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Claims Canada February March 2016

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February/March 2016

Future Thinkers

Official Journal of the Canadian IndeÊpendent Adjusters’ Association

Adjusters ready to take on new claims environment

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Contents ' & # 3 6 " 3 : . " 3 $ ) t 7 0 - 6 . & t / 6 . # & 3

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Cover Feature 12 Future Thinkers Independent adjusters across Canada face a wide range of issues in the coming year. Those developments fall into familiar themes: consolidation; the role of technology; a possible decrease in auto claims; how to manage peaks and valleys; and, revenue growth vs controlling expense. Claims Canada asked leading adjusters at top-ranked firms across the country what trends and developments they expect to unfold in 2016. How should claims professionals and their firms best prepare?

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BY ANGELA STELMAKOWICH

Spotlight 20 Changing the Environment Social justice drives Pieter Heydenrych’s practice in his Halifax-based specialist firm Emergency & Environmental Claims Management (EECM Ltd.). BY EMILY ATKINS

News Features

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22 Top Ten Insurance Decisions This was an active year at the provincial appellate court level, with two issues dominating the insurance coverage landscape. BY CHRISTOPHER R. DUNN AND JOSIAH T. MACQUARRIE

26 Nudging Claimants The field of behavioural economics could have potential applications in insurance claims, fraud deterrence, injury management, driver safety and client service, experts contend. BY CRAIG HARRIS

28 Monk v. Farmers’ Mutual Insurance Co. (Lindsay) Further Lessons in Policy Language and Interpretation

Departments

BY MICHAEL S. TEITELBAUM

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4 First Notice 30 On The Scene

Columns 10 President’s Message

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t ĂĽSTU OPUJDF FN Adjusters will need new skills for tech claims The face of claims is changing and will continue to do so with rapidly unfolding technology. There are several areas “where the risk and expertise required is new,â€? says Paul Hancock, national director of global technical services at Crawford & Company. Hancock explained to attendees at the 49th Annual Canadian Insurance Claims Managers Association/ Canadian Independent Adjusters’ Association Ontario Chapter Joint Conference that drones, for example, are a new technology that could lead to more claims given the current environment, but also clearly illustrate the need for a fresh breed of adjuster equipped with a different skill set. “Due to obstacles like the skills of operators, lack of training, untested technology and the liability associated with drones in crowded areas, I think there’s going to be more collisions, accidents, injuries and property damage,â€? Hancock predicted. “Do we have the skilled adjusters that understand the regulation, the technology, that are able to handle the claims?â€? he asked. There is a “growing need for more and different complex loss adjusters. The future of adjusting will be engineering, IT professionals, data analysts, lawyers, accountants, quantification experts doing their thing, for the most part, 24/7, 365, remotely and virtually,â€? Hancock suggested.

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Along with drones, he said driverless cars will challenge the adjustment process. Who will be responsible when a driverless car gets into an accident? There are many parties it could be, from the vehicle manufacturer, to the software maker, the city, the town, or the province that had to create the infrastructure to support the driverless car. “Claims adjudication will not be a human response based on witnesses,� Hancock said. It will purely be based on technology. For the most part, new technologies like drones, the Internet of Things, telematics and driverless cars offer the promise of helping to reduce the number of claims, Hancock said. His company has recently purchased a drone that can serve as the “eye of adjusters,� for example. “Drones are going to offer us the ability to improve the efficiency and the effectiveness of a variety of claims-handling and risk management tasks that otherwise may be tedious, difficult and even dangerous to the people who do them,� he said. �

Preparation key to reducing losses from cats The flooding in southern Alberta in 2013 has left claims executives better prepared for another major catastrophe, speakers suggested at the inaugural Canadian Catastrophe Conference. “You think you are ready, but you’re never quite ready for what was to unfold,� Mathieu Lamy, senior vice president of claims at Intact Financial Corp., said. “I don’t think we were quite ready to handle that from an adjusting standpoint.� There was a lot of learning from that event, Lamy added. “Calgary was challenging,� he conceded. “We never prepared as much as we should have for water. I think now we’d be in a better place to do that.� Preparing in advance for such events can help mitigate losses when they do occur and improve claims experience, speakers suggested at the conference. “We incorporate a process of what we call a ‘pre-mortem,’� Pat Van Bakel, president and CEO of Crawford and Company (Canada) Inc. said. “Before the event happens, and before anybody is going to get blamed for anything, frankly, you can sit in a room and throw scenarios at the wall of what could go wrong, what are all of the things that might happen here that might cause us a problem?� Van Bakel said. “And that gives you the forwardlooking opportunity to build mitigation strategies to hopefully prevent some of those failures when they happen.� Lamy noted that Intact spent “quite a bit of time� to establish what it called a ‘coverage guide’ for the 2013 floods. As well, the company wanted a solid guide for anybody who would help adjust, either from Intact, from other regions or outside partners. “That ended up being, I think for us, a saving grace,� Lamy said. � www.claimscanada.ca

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t ĂĽSTU OPUJDF FN Western Canada hit hardest by 2015 catastrophes Canada was hit with six severe-weather catastrophes, each causing more than $25 million in damage in 2015, and all but one affected the West. “2015 was the year all hail broke loose,â€? said Carolyn Rennie, director of catastrophic loss analysis for Catastrophe Indices and Quantification Inc. (CatIQ), at the company’s Canadian Catastrophe Conference in Toronto. CatIQ—a sister company to Toronto-based MSA Research Inc.—tracked six catastrophic events and 10 “notableâ€? events last year, Rennie added. A “notableâ€? event is one with losses between $10 million and $25 million. The most expensive was on July 21, when a severe convective thunderstorm in Alberta caused $260 million in insured losses. There was tennis-ball-sized hail and wind gusts up to 110 kilometres per hour, Rennie noted. This caused damage to roof shingles, siding and “extensive auto damage,â€? she said. “Alberta incurred the majority of losses from catastrophesâ€? in 2015, she said. The second most expensive event was Aug. 4-5. Golf ball-sized hail affected Calgary. That storm, with losses estimated at $165 million, packed winds near 80 km/h. On June 12 a storm hit the Prairies with gusts up to 119 km/h and golf ball-sized hail in places. Losses were estimated at more than $70 million, with the “majority of the damageâ€? occurring in Alberta. On July 22, a cold front passed through Alberta, with a tornado touching down near Calgary. Overall losses from that storm were estimated at $51 million.

The last catastrophe occurred Aug. 29, when a windstorm smashed British Columbia. That storm, which caused about $33 million in damage, caused trees to fall, cutting power to more than 530,000 people. In Ontario, severe thunderstorms the night of June 22 caused losses estimated at $32 million. Balz Grollimund, head of earthquake for Swiss Reinsurance Company also spoke at the conference. Grollimund suggested the experience in Christchurch, New Zealand—which was hit by a series of earthquakes five years ago—provides lessons if a major tremor hits British Columbia. The cost of those quakes is now about $36 billion. The main quake in Christchurch was 6.3 on the Richter scale, but it hit “the wrong place,� Grollimund said. Grollimund referred to a report from AIR Worldwide that modelled the effects of two hypothetical earthquakes affecting Canada. The report, commissioned by Insurance Bureau of Canada and released in October 2013, predicted the effects—including economic and insured losses—of a magnitude 9.0 temblor off the West Coast and a magnitude 7.1 quake northeast of Quebec City. Large parts of suburban Vancouver would be affected by liquefaction—which also affected areas of Christchurch in 2011, said Grollimund. “That’s the ground underneath the buildings, becoming not solid but liquid,� he said. The threat of an earthquake in B.C. should have reinsurers checking policy terms carefully, he added. �

App for quicker environmental spill response Zurich has released a mobile app—designed for qualified customers throughout North America in industries that deal with hazardous materials—meant to help them speed up response to spills requiring emergency environmental cleanup. The Zurich Environmental Emergency Response (ZEER) app is designed for industries, including transportation and manufacturing, where hazardous materials spills can lead to environmental contamination at or beyond a company’s facilities, notes a statement from the global multi-line insurer. Originally developed for Zurich’s environmental underwriting and claims professionals— in collaboration with environmental response company Spill Center, Inc.—ZEER offers customers the ability to report spills from a mobile device immediately at the scene of an incident. Among other things, the app can do or be used to do the following: t QSPWJEF DVTUPNFST BDDFTT UP B DBMM DFOUSF for environmental spill consultation; t HFOFSBUF TQJMM SFQPSUT PO CFIBMG PG DVTUPNFST UP IFMQ meet regulatory requirements to reduce liability exposures and possible penalties;

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t QSPWJEF DVTUPNJ[FE JOUFSOBM BMFSUT GPS B DVTUPNFS T DSJTJT management communications; t HFP MPDBUF UIF TQJMM SFRVJSJOH FNFSHFODZ FOWJSPONFOUBM clean-up via customer’s mobile device; and, t JNNFEJBUFMZ VQMPBE DSJUJDBM EBUB GPS B TQJMM report, such as insurance policy information and spill location. “An accidental spill that results in an environmental hazard is, for most businesses, an extraordinary occurrence,� Steve Hatch, chief claims officer for Zurich North America, notes in the company statement. That said, every business should be prepared, Hatch emphasizes, adding the new app “can help customers mitigate damages and reduce potential liability associated with spills.� For Android, Blackberry and Apple devices, the mobile app is available for use in both English and French. Noting that the world is experiencing a huge increase in innovation of various kinds, “Zurich is incorporating new technology into its own efforts to increase efficiency and profitability and, in turn, improve the quality of products and services we provide to our customers,� the statement adds. � www.claimscanada.ca

