phone: (604) 699-6550 Fax: (604) 659-6570 E-mail: david.porter@graniteclaims.com

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APPOINTMENT

The Ontario Chapter of the Risk & Insurance Management Society (ORIMS) held its Christmas Luncheon on December 13, 2012, at the Westin Harbour Castle in Toronto. More than 700 attended. In all, $8,500 and hundreds of pounds of food were for collected The Daily Bread Food Bank. l

Deborah Brockway Claude Blouin and Jamie Dunn, Partners at Blouin Dunn LLP, are extremely pleased to announce that Deborah Brockway has joined the firm as Director, Marketing & Communications.

Deborah comes to Blouin Dunn with over 10 years of combined experience in Business Development, Marketing, Client Services Coordination, Recruitment and Healthcare and will be responsible for leading all aspects of Blouin Dunn’s marketing and communication efforts including advertising, client relationship management, sponsorships and events Outside of work, Deborah’s interests include fitness, beach volleyball, music and travel.

Deborah’s contact information is: dbrockway@blouindunn.com (416) 365-7888 ext. 147 (416) 737-3668 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

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SAVE THE DATE –– Further details available soon SAVE THE DATE Further details available SAVE THE DATE – Further details available soon soon

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