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“With over 1600 Independent Adjusters committed to professionalism in 400 offices throughout Canada… CIAA Members are dedicated to fair practice and integrity on all claims-related services” NOVA SCOTIA Action Investigations Incorporated Dartmouth AMG Claims Inc. Halifax ASAP Claims Adjusting Limited Sydney ClaimsPro Antigonish Coldbrook Dartmouth New Glasgow Sydney Crawford & Company (Canada) Inc. Dartmouth Kentville Stellarton Sydney Yarmouth Cunningham Lindsey Canada Claim Services Ltd. Dartmouth Kentville New Glasgow Integral-Adjuster Newport Kernaghan Adjusters Limited Halifax Sydney Marsh Adjustment Limited Antigonish Bedford Bridgewater Kentville Lawrencetown Sydney Truro Yarmouth G.E. Morgan Adjusters Limited Bedford N.S. TASKS Ltd. Truro

NEW BRUNSWICK AMG Claims Inc. Fredericton ClaimsPro Bathurst Campbellton Dieppe Edmundston Hanwell Fredericton Grand Falls Miramichi Moncton Saint John Crawford & Company (Canada) Inc. Bathurst Fredericton Moncton Saint John Cunningham Lindsey Canada Limited Caraquet Dieppe Edmundston Saint John Greater Moncton Adjustment Bureau Inc. Dieppe C. Landry Adjustment Ltd. Caraquet Réclamation Marsh Adjustment Bathurst Moncton Robichaud Claims Services Cocagne Young’s Claim Service Moncton

PRINCE EDWARD ISLAND AMG Claims Inc. Charlottetown CKS Holdings Inc. Charlottetown ClaimsPro Mount Stewart Crawford & Company (Canada) Inc. Charlottetown DeLong & Associates Inc. Charlottetown Summerside Prince Edward Claims Services Inc. Charlottetown NEWFOUNDLAND ClaimsPro Clarenville Corner Brook Gander Grand Falls-Windsor St. John’s Colonial Adjusting & Appraisal Services St. John’s Crawford & Company (Canada) Inc. Mount Pearl Cunningham Lindsey Canada Claim Services Ltd. Corner Brook Grand Falls St. John’s Insurance Consulting and Mediation Services Ltd. St. John’s Peninsula Adjusting Services Ltd. Marystown Pike and Associates Adjusting Ltd. Holyrood

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

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

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t ĂĽSTU OPUJDF FN Incentives could improve municipal risk management Offering incentives to municipalities to invest in addressing risk and improving resilience is a dialogue that deserves more attention. “We want to move to dialogue that can help provide clear incentives for cities that invest in improving and addressing risk, and encourage other stakeholders in investing in addressing risk and improving resilience,â€? said Matthew Lynch, vice president of global partnerships and initiatives with the Toronto-based World Council on City Data, speaking at the Canadian Catastrophe Conference in early February. Lynch used the example of the National Flood Insurance Program’s community rating system, “where if communities take certain levels of actions, it feeds back into the premiums they are offering.â€? “We’re looking at those linkages—standardized indicators that can help broker those linkages between risk resilience and insurability,â€? Lynch added. “When you start looking at the city-level performance‌there are a number of things that greatly influence that risk base, be it planning controls, design and implementation of building codes, performance and infrastructure, emergency response capabilities,â€? he said, adding that dialogue between insurers and municipalities in Canada is “already happening a lot anyway, but I think there’s always room for more.â€? Ewa Jackson, manager of ICLEI Canada, a Toronto-based association for urban sustainability, pointed to a climate change-related incentive for municipalities, introduced by the

government of Nova Scotia. “It said that in order to access your gas tax funding, we require you to create and submit to us a municipal climate change action plan (MCAP),� Jackson said at the conference. “The MCAPs essentially provide a roadmap that each and every municipality in Nova Scotia is going to follow to get more climate ready, and that’s both on the mitigation and adaptation side,� she said, adding that implementation funding for these action plans will be the next step. “Climate change has really amplified existing risks.� Barb Szychta, vice president of risk management services with Princeton, Ont.-based Frank Cowan Company, a provider of specialized insurance programs, including risk management and claims services to municipalities and other organizations, also spoke. She said the company sees climate change as a “very significant emerging risk� for municipalities because it impacts a vast variety of local services. “Municipalities have to identify how does climate change [affect] their operations,� Szychta said. “It’s identifying your vulnerabilities, your funding sources, resources, categorizing your risk, where should I go first? Where does my money go first? What can I do in five years? What can I do in 10 years?� �

Paul Aquino Publisher (416) 510-6788 paul@canadianunderwriter.ca

Steve Wilson Senior Publisher (416) 510-6800 steve@canadianunderwriter.ca

Christine Giovis Account Manager (416) 510-5114 christine@canadianunderwriter.ca

Emily Atkins Editor (416) 510-5130 emily@claimscanada.ca

Karen Samuels 1SPEVDUJPO .BOBHFS t karens@newcom.ca

Mike Wells "DDPVOU .BOBHFS t mike@canadianunderwriter.ca

Subscription inquiries (416) 614-5831

Michael Chimienti Art Director mike@newcom.ca

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

A bi-monthly magazine (6x per year), Claims Canada is published by NEWCOM Business Media Inc. is located at: 80 Valleybrook Drive, Toronto, ON, M3B 2S9. Claims Canada magazine is the Official Publication of the Canadian Independent Adjusters’ Association [CIAA] and through its editorial content and circulation brings together the ‘entire property & casualty insurance claims market nationally’ with information and insight into the profession, business and people of insurance claims and loss adjusting. All key claims process stakeholders are reached as part of our readership community – including: both CIAA member and non-member independent claims adjusting firms; insurance and reinsurance company executive, claims management

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and claims adjusting personnel; corporate risk managers and loss control professionals; insurance brokers; insurance law firms; forensic engineers and accountants; appraisal, restoration, rehabilitation and collision repair professionals; Insurance Institute chapters; insurance associations, regulators and related claims market recipients. The contents of this publication may not be reproduced or transmitted in any form, either in part or in full, without the written consent of the copyright owner. Nor may any part of this publication be stored in a retrieval system of any nature without prior written consent.

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CIAA REGIONAL PRESIDENTS 2015 – 2016 NEWFOUNDLAND & LABRADOR TBA

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

NEW BRUNSWICK & PRINCE EDWARD ISLAND Greg Potten, BPE, CIP, CFEI AMG Claims Inc. 212 Queen Street, Unit 308 Fredericton, NB E3B 1A8 Phone: (506) 458-9000 Fax: (506) 458-9595 E-mail: greg.potten@amgclaims.ca

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

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

MANITOBA Craig Shanks, BA, CIP Network Adjusters Ltd. 64 Regent Cres. Brandon, MB R7B 2W9 Phone: (204) 725-7436 Fax: (204) 725-7437 E-mail: craig.shanks@mymts.net

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

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

PACIFIC Blair McGregor, CIP, ClaimsPro #400, 4370 Dominion Street Burnaby, BC, V5G 4L7 Phone: (604) 659-6550 Fax:1-888-452-5246 E-mail: blair.mcgregor@scm.ca

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

Heather Matthews, CIP, CRM Crawford & Company (Canada) Inc. 539 Riverbend Dr. Kitchener, ON N2K 3S3 Phone: (519) 578-5540 Fax: (519) 578-2868 E-mail: Heather.Matthews@crawco.ca Monica Kuzyk, FCIP, CRM Curo Claims Services 125 Northfield Dr. W., P.O. Box 218 Waterloo, ON N2J 3Z9 Phone: (866) 952-2876 Fax: (519) 888-9704 E-mail: mkuzyk@curocanada.com Albert Poon, CIP Cunningham Lindsey Canada Claims Services Ltd. 1102 – 50 Burnhamthorpe Rd. W. Mississauga, ON L5B 3C2 Phone: (905) 896-8181 Fax: (905) 896-3485 E-mail: apoon@cl-na.com

CAREER RECRUITMENT PLANNING Richard Swierczynski, BA, CIP AZ Claims Services Inc. 1500 Upper Middle Rd., Unit #3, P.O. Box 76041 Oakville, ON L6M 3G3 Phone: (905) 825-0027 Fax: (905) 825-5543 E-mail: richard@azclaims.ca COMMUNICATIONS Richard Swierczynski, BA, CIP AZ Claims Services Inc. 1500 Upper Middle Rd., Unit #3, P.O. Box 76041 Oakville, ON L6M 3G3 Phone: (905) 825-0027 Fax: (905) 825-5543 E-mail: richard@azclaims.ca

John D. Seyler, CIP Integrated Insurance Resources 5080 Timberlea Blvd., Suite 214 Mississauga, ON L4W 4M2 Phone: (905) 238-4985 Patricia M. Battle Fax: (905) 238-2735 Canadian Independent Adjusters’ AsE-mail: jseyler@integrated-ins.ca sociation/L’Association Canadienne des Experts Indépendants Fred R. Plant, AIIC Centennial Centre, ClaimsPro 5401 Eglinton Ave. West, Suite 100 85 Englehart Street Etobicoke, ON M9C 5K6 Dieppe, NB E1A 8K2 Phone: (416) 621-6222 Phone: (506) 853-8507 Toll Free: 1-877-255-5589 Fax: (506) 853-8501 Fax: (416) 621-7776 E-mail: fred.plant@scm.ca E-mail: pbattle@ciaa-adjusters.ca CONSTITUTION & RULES Marie C. Gallagher, FCIP, CRM Paul Féron, FCIP, CRM Kernaghan Adjusters Limited ClaimsPro 602 – 1 St. Paul Street 210 – 746 Baseline Rd. East St. Catharines, ON L2R 7L3 London, ON N6C 5Z2 Phone: (289) 786-1074 Phone: (519) 645-6500 Fax: (289) 723-1979 Fax: (519) 645-2250 E-mail: mgallagher@kernaghan.com E-mail: paul.feron@scm.ca Craig J. Walker, CIP, FCIAA, FIFAA CONVENTION Maltman Group International TBA 3550 Victoria Park Ave., Suite 301 Toronto, ON M2H 2N5 DESIGNATION Phone: (416) 492-4411 Paul W. Greening, CLA, FCIAA Fax: (416) 492-5657 Greening Aviation Claims Inc. E-mail: cwalker@maltmans.com 26C Palliser Park, Box 190 Riverhurst, SK S0H 3P0 Sasha Alexander Phone: (306) 353-2000 University of Guelph Fax: (306) 353-2200 Alexander Hall E-mail: pgreening@sasktel.net 50 Stone Road East Guelph, ON N1G 2W2 Robert V. Pearson, CLA, FCIAA Phone: (519) 824-4120 CIAA Honorary Life Member Fax: (519) 824-0364 c/o CIAA National Office E-mail: sasha@uoguelph.ca 5401 Eglinton Ave. W., Suite 100 Etobicoke, ON M9C 5K6 Ian Frost, FCIP Phone: (416) 621-6222 Wawanesa Mutual Insurance Company Fax: (416) 621-7776 191 Broadway E-mail: info@ciaa-adjusters.ca Winnipeg, MB R3C 3P1 Phone: (204) 985-3886 Fax: (204) 942-7724 E-mail: ifrost@wawanesa.com Tim Guernsey RSA Canada 18 York Street, Suite 800 Toronto, ON M5J 2T8 Phone: (416) 366-7511 Fax: (416) 367-9869 E-mail: tim.guernsey@rsagroup.ca Peter Hohman Insurance Institute of Canada 18 King Street East, 6th Floor Toronto, ON M5C 1C4 Phone: (416) 362-8586 Fax: (416) 362-1126 E-mail: phohman@insuranceinstitute.ca Glen Hopkinson XL Insurance Company SE 100 Yonge Street, Suite 1200 Toronto, ON M5C 2W1 Tel: (647) 277-8650 E-mail: glen.hopkinson@xlcatlin.com Dan Langer E-mail: danlanger@sympatico.ca Justin MacGregor Highgate Insurance Brokers Inc. 151 Rose Glen Rd. Port Hope, ON L1A 3V6 Phone: (905) 885-1551 E-mail: justinmacgregor@highgateinsurance.com Alex Walker, CIP Aviva Canada 211 Pritchard Road, Unit #4, Hamilton, Ontario L8J 0G5 Phone: (905) 330-7752 E-mail: Alex_Walker@avivacanada.com Mark Weir E-mail: 4markweir@gmail.com

EDITORIAL Mary Charman, CIP Crawford & Company (Canada) Inc. 1 – 120 Mulock Dr. Newmarket, ON L3Y 7C5 Phone: (905) 898-0008 Fax: (905) 898-1705 E-mail: Mary.Charman@crawco.ca John M. Sharoun, FCIP, FCIAA, CRM Crawford & Company (Canada) Inc. 300 – 123 Front Street West Toronto, ON M5J 2M2 Phone: (416) 867-1188 Fax: (416) 867-1925 E-mail: John.Sharoun@crawco.ca EDUCATION Gary Ellis, BBA, FCIP, RF, FCLA, FCIAA, FIFAA AMG Claims Inc. P.O. Box 20102 Sherwood Charlottetown, PE C1A 9E3 Phone: (902) 628-9091 Fax: (902) 628-9093 E-mail: gary.ellis@amgclaims.ca EMERGENCY MEASURES Richard Van Horne Action Investigations Inc. 2 Catelina Court Dartmouth, NS B2X 3G9 Phone: (902) 462-1222 Fax: (902) 462-3688 E-mail: richardvanhorne@actioninvestigations.ca FINANCE John D. Seyler, CIP Integrated Insurance Resources 5080 Timberlea Blvd., Suite 214 Mississauga, ON L4W 4M2 Phone: (905) 238-4985 Fax: (905) 238-2735 E-mail: jseyler@integrated-ins.ca

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Fred R. Plant, AIIC ClaimsPro 85 Englehart Street Dieppe, NB E1A 8K2 Phone: (506) 853-8507 Fax: (506) 853-8501 E-mail: fred.plant@scm.ca Albert Poon, CIP Cunningham Lindsey Canada Claims Services Ltd. 1102 – 50 Burnhamthorpe Rd. W. Mississauga, ON L5B 3C2 Phone: (905) 896-8181 Fax: (905) 896-3485 E-mail: apoon@cl-na.com IBC: LIAISON, LEGISLATIVE & FORMS Paul Hancock, B.Sc., CIP Crawford & Company (Canada) Inc. 300 – 123 Front Street West Toronto, ON M5J 2M2 Phone: (416) 867-1188 Fax: (416) 867-1925 E-mail: Paul.Hancock@crawco.ca LICENSING J. Miles O. Barber, B.Comm. (Hons.), FCIP, CRM Network Adjusters Ltd. 67 Folkestone Blvd. Winnipeg, MB R3P 0B4 Phone: (204) 897-5793 Fax: (204) 897-5797 E-mail: mbarber@mts.net MEMBERSHIP & QUALIFICATIONS Marie C. Gallagher, FCIP, CRM Kernaghan Adjusters Limited 602 – 1 St. Paul Street St. Catharines, ON L2R 7L3 Phone: (289) 786-1074 Fax: (289) 723-1979 E-mail: mgallagher@kernaghan.com NOMINATING Albert Poon, CIP Cunningham Lindsey Canada Claims Services Ltd. 1102 – 50 Burnhamthorpe Rd. W. Mississauga, ON L5B 3C2 Phone: (905) 896-8181 Fax: (905) 896-3485 E-mail: apoon@cl-na.com Fred R. Plant, AIIC ClaimsPro 85 Englehart Street Dieppe, NB E1A 8K2 Phone: (506) 853-8507 Fax: (506) 853-8501 E-mail: fred.plant@scm.ca Lorri Frederick ClaimsPro 120 Adelaide St. W., Suite 2401 Toronto, ON M5H 1T1 Phone: (905) 308-6292 Fax: (416) 360-7335 E-mail: lorri.frederick@scm.ca James B. Eso, CIP, CIOP Crawford & Company (Canada) Inc. 539 Riverbend Drive Kitchener, ON N2K 3S3 Phone: (519) 578-5540 Fax: (519) 578-2868 E-mail: Jim.Eso@crawco.ca Craig J. Walker, CIP, FCIAA, FIFAA Maltman Group International 3550 Victoria Park Ave., Suite 301 Toronto, ON M2H 2N5 Phone: (416) 492-4411 Fax: (416) 492-5657 E-mail: cwalker@maltmans.com PRIVACY James B. Eso, CIP, CIOP Crawford & Company (Canada) Inc. 539 Riverbend Drive Kitchener, ON N2K 3S3 Phone: (519) 578-5540 Fax: (519) 578-2868 E-mail: Jim.Eso@crawco.ca Keith P. Edwards, FCILA, CLA, FUEDI-ELAE ClaimsPro 120 Adelaide St. W., Suite 2401 Toronto, ON M5H 1T1 Phone: (416) 777-4479 Fax: (416) 360-7335 E-mail: keith.edwards@scm.ca PROFESSIONAL PRACTICES Albert Poon, CIP Cunningham Lindsey Canada Claims Services Ltd. 1102 – 50 Burnhamthorpe Rd. W. Mississauga, ON L5B 3C2 Phone: (905) 896-8181 Fax: (905) 896-3485 E-mail: apoon@cl-na.com

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Message from the President La Plume du Président FRED PLANT

Ours is a noble profession and you should be proud of the important work you do, every day - delivering the product of the Property & Casualty Insurance Industry in Canada. The Ontario Chapter of the Canadian Independent Adjusters’ Association (CIAA) and The Canadian Insurance Claims Managers Association (CICMA) recently collaborated on their 49th annual joint conference which was held in Toronto during the first week of February. These organizations put on collaborative seminars across Canada to promote professional development and encourage contact between Insurers’ claims staff and CIAA-member Independent Adjusters. This year’s theme was “Technology Bytes Insurance” and focused on disruptive technologies and potential new exposures affecting the P&C Industry. The term disruptive technology was coined approximately 20 years ago and refers to technological change that displaces an established technology and shakes up the industry. Change. There’s that word again. Those in attendance heard from a distinguished panel of P&C claims and underwriting veterans speculating on what impact technological change will have on the P&C Insurance Industry and what claims people might reasonably expect do to be prepared for what is coming our way. The difficulty with all of this, as was really driven home by the day’s keynote speaker, well-known CBC journalist Jesse Hirsh who is described, among other things, as an internet evangelist, is that no one really knows what will come our way or even what has already come our way and the impact it will have on our businesses. Since 1688 the Property and Casualty Insurance Industry has been evolving. Much has changed in the world over the last 328 years and while, admittedly, more has happened in the last 58 years than happened in the first 270 of those years, the fact is the insurance industry has adapted to changing technologies and so too will it adapt to what is now before us and is to come. I am not so optimistic that governments and the legal system will be as proactive and adaptive to the rush of change we are experiencing, however the insurance industry has a pretty good record of identifying and filling needs and opportunities. The subject of overland flooding is a recent example of such adaptation. Forever, such coverage was just not offered as there was no demand. However, when the profile of the coverage gap was elevated, the industry responded and that coverage is available today. 10

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Notre profession est une profession noble; vous devriez être fiers du travail important que vous accomplissez chaque jour, c’est-à-dire d’offrir le produit du secteur de l’assurance de dommages au Canada. La section de l’Ontario de l’Association Canadienne des Experts Indépendants (ACEI) et l’Association Canadienne des Directeurs de Sinistres d’Assurance (ACDSA) ont récemment collaboré dans le cadre de leur 49e congrès conjoint annuel qui a eu lieu à Toronto pendant la première semaine de février. Ces organisations tiennent des séminaires collaboratifs dans l’ensemble du Canada en vue de promouvoir le perfectionnement professionnel et d’encourager le contact entre le personnel chargé des sinistres chez les assureurs et les experts indépendants membres de l’ACEI. Le thème de cette année était « Technology Bytes Insurance » (technologie, octets, assurance); il mettait l’accent sur les technologies perturbatrices et les nouvelles expositions potentielles touchant le secteur de l’assurance de dommages. Le terme « technologie perturbatrice » a été formulé il y a environ 20 ans et fait référence à un changement technologique qui supplante une technologie établie et bouleverse le secteur. Changement. Voilà encore ce terme. Les gens présents ont écouté un panel de vétérans distingués en matière de sinistres de dommages et de souscription faire des suppositions concernant l’incidence du changement technologique sur notre secteur de l’assurance de dommages et ce à quoi les personnes chargées des sinistres pourraient raisonnablement s’attendre à l’avenir. La difficulté dans tout cela comme l’a souligné le conférencier d’honneur, le renommé Jesse Hirsh, journaliste de la CBC qui est, entre autres, décrit comme un évangéliste du Web, c’est que personne ne sait ce qui nous arrivera, ou même, ce qui nous est déjà arrivé, et l’incidence que cela aura sur nos affaires. Le secteur de l’assurance de dommages évolue depuis 1688. Il y a eu beaucoup de changements dans le monde au cours des 328 dernières années, et bien qu’il faut avouer que plus de choses se sont produites au cours des 58 dernières années que pendant les 270 premières, le fait est que le secteur de l’assurance s’est adapté à l’évolution des technologies et continuera à s’adapter à ce qui est maintenant devant nous et à ce que l’avenir nous réserve. Je ne crois pas avec autant d’optimisme que les gouvernements et le système juridique seront aussi proactifs et capables de s’adapter au rythme des changements auxquels nous faisons face. Toutefois, le secteur de l’assurance a de bonnes références en ce qui concerne le fait de déterminer les besoins et les occasions et d’y donner suite. Le sujet des inondations de surface est un exemple récent d’une telle adaptation. Depuis toujours, une telle protection n’avait simplement jamais été offerte, puisqu’il n’y avait aucune demande. Toutefois, lorsque le profil de la lacune en matière de protection a été élargi, le secteur a réagi et www.claimscanada.ca

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We traveled a long way on that in a relatively short time span. There was also a time when there was no automobile insurance. As needs develop and coverages are written to fill those needs, the process of fine-tuning the coverage will be accomplished through experience. There are risks out there covered by policies that were never designed to cover those risks; and we do not even know what the risks are and won’t know until the claim notices start flowing. That’s where the skilled claim professional comes in. These disruptive technologies should be viewed as tremendous opportunities for Independent Adjusters to put to use their skills in completing detailed investigations and understanding the implications of events in relation to coverage. There will be many tests of coverage that will shape the policies that get designed to cover the risks that emerge with evolving technologies. There will be great uncertainty and cool heads will prevail. Overall, these so-called disruptive technologies are really a new name on what our industry has been dealing with for over three centuries. We thrive on this stuff. Opportunity is knocking. Seize the opportunity. Members of CIAA from across Canada will be meeting at the CIAA National Convention to be held in beautiful Saint Andrews, New Brunswick, September 22-25, 2016. Mark those dates in your calendar and start planning to attend. We are at a turning point in our profession. Be part of steering us in the right direction. ■

cette protection est offerte de nos jours. Nous avons parcouru un long chemin pendant une période relativement courte. Autrefois, il n’y avait aucune assurance automobile. Au fur et à mesure que les besoins évoluent et que les protections sont souscrites pour combler ces besoins, le processus d’ajustement des protections sera accompli grâce à l’expérience. Il existe des risques qui sont couverts par des polices qui n’avaient jamais été conçues pour couvrir de tels risques, nous ne savons même pas quels sont ces risques et nous ne le saurons pas avant que les avis de sinistres ne commencent à affluer. C’est là où le professionnel chevronné en matière de sinistres entre en jeu. Ces technologies perturbatrices doivent être considérées comme des occasions énormes pour les experts indépendants de mettre en pratique leurs compétences, en effectuant des enquêtes détaillées et en comprenant les conséquences des événements liés à la protection. Il y aura plusieurs épreuves pour les protections qui viendront façonner les polices conçues pour couvrir les risques découlant de l’évolution des technologies. Il y aura une grande incertitude et ceux qui garderont la tête froide réussiront. Dans l’ensemble, ces technologies perturbatrices sont en réalité un nouveau nom pour les situations auxquelles notre secteur fait face depuis plus de trois siècles. Nous prospérons grâce à ces situations. Des occasions se présentent à nous. Saisissez-les. Les membres de l’ACEI provenant de l’ensemble du Canada se rencontreront à l’occasion du congrès national de l’ACEI qui aura lieu dans la magnifique ville de Saint Andrews, au Nouveau-Brunswick, du 22 au 25 septembre 2016. Inscrivez ces dates à votre calendrier et commencez à planifier votre participation. Nous sommes à un moment décisif dans notre profession. Contribuez à nous orienter dans la bonne direction. ■

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

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TREASURER John D. Seyler, CIP Integrated Insurance Resources 5080 Timberlea Blvd., Suite 214 Mississauga, ON L4W 4M2 Phone: (905) 238-4985 Fax: (905) 238-2735 E-mail: jseyler@integrated-ins.ca PAST-PRESIDENT Albert Poon, CIP Cunningham Lindsey Canada Claims Services Ltd. 1102 – 50 Burnhamthorpe Rd. W. Mississauga, ON L5B 3C2 Phone: (905) 896-8181 Fax: (905) 896-3485 E-mail: apoon@cl-na.com EXECUTIVE DIRECTOR Patricia M. Battle Canadian Independent Adjusters’ Association/ L’Association Canadienne des Experts Indépendants Centennial Centre, 5401 Eglinton Avenue West, Suite 100 Etobicoke, ON M9C 5K6 Phone: (416) 621-6222 Toll Free: 1-877-255-5589 Fax: (416) 621-7776 E-mail: pbattle@ciaa-adjusters.ca

DIRECTOR Paul Féron, FCIP, CRM ClaimsPro 210 – 746 Baseline Rd. East London, ON N6C 5Z2 Phone: (519) 645-6500 Fax: (519) 645-2250 E-mail: paul.feron@scm.ca DIRECTOR Lorri Frederick ClaimsPro 120 Adelaide St. W., Suite 2401 Toronto, ON M5H 1T1 Phone: (905) 308-6292 Fax: (416) 360-7335 E-mail: lorri.frederick@scm.ca DIRECTOR James B. Eso, CIP, CIOP Crawford & Company (Canada) Inc. 539 Riverbend Drive Kitchener, ON N2K 3S3 Phone: (519) 578-5540 Fax: (519) 578-2868 E-mail: Jim.Eso@crawco.ca DIRECTOR E. Grant King, BA, B.Ed., CIP Crawford & Company (Canada) Inc. 120 – 237 Brownlow Avenue Dartmouth, NS B3B 2C7 Phone: (902) 468-7787 Fax: (902) 468-5822 E-mail: Grant.King@crawco.ca

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

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Adjusters ready to take on new claims environment Change, it seems, is the only constant

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ndependent adjusters across Canada can expect to face a wide range of issues over the coming year. Those anticipated developments, though, fall under some familiar themes: the effect of consolidation, not only among IA firms, but among insurers as well; the need to attract talent to ensure the sector remains healthy and sustainable; the role of technology to make the claims-handling process as efficient and customer-friendly as possible; the effect of a possible decrease in auto claims resulting from improved technology; how best to manage peaks and valleys to adapt to current conditions; identifying the balance between producing revenue and controlling expense; and determining how to address fluctuating claims volumes. Claims Canada asked leading adjusters at top-ranked firms across the country what trends and developments they expect to unfold in 2016. How should claims professionals and their firms best prepare? Read on to find out what those leaders had to say, presented in alphabetical order by last name. ➜

BY ANGELA STELMAKOWICH

Dara Banga, FCIP, CFEI President & Chief Adjusting Officer, DSB Claims Solutions Inc.

How will consolidation impact Canada’s independent claims adjusting landscape?

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In all, 59% of surveyed Canadian executives plan to actively pursue acquisitions in the next 12 months, placing mergers and acquisitions (M&A) appetite at a six-year high, according to EY’s 2015 Canadian Capital Confidence Barometer. While this statistic reflects business in general, the insurance industry is following the trend. Supporting that view are findings from a 2014 survey by Towers Watson that 86%

of North American insurance executive respondents expected to see an increase in M&A activity in the next three years, and 78% were actively considering acquisitions. But M&A activity is not involving just insurance companies and brokers. Consolidation is also happening among vendors, including tech companies, claims adjusters and restoration firms, which are buying companies to help expand their

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service offerings and broaden their reach. Recent insurance M&A examples include ACE Limited’s acquisition of The Chubb Corporation; the Towers Watson and Willis Group Holdings merger; Hub International’s acquisition of two home warranty companies; and SCM Insurance Services’ acquisition of Granite Claims. What does all this M&A activity mean for independent claims adjusting services? Two words: buyer beware. While acquisitions may yield positive results five years down the road, the transition period — while two companies struggle to integrate goals, people, systems and processes — can be nothing short of chaos. And the biggest losers during the transition period tend to be clients. Just ask Comcast/Time Warner Cable customers following their failed merger. Customer satisfaction scores dropped 10% and 9%, respectively. In the serious and time-sensitive business of claims management, there’s simply no room for error or ambiguity. People’s lives, assets and futures are at stake. Insureds trust that the policies they’ve diligently paid for will deliver in spades when they need them most. They are 100% reliant on an adjuster’s rapid response, investigation, reporting and action. Then, there’s the bottom line to consider. Insurers and self-insured organizations rely on adjusters to defend their profits and reputations with quality claims services — keeping policyholder retention levels high and fraud and claims leakage low. These goals may be difficult to achieve with an adjusting partner who is in the midst of merger chaos. Independent adjusters need to take charge of change. Smaller North American brokerages outperform larger ones in overall satisfaction according to J.D. Power’s 2015 Large Commercial Insurance Study. Smaller brokers received higher satisfaction ratings in three key areas: quality of advice, guidance provided and reasonableness of fees, Canadian Underwriter recently reported. Likewise, if policyholder satisfaction and profitability are important goals, insurers and self-insured organizations may want to choose smaller, service-driven adjusting firms rather than larger firms in transition. They should look for adjusting firms that are focused on clients and the crises at hand, that aren’t burdened by satisfying shareholders’ expectations. They should insist on adjusters who aren’t inhibited by big-company bureaucracy or unclear pro14

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tocols, who can respond to changing needs with speed and agility. Taking charge of change is necessary to prevent change from taking charge of organizations’ claims results. ● Ross Betteridge, CPA, CA President, ClaimsPro

2016, holds many opportunities and a few challenges for the independent adjusting industry. The industry has just finished one of the most benign weather years in recent memory and, with that, came a significant drop in frequency of property-related claims. This is far different from the 2013/2014 period, which saw Canada experience some of the most catastrophic weather in recent memory. In both of these scenarios, however, a key success driver of independent adjusting (IA) firms is borne by its people, its financial strength and the flexibility to provide the service that our clients need, when they need it. Helping our clients deliver at the “moment of truth,” in a manner that meets all stakeholders’ needs, is a key challenge to which independent adjusting companies must respond. Insurers are increasingly measuring their own success in this regard, through key performance indicators such as handling costs, cycle times and net promoter scores (NPS). Delivering cost-efficient claims handling will require IA firms to invest in technology that not only reduces the administrative burden of claims handling on the adjuster, but allows IA firms to seamlessly connect with insurers’ claims management systems. Our adjusters’ professional experience, training and opportunity to interact on-site with the end-customer, when required, will be important to delivering the excellent customer experience that translates into positive NPS scores. With consolidation expected to continue among property and casualty (P&C) insurers, IA firms will need to ensure they have the scale and presence to not only serve clients across the entire country, but also to deliver the breadth of specialty services increasingly called upon by clients. In order to successfully grow and meet these scale and skill set needs, IA firms must invest in robust succession planning facilitated by strong recruiting and retention pro-

grams, training and mentoring, and clarity of career path options. Due to the regulated nature of the industry, P&C insurers are increasingly faced with strict governance requirements. This, in turn, puts additional pressure on IA firms to ensure they, too, have the appropriate control environment in place as they act in partnership as a true extension of the insurer/customer relationship. Education, monitoring and reporting on compliance will also be important to provide our clients with the confidence to fully use our services. ClaimsPro has recently joined the Canadian Independent Adjusters Association (CIAA) and is excited to be working with all members in prioritizing the industry’s goals for 2016. These goals include working with provincial regulators to gain support for relaxing restrictive legislation that requires adjusters to hold a license from a province in order to adjust claims in that territory. This will dramatically improve our ability to respond and help Canadians during catastrophic events. Other priorities include further support for education and training, as well as better promotion of the profession and the career opportunities it provides. While no one can predict what Mother Nature will bring in the coming months, IA firms, including everyone at ClaimsPro, are prepared and eager to respond to meet the needs of our clients! ● Patti Kernaghan, FCIP, CRM President & Chief Executive Officer, Kernaghan Adjusters

2016 started with a soft market and low interest rates. Both have an effect on the use of independent adjusters, as insurers not only look to tighten their underwriting practices, but also to streamline their claims practices. One positive development is that the industry is very strong on leveraging technology. This is important since consumer expectations are very high around the use of technology. If one can use Craig’s List to buy and sell items and transact immediate payments using e-transfer technology, can the insurance industry harness better technology processes to keep insureds happy during the adjustment of their claim? Workflow issues could be solved through increased use of technology. www.claimscanada.

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Consumers will drive that change and independent adjusters must be ready to embrace new ways of using technology. Independent adjusters will need to keep current not only with what they themselves are doing, but also with how they can be affected by what others are doing. For example, one of Canada’s larger insurers was recently quoted as saying it is developing a “once and done” claims service for customers, and that its new platform will include self-service claims for very quick settlements. Where does this leave IAs? Will they need to incorporate new technology processes to reduce their cycle times? This is an opportunity for independent adjusting firms to differentiate their service by creating workflow efficiencies for their adjusters. Catastrophic events are the biggest unknown in the industry. Typically, the industry waits for an event and then decides on a course of action according to the event’s location and severity. Overall, 2015 was slower than usual for storm claims. However, weather events come in cycles and adjusters cannot afford to be complacent. In 2016, we need to prepare ourselves and undertake more training, develop new processes to shorten storm claim cycle time, and be prepared to increase the size of our storm teams — thereby allowing us to respond to weather events with fast on-the-ground service, using fully licensed professionals, to control the claims. ●

both nationals and the boutique firms to respond to various needs. From a personal lines perspective, I anticipate the industry will see a decrease in claims throughout 2016 and ongoing into the future, largely due to technological advances in society such as smart homes, autonomous vehicles and telematics. Our homes are safer because of the security and monitoring systems consumers are purchasing, as well as the apps and programs that can alert homeowners to smoke and intruders in real time.

On the roads, many drivers choose to install telematics devices into their vehicles for purposes of reducing their insurance rates. This not only provides the insurer with data on the driver’s behaviour, but also serves to curtail poor driving habits. Drivers tend to consciously attempt to improve their habits to reduce their insurance rates, which, ultimately, leads to fewer accidents. Accident avoidance systems have been around for many years and can be as simple as a light on the side-view mirror that

Your custo customer er has a list of o the ve ehicles that are covered co overe by your fleet policy. polic You have a list li t off the th vehicles hicles hi cle l that th t are covered c ered d by b that p policy. And y your llists ts aren’t aren t the ssame same. When the one vehicle ehi thatt is involved ed in an ac ccident ciden iss the one that that do doesn’t n’t appear on both lists, d do o you know w what hat ha happens ppens next? ARC does.

Tammie Norn, FCIP Chief Executive Officer, ProFormance Group Insurance Solutions ARC Group Canada is a national network of independent law firms, each intimately connected to their local market.

The world of independent adjusting has undergone plenty of changes over the past number of years and continues to evolve at a rapid pace. There is something to be said for consistency and stability, but in this day and age, if an adjuster is not continuing to develop, change and grow in concert with society, technology and industry trends, then it will be difficult to continue to operate a sustainable business. Small independents rely largely on specialization, relationships and the ability to be agile and responsive to change, whereas nationals have an advantage due to the size, breadth and scope of coverage they can provide. I believe the industry needs www.claimscanada.ca

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Insurance and risk management experts. Regional strength. National scope. Go to AskARC.com

A National Network of Independent Law Firms

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By 2040, the Institute of Electrical and Electronics Engineers reports that it expects 75% of all cars on the road will be automated to some extent. flashes if a vehicle in the next lane is in the driver’s “danger zone”, or as complex as automatic braking features if the car senses the driver is too close to an object in front of the vehicle. All new cars these days come with some form of safety features that help reduce driver error and resulting accidents. Let’s take this one step further and look at autonomous cars. Ontario will be the first province in Canada to allow the testing of self-driving cars. Testing was to start in January 2016 at the University of Waterloo, which is home to a lab dedicated to self-driving vehicles. By 2040, the Institute of Electrical and Electronics Engineers reports that it expects 75% of all cars on the road will be automated to some extent. The experts further believe that this change will come quicker than we think. There are already almost 100 companies in Ontario working on technology in this field. These are all great transformations for society and insurers. However, some experts anticipate as much as an 80% reduction of car accidents within the next decade, which will have a significant impact on the independents who deal with personal lines claims. As an optimist, I like to see the opportunity in every challenge and choose to believe that this considerable reduction, if realized, may lead insurers to rethink their

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business models and outsource personal lines claim departments all together. Furthermore, independent adjusters are often used for their expertise in a certain field. With so much change and innovation, there will be a shift in liability from personal lines to commercial products. It is an opportune time for IAs to further develop investigation skills to adjudicate claims involving disruptive technologies such as drones, autonomous vehicles, smart homes and 3D printing. As specialists in these fields, IAs will be able to coordinate experts, investigate and evaluate at a superior level than that of a general adjuster. ● Albert Poon Chief Operating Officer, Cunningham Lindsey Canada

The independent adjusting business is coming off a year of lower claims outsource volumes due to a lack of weatherrelated events. The outlook for 2016 does not appear to be any different, as long as the weather remains benign. As in the past, this mild environment represents a challenge for the industry. IA firms are continually faced with the need

to right size their organizations for the current conditions, while also ensuring resources are available to meet customer needs, especially should claim volumes spike. Managing peaks and valleys has — and will continue to be — a primary challenge for any independent adjusting firm and this is not expected to change. What has evolved is how IAs manage resourcing when major events do occur. As global expansion continues in the industry, it affords access to resources from other parts of the global community. Sharing adjusting resourcing and expertise from within Cunningham Lindsey’s worldwide operations, for example, has become an effective way of quickly bringing in trained and knowledgeable people. Technology is also a key area to support major loss events. The IA industry is looking at a wide range of ways to leverage innovation — everything from smartphones to tablets, video adjusting and drone technology — to better manage catastrophe events. Our operation in the United Kingdom, for example, has been using drone technology for several years now in a variety of scenarios. When a major event occurs, a drone is deployed to survey the area and build a picture of the general area to determine how many people need to be deployed in a certain area. This helps separate

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fact from fiction in terms of where to send people and resources. Technology is definitely changing how independent adjusters do business. Data and analytics are now fundamental to service offerings. Providing meaningful claims experience data can significantly assist corporations with their risk management programs. And, for insurers, it means claims can be paid more quickly, which fits into the “customer experience” mantra that is echoing throughout the industry. Greater innovation through process improvement and technology will help to deliver a better service model. Low insurance premium rates have led to record levels of mergers and acquisitions activity in the industry and insurers are looking to achieve savings through these deals, often through in-sourcing claims. Faced with this challenge, independent adjusters understand they can play a key role as a provider of specialty services. Cunningham Lindsey anticipates the need for increased expertise in specialty lines to remain core to our business, and the strategy remains to grow in large loss and specialty lines capabilities through recruitment and organic growth. While the IA industry has and will continue to change, it brings with it new opportunities. 2016 should be viewed with great optimism and excitement. ● John Seyler, CIP President, Integated Insurance Resources Inc.

In 2011, there was an article in Claims Canada written by my friend and colleague, Terri Mitchell. In that article, she said, “Unfortunately, I have heard rumblings throughout the independent adjusting community about us being a dying breed.” It seems we have been falling out of style for years. From the perspective of a small adjusting firm owner, these firms do face challenges that are not unique to small business in Canada. The bureaucracy of government and administration of businesses big and small detract from our ability to focus on serving our clients and, specifically, the insuring public. In conversations with fellow adjusters, a common lament is, “I just need to find time to deal with the issues of my company like payroll, benefits and human resources.”

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I think every business owner simply wants to be free to handle files and market clients. Let’s face it. Producing revenue may be the easy way to succeed, but controlling rising expenses is where the longterm success lies. It is apparent that the resulting pressures facing small IAs has led to consolidation of the industry and demise of the independent operator. As is the case with property and casualty insurer consolidation — where the bigger-is-better philosophy prevails — that this trend will continue to extend into the claims industry. With the implementation of restrictive vendor lists as opposed to the model of using the best vendor in a market, the small general adjusting firm may be a thing of the past. It seems the idea of a thorough investigation by insurers is disappearing. Combine these issues with the advantage that a national firm has thanks to economies of scale and access to national vendor managers, this can make any small operator jealous. Yes, I can hear three or four national CEOs bemoaning my comments, pointing out that I haven’t walked in their shoes, but little is more distressing than finding out how little big operations pay for office supplies, insurance and equipment in comparison to a small volume purchaser. With all that said, I believe that while the general claims business is fading for small independent adjusters (IAs), we still have a lot to offer the industry. So, Terri, I would say that in 2016 the rumours of our death have been greatly exaggerated, but do offer food for thought. Like vendors large and small, IAs need to keep investing in technology and keep searching for the niche market where our intellectual property has value to insurers. Unless you operate in a remote location and are the only game in town, it is necessary to handle the type of claims the competition doesn’t, or to do it better. Small independent adjusters looking to compete with a national independent company or the company adjuster must provide a better product. It is essential to constantly add value in exchange for the use of your firm. Having niche capabilities can overcome the restrictions of the exclusionary vendor list. There are many problems facing independent adjusters in general. In-sourcing by insurers is a key factor. This only makes proving our value proposition every day — without creating an hourly rate race to

the bottom between competitors — all the more important. Automation of the claims process looms and the interface of technology with our clients is inevitable, but at what cost? With the addition of ClaimsPro to the CIAA, this coming together provides an excellent opportunity to make our single voice heard. The opportunity to be heard by insurers and regulators as a true national representation cannot be squandered. However, capitalizing on the opportunity means we need to develop — first at a grass-roots level — pride and enthusiasm in the IA profession. It seems we have an industry-wide self-esteem issue. Building confidence and strength starts with every adjuster being proud to hold a license. Whether grinding through mundane physical damage claims or an industry leader working a multi-million-dollar loss, adjusters deserve the recognition by principals of large and small firms alike. The work of the independent adjuster is changing as a result of an ever-changing environment. I, for one, plan to scuttle the rumours and adapt to a new reality where IAs can continue to offer insight and value to clientele. ● Pat Van Bakel, BA, CIP President & Chief Executive Officer, Crawford & Company (Canada) Inc.

It is the time of year where everyone is looking into their crystal balls and trying to predict what the year ahead will deliver — in the way of both challenges and opportunities. The same applies to the claims industry and the role of the independent adjuster. It seems nearly impossible to go a full day where there are not multiple headlines highlighting the profound changes that have taken place or are about to come into effect, all of which lead to significant and irreversible effects on the independent adjusting industry. Throughout 2015, we witnessed considerable merger and acquisition activity within the insurance industry. The 2016 large-scale acquisition of RBC General Insurance Company by Aviva Canada signifies that mergers and acquisitions may continue to play a significant role in shaping the landscape of the insurance market. With a single transaction, a carrier can significantly increase both its market share

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and competitive advantage. The ripple effect of such a transaction has considerable impacts on supporting service providers and business partners, such as IA firms. Within a split second, two of your larger clients can become your largest client. The reverse could also be true, whereby you lose a large client as a result of an acquisition and are left with a significant loss within your business portfolio. Adaptability within an ever-changing landscape is key to the success of an IA

cesses and create efficiency gains, better manage our businesses, increase engagement with clients, enhance the insured’s experience, and better interact with our business partners. Carriers are rapidly shedding legacy systems, unlocking the potential for more agile, strategic and integrated partnerships with IAs. This serves to solidify the business partnership between the two, as IA firms become the true variable extension of a carrier’s internal capabilities,

From brokers to carriers to IA firms, we are all striving to use technology to drive improved processes and create efficiency gains, better manage our businesses, increase engagement with clients, enhance the insured’s experience, and better interact with our business partners.

firm. Being flexible in terms of altering short and long-term strategies to adapt to current conditions, as well as the needs and expectations of your client base, is vital. The diversification of clients and service offerings is one way in which a successful IA firm counteracts the risks associated with M&A activities. The insurance industry is in the midst of a digital transformation. From brokers to carriers to IA firms, we are all striving to use technology to drive improved pro-

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with both service and data being closely integrated. These factors will impact our industry in a significant way. But so, too, will the advancements in technology and developments in insurance products currently being tested in research and development labs across the globe in areas like autonomous cars, drones or unmanned aerial vehicles, the Internet of Things, cyber risk, data analytics, self-service and video streaming, telematics and usage-based

insurance, and the emergence of sharing economies. Through these advancements, it is almost possible to peer into the future, which upon first glance, bears little to no resemblance to the past. Parallel to this is the increased industry demand placed on IA firms to develop first-class talent in these new disciplines so that carriers and risk managers have the confidence to underwrite or confront these risks. As an industry, we are always trying to define the “new norm”. At a macro level, we look at the “claims economy” and the fact that it is in an extended period of benign weather in Canada with low claim frequency. This presents an opportunity for carriers to strengthen their solutions with IA partners and prepare for the inevitable return to higher claims frequency or catastrophe events. The timing is ideal for carriers to work with IAs to redefine their field service strategy, be more prescribed with respect to service proposition and segmentation, implement effective triage practices, leverage best-response resources, develop strategies on how to use technology to deliver a more cost-effective and serviceoriented approach to claims, and obtain alignment on what the expectations of that service proposition will be in the short and long term. As IAs, we need to be culturally and operationally aligned with the changing competitive dynamics of our clients, who are facing rapidly evolving service expectations from personal and commercial policyholders alike. Technical skills in claims investigations and coverage analysis are as critical as ever, but are now overlaid with an equal focus and priority around customer experience and more predictable service outcomes. Ultimately, IAs need to be students of the industry, rethinking corporate orientations from the inside-out to the outside-in. It has never been more important to stay on top of emerging trends and products as we face unprecedented changes in core property and auto products. Whether it is rapidly changing property coverages in response to demand for flood cover, or yet again more regulatory changes on the horizon for Ontario automobile insurance, IAs need to keep abreast of these evolutions and assist clients in their quests to adapt to new landscapes.

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That led quickly to an ownership stake in a brokerage firm focused on commercial and marine insurance. It was a serendipitous conversation with a claims manager he placed business with that led to his career in adjusting. “Believe it or not, I wasn’t planning a career in claims,� he says.

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“My passion in life is social enterprise. That’s what I want; that’s what I love,� says Pieter Heydenrych, CIP. Thanks to that overarching philosophy, his company, Halifax-based Emergency & Environmental Claims Management (EECM Ltd.), is more than an adjusting firm. Not only does the company provide claims services and environmental consulting services, it also has a strong commitment to social responsibility. Heydenrych started EECM in 2014 with partner Torgny Vigerstad, PhD, who operates under the title of Science Director. The company handles primarily property losses and liability stemming from environmental losses. “It’s always complicated and painful,� Heydenrych says, adding he prefers to solve complex problems, and ones that involve a lot of the human element. “Inevitably there are 101 people involved with every environmental claim,� he says, tongue firmly in cheek. “Everybody’s got a different interest, everybody’s got a different need, and to make them all work together is challenging, exciting and fun to do. I like the challenge of sorting it all out; finding a solution that makes people happy at the end of the day.� To understand his social justice focus, a little background about Heydenrych helps. He started his insurance career in 1994 in South Africa as a sales rep.

The claims manager lamented the lack of expertise available to deal with claims related to computers and engineering. When Heydenrych admitted to a little IT knowledge, having trained as a technician and knowing programming, he was granted an interview and got a new job on the spot. It was August 1997, and he immediately established his first adjusting company. He sold his stake in the brokerage, as the adjusting side seemed a better option. It was electronic equipment and data losses claims at first, but another chance meeting resulted in taking on a cargo loss file, and from

there he spent nine years specializing in cargo losses—local, international and mostly dockside. “It was fascinating work, and painful work, and fun work,� he says. “But fascinating especially because I’ve had opportunities to work claims dealing with everything from McDonald's buns to sulfuric acid. If it’s been on a truck somewhere, I’ve probably had a claim on it.� In 2006 Heydenrych decided to leave South Africa permanently and sold the business, which by that time had expanded to include a network of adjusters who could respond to cargo claims from the very southern tip of the continent right up to Zambia in a matter of hours. After a couple years working in Europe he got a work permit and came to Canada, ultimately moving to Halifax in 2010 once he received his permanent resident status. Starting his career in South Africa gives Heydenrych a different perspective on doing business in Canada. The differences in insurance industry culture between here and there are as vast as the oceans that separate us. “The guy with the biggest lawyer in South Africa is the guy that wins the case,� he laughs. “The South African insurance industry is very wild, wild West. Canada is very civilized and pleasant. You can really make a difference here as an adjuster by following the rules as they are laid out.� www.claimscanada.ca

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Pieter Heydenrych

Coming out of secondary school Heydenrych was told he had a seven percent chance of finding a job in South Africa—a statistic that has since dropped to five percent, he says. “Canada doesn’t have the same level of challenge in this arena, although the environment we are living in has become very capitalist-driven with no real regard for people. That distresses me personally greatly because I’ve seen what that does to a place.” This fuels his drive to help others succeed. Heydenrych volunteers as an advisor for the Junior Achievement program, among other social responsibility projects he’s working on. “I am very passionate about social enterprise and in doing things that make it possible for people to make their own lives better. I have a lot of www.claimscanada.ca

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experience as an entrepreneur, as a businessperson, and if I can teach one person one thing that makes their life better then it was worth it. It’s something that’s seriously lacking in our industry.” As a new member of the CIAA, Heydenrych says he is sure he hasn’t even begun to tap the full potential of his membership, but he values the opportunity that it gives him as a smaller adjusting firm. “I do like that there are a fair number of smaller firms,” he says. “It makes it easy to connect with other firms. It also adds a level of credibility for me when dealing with other companies.” As a small company, EECM may well need the association’s support. Heydenrych says it himself: the adjusting business in Canada is facing a

near-perfect storm, especially as it pertains to smaller adjusting firms. “There’s been a significant move by larger insurance companies to follow procurement processes which…seem designed to exclude the smaller firms. They are losing ground at a rate that is completely frightening,” he says. “We’re about to lose a dramatic number of very skilled adjusters to retirement. There’s no succession planning; they’re just taking less work… That brain trust is being lost at this time.” His concern is it’s making it difficult for young, new adjusters starting out to find a place to learn and grow. “Entrepreneurship in our industry is dying completely. As a new entrant to the market myself, I find it very frightening.” His advice to those starting out: “It’s hard. Get ready to grind your teeth, there’s no shortcuts, you need to just get in there and do what needs to be done.” As for his own future, having been successful in South Africa’s hostile business environment “has given me staying power,” Heydenrych says. “I’m going to be around for a while.” Plans for EECM’s future development will depend on the opportunities that arise, he says. “I’m not afraid to take the risk to take advantage of an opportunity. I’ve created a vehicle here for people with an entrepreneurial flair [to join us]. It’s more of a collaboration than a partnership.” February/March 2016

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Insurance Decisions

A review of the ten most important insurance coverage cases of 2015 BY CHRISTOPHER R. DUNN AND JOSIAH T. MACQUARRIE

This was an active year at the provincial appellate court level, with two issues dominating the insurance coverage landscape. The first was the “faulty workmanship” vs. “resultant damage” debate, which was addressed by three separate appellate courts and is headed to the Supreme Court in 2016. The other is the application of the Supreme Court of Canada’s decision in Sattva Capital to standard-form insurance policies. While 2015 saw little activity from the Supreme Court of Canada, 2016 is shaping up to be much more interesting, with at least one major appeal set to be heard by the top court, and several other decisions seeking leave. Here’s the top 10…

Ledcor Construction Limited v Northbridge Indemnity Insurance Company, 2015 ABCA 121; leave to appeal to SCC granted September 24, 2015 (Builders’ Risk - Poor Workmanship vs. Resultant Damage) Ledcor dealt with the line-drawing exercise between faulty workmanship and resultant damage. A window cleaner damaged the windows of a commercial building. The owner sought indemnity from its builder’s risk insurer, Northbridge, for the cost to replace the windows. Northbridge denied the claim, taking the position that the loss was caused by faulty workmanship, and was therefore excluded. The trial judge initially found in favour of the insured, but the Alberta Court of Appeal disagreed, holding that 22

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the cleaning service was “workmanship”, and the cost to repair the cleaner’s faulty work was not “resultant damage”, but instead, a direct result of the faulty work. The court confirmed builder’s risk coverage is not intended to provide a construction warranty, in spite of fact that the policy covers “all-risks”. The court also suggested that the deference standard of appellate review established by the Supreme Court in Sattva Capital may not be applicable in insurance cases where standard form language is used. Leave to appeal was granted by the Supreme Court of Canada in September, which is helpful, given the starkly differing approach taken in the next decision on our list.

Acciona Infrastructure Canada Inc. v. Allianz Global Risks US Insurance Co., 2015 BCCA 347; leave to appeal to SCC filed October 21, 2015 (Course of Construction Policy – Defects exclusion) The trial decision in Acciona made last year’s Top 10 list, a decision which has now been upheld by the B.C. Court of Appeal. Acciona involved wide-spread cracking of concrete during the construction of a large hospital. The concrete failed to set properly due to improper formwork and re-shoring. The trial judge held that, while the improper formwork and shoring was faulty workmanship, the subsequent cracking of the concrete was “resultant damage”, and therefore outside the scope of the faulty workmanship exclusion. The BC Court of

Appeal looked to the purpose of the faulty workmanship exclusion in deciding that there was coverage for this loss. The court found that the purpose of the exclusion was to prevent recovery for negligent work, but not the damage resulting from negligent work. This is a completely different approach than that seen in Ledcor, and reconciling these two different approaches will be a challenge left to the Supreme Court of Canada, hopefully in 2016. Leave to appeal was filed on October 21, 2015.

Precision Plating Ltd. v. Axa Pacific Insurance Company, 2015 BCCA 277; leave to appeal to Supreme Court of Canada dismissed January 14, 2016 (CGL Policy – Pollution Exclusion) Precision Plating is another case that we covered in 2014 that has now gone to appeal. Precision Plating was sued by a third party after a fire triggered the sprinkler system at its property, resulting in the overflow of dangerous chemicals. Axa denied coverage under its liability policy, relying on the absolute pollution exclusion. Although the claim alleged concurrent causes of damage from the fire and pollutants, the court found no possibility that the insurer would be obligated to indemnify the insured. Ultimately, the purpose of the absolute pollution exclusion is to exclude damage caused by the escape of pollutants, however caused. The fact that the escape of pollutants resulted from an insured peril (fire) did not nullify that purpose. Similar to the Alberta Court of Appeal in Ledcor, the Court openly questioned whether the deference standard of appellate review from Sattva Capital applies to boilerplate insurance contracts. The Supreme Court of Canada refused leave to appeal on January 16, 2016. www.claimscanada.ca

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Allstate Insurance Company of Canada v. Aftab, 2015 ONCA 349 (Homeowner’s Policy – Exclusion for claims arising out of bodily injury to member of household) The Ontario Court of Appeal has now clarified its earlier decision in Bawden v. Wawanesa Mutual Insurance Company, which refused to enforce the standard exclusion in homeowner’s liability policies for claims of bodily injury to members of the insured household. Ms. Atfab sued a third party for injuries suffered by her young son while he was exiting a vehicle. The third party counterclaimed against Atfab for failure to supervise her child. Atfab sought coverage from her homeowner’s insurer Allstate. The application judge, relying on the Ontario Court of Appeal decision in Bawden, held that there was a duty to defend in spite of her son being a “member of the household�. Allstate successfully appealed based on the wording of its policy. The Court of Appeal distinguished Bawden, as the policy wording in Bawden excluded claims “for� injury to any person in the household, while the Aftab policy excluded coverage for claims “arising out of � an injury to a member of the household. This broader exclusionary language was sufficient to preclude coverage.

to prevent sexual, physical, psychological or emotional abuse. The insureds argued that the claims against them were based in negligent failure to supervise their children, not intentional acts. The insurers argued that such claims were derivative of the underlying claim of bullying, which was expressly excluded. The application judge held that the policies

did not clearly exclude a “negligent� failure to prevent abuse, finding in favour of coverage. Unifund and TD successfully appealed. The Ontario Court of Appeal agreed that, regardless of the degree of intention, the only way to find liability on the parents was to find that they failed to prevent the bullying from happening, thus falling squarely within the abuse exclusion.

EPS Settlements Group of Canada has launched!

Brad Cantwell, President of EPS Settlements Group, and Bob Nigol are pleased to announce a partnership through the launch of EPS Settlements Group of Canada. EPS Settlements Group is ð oldest and largest structured settlements organization in North America. Bob Nigol is a former owner and President and CEO of Henderson Structured Settlements and now the Managing Partner of EPS Settlements Group of Canada.

Unifund Assurance Company v. D.E., 2015 ONCA 423; C.S. v. TD Home and Auto Insurance Company, 2015 ONCA 424; leave to appeal to SCC filed September 29, 2015 (Homeowner’s Policy – coverage for bullying claims) These companion decisions addressed coverage for claims arising out of bullying. The homeowner’s policies at issue contained typical language indicating that the insurer would pay all sums to which the insured becomes legally liable for unintentional bodily injury or property damage, but excluding claims resulting from intentional acts. An abuse exclusion sought to negate coverage for any failure www.claimscanada.ca

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Together Brad and Bob wish to invite past and prospective clientele to engage in what assuredly will be the very highest standard of service achievable in the structured settlements market in Canada.

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Onex Corporation v. American Home Assurance Company, 2015 ONCA 573; leave to appeal filed October 13, 2015 (D&O Policy – coverage for defence costs)

of standard form contracts, the standard of review must remain one of “correctness”. This allows appellate courts to step in more readily in any case where a trial judge has incorrectly interpreted a standard form insurance contract.

This is the second trip to the Court of Appeal for Onex v. American Home, a coverage dispute between Onex and American Home under both D&O and Run-Off policies. The 2015 appeal results from the Court of Appeal originally sending the case back to the Superior Court for a determination of coverage. The new issue involved the interpretation of the term “Claim”. After finding that the full $15 million policy limit was available to Onex, the case made its way back to the Court of Appeal. The Court of Appeal agreed that the trial judge correctly used extrinsic evidence to resolve the ambiguity of the term “Claim” in Endorsement 14. The court pointed to the fact that the trial judge was not tasked with interpreting the policy afresh, but rather with using extrinsic evidence to resolve a specific ambiguity that had already been found. The Court agreed with the trial judge’s interpretation of Endorsement 16, holding that “Claim” was not used in isolation, but rather was part of the phrase “claim under this policy”, thus applying to claims under the Run-Off policy, which would not include claims under the Onex policy. Leave to appeal to the Supreme Court of Canada was sought on October 13, 2015.

Daverne v. John Switzer Fuels Ltd., 2015 ONCA 919 (CGL Policy – Limitation Periods)

MacDonald v. Chicago Title Insurance Company of Canada, 2015 ONCA 842 (Modifying the Sattva Capital test for standard form contracts). MacDonald represents the Ontario Court of Appeal’s opportunity to weigh in on Sattva Capital, and the standard of review on appeal as it applies to insurance contracts. In MacDonald, the Ontario Court of Appeal held that the Sattva Capital decision heightening the standard of appellate review does not apply in the case of standardform contracts. Given the importance of appellate review in the case

M&W was sued over a fuel tank leak, and tendered the claim to its liability insurer, Federated, which denied coverage on April 9, 2010. M&W sued Federated for coverage on March 11, 2012, almost two years later. On a summary judgment motion, Federated argued that the one-year limitation period set out in the policy, running from the insured suffering “loss or damage”, barred M&W’s claim. While the motion’s judge held in favour of coverage, the Ontario Court of Appeal agreed with Federated, holding that the one-year limitation period barred the claim. The Court held that the insured suffers “loss or damage” on the date of the insurer’s refusal to defend. Importantly, M&W’s claim was barred only with respect to defence costs, as the issue of indemnity hadn’t crystallized, as the action remained ongoing. The finding that there can be two separate limitation periods for defence costs and indemnity represents a significant shift from the historic approach taken under commercial liability policies, where the limitation period for both defence costs and indemnity generally ran from the date of settlement or judgment. Of course, the policy language is paramount.

Monk v. Farmer’s Mutual Insurance Company (Lindsay), 2015 ONCA 911 (Homeowner’s Policy – exclusion for repair of faulty workmanship) Monk put in a claim under his homeowner’s policy after existing property in the home was damaged by a contractor. Farmer’s Mu-

tual denied the claim on the basis of the faulty workmanship exclusion. Monk sued for coverage. The court held that the claim was not for faulty workmanship, but rather “resultant damage”. The “faulty workmanship” exclusion was to be interpreted narrowly, while the grant of coverage in the “all-risks” policy should be interpreted broadly. The faulty workmanship exclusion was in conflict with the “property being worked on” exclusion, which expressly preserved coverage for resulting damage to other insured property. (For a detailed review of this case, see page 28.)

Ontario Society for the Prevention of Cruelty to Animals v. Sovereign General Insurance Co., 2015 ONCA 702 (CGL Policy – fortuity principle) The OSPCA was sued for malicious prosecution and defamation, claims arguably involving intentional conduct. When OSPCA’s liability carrier, Sovereign General, denied coverage, the OSPCA sued. While Sovereign admitted that certain claims were covered by the policies, it nonetheless denied on the basis of certain exclusions in addition to the claims not being “fortuitous”. The Ontario Court of Appeal rejected Sovereign’s argument. The alleged damages were fortuitous, as there were no allegations that the OSPCA intended the harm that resulted from its actions. There is also no general insurance ‘rule’ that non-fortuitous claims are automatically excluded.The Court noted that the policy expressly covered several non-fortuitous acts such as malicious prosecution. It is only in circumstances where an intentional act accomplishes an intentional result that coverage will be unavailable. Chris Dunn is a partner and Josiah MacQuarrie is an associate with Dutton Brock LLP. Both specialize in insurance litigation. Dutton Brock LLP is a member of Canadian Defence Lawyers (CDL), the only national organization representing the interests of civil defence lawyers. It offers broad opportunities to unite the defence bar over common issues, as well as providing accredited continuing legal education.

1. For a detailed review of this case, see page 28. 24

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Canadian Independent Adjusters’ Association

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Nudging Claimants The concept of behavioural nudging is gaining interest among insurance professionals looking for ways of influencing the behaviour of claimants BY CRAIG HARRIS, FREELANCE WRITER

The field of behavioural economics could have potential applications in insurance claims, fraud deterrence, injury management, driver safety and client service, some experts contend. Led by academics such as Richard Thaler, Cass Sunstein and Dan Ariely, behavioural economics holds that psychological bias or irrationality often pushes people to make decisions contrary to their best interests. The concept of nudging is based on research that shows it is possible to guide e to socially ethical or utilitarian ends by presenting choices in different, often simplified ways. “Nudge theory” in particular was popularized in the 2008 book, Nudge: Improving Decisions About Health, Wealth, and Happiness by Thaler and Sunstein. The book explores the potential for behavioural economics to improve the effectiveness of government (and other) programs by better understanding social norms and human behaviour, especially related to ethics in the decisionmaking process. Far from an abstract theory, nudge has been put into practice in government and policy settings around the world (interestingly, Sunstein was Administrator of the U.S. White House Office of Information and Regulatory Affairs from 2009-2012). The concept really took hold in the United Kingdom in 2010 when Prime Minister David Cameron set up a Behavioural Insights Team (BIT), dubbed the “nudge unit.” The team examined a wide range of policies in diverse areas—everything from taxation to pensions to police diversity—before it was spun off from government in 2014 to become a private company. More recently, the U.S. government formed a nudge unit called the Social and Behavioural Sciences Team. One interesting project from BIT involved testing whether a new tax reminder letter to recipients informing them that most of their neighbours had already paid (social norm) would increase payments. The unit claimed that it nudged forward £30 million ($62 million) per year in income tax for HM Revenue and Customs. “A number of governments are setting up think tanks to specifically focus on behavioural science,” notes Keith Walter, joint leader of the actuarial, reward and analytics team at Deloitte in Canada. “It is a huge public policy issue and a big theme right now in government in Canada, particularly regarding evidence-based decision making linked with behavioural insights.” So what does this have to do with property and casualty insurance? Potentially, a great deal, according to Deloitte Consulting’s chief data scientist, James Guszcza. 26

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“Advertising has effectively done this behavioural nudging for years, and now you are seeing its use for more efficient government, better policies and improved social outcomes,” he says. “I think nudges can be used in other pro-social ways, and the insurance claims process is a great example.”

Identifying Abuse For instance, Deloitte worked with the unemployment insurance agency of a U.S. state to test low-cost methods of identifying and curbing fraud amongst claimants. Deloitte did not release the name of the state. Guszcza notes that his firm used sophisticated analytics capabilities—including predictive modeling, machine learning, anomaly detections, and analysis of behavioral patterns— to identify likely abuse early so preventative action could be taken. Coupling predictive analytics with behavioral nudge tactics, claimants were given helpful information at key moments in the application and certification process. The UI agency has seen substantial improvement in the accuracy of initial claim filings and weekly certifications, according to Guszcza. “It was a ‘Eureka’ moment for us that showed this actually can and does work,” he says. “We have floated these and other results to insurance companies and the interest has been very strong. There is little downside risk to experimenting and there is a lot of upside potential that has a positive social effect.” An obvious example in p&c insurance is fraud detection, especially the “soft” or opportunistic variety (honesty-prompting nudges would have little effect on organized, premeditated activity, Guszcza notes). “The issue around opportunistic fraud is one that gets people’s attention,” says Walter. “There is a general recognition that bringing behavioural science into managing the claims process around soft fraud is a key issue. There is a lot of interest in how you actually influence behaviour so that the claimant is less likely to exaggerate or pad the claim.” Nudge tactics “offer a ‘soft touch’ approach that is well suited to the ambiguous nature of much fraud detection work,” Guszcza notes. There are extrinsic or external factors involved in soft fraud, which can be addressed through what Guszcza calls “judiciously worded letters” that include specific details about the claim and remind claimants about fraud detection policies. Letters could also refer to random or “lottery” fraud investigations that may have a “sentinel effect” on exaggeration of embellishment, according to Guszcza. However, insurers could also appeal to the individual’s intrinsic reward system as well. Research in behavioural economics sugwww.claimscanada.ca

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gests that a small amount of cheating flies beneath the radar of people’s internal ethical codes, according to Guszcza. Behavioural economist Dan Ariely coined the term “personal fudge factor” to describe this tendency. “Such nudge tactics as priming people to think about ethical codes of honour and contrasting their actual behaviour with their (honest) self-images are non-economic levers for promoting honest behaviour,” Guszcza notes in a recent article he wrote in the January 2015 issue of Deloitte Review called The Last Mile Problem: How Data Science and Behavioural Science can Work Together. Behavioural economics is not restricted to fraud detection. Guszcza observes that the applicability could extend to returnto-work or pre-accident level of functioning for injured insurance claimants. In fact, it is here that the confluence between data analytics and behavioural science is most evident. “We can run predictive models and all sorts of analytics about the rates of return to work or normal living for certain types of claimants,” Guszcza observes. “But it is when you combine this with behavioural insights that it really gets interesting. If you are able to inform an individual that 90 percent of the people with the same injury go back to work within three weeks, I suspect it will give that person something to work towards. It might provide an unconscious motivator. It is a pro-social outcome,” he adds.

Driving Behavior The use of telematics in tracking driving statistics is another potential example of the use of behavioural insights for economic and social purposes. Here, the interest is not just offering premium discounts, but improving driver safety. “There is certainly a behavioural impact when it comes to telematics,” says Walter. “As that whole process is developing, I see more interest in the discussion around the behavioural side of interacting with customers—from a claims prevention approach rather than claims management standpoint.” Telematics is not only valuable for underwriting but also “for pro-social nudges,” Guszcza adds. “You can give people a report card on their driving, how they compare with a survey of their peers. It gives insurance companies a way of increasing positive touch points and giving people a data service to help them understand their risk better.” Other key elements of behavioural economics are the interlinked concepts of “choice architecture” and “design thinking.” When it comes to choices in complex areas, such as insurance coverages, this means that options are simplified based on how people actually think and respond. www.claimscanada.ca

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“Rather than design products or programs based on perfect rationality, we should go with the grain of human psychology,” Guszcza comments. ‘’So if an insurance company is going to offer a choice of coverage options, rather than this complicated menu of 40 possibilities, why don’t we use what we know about peoplecentric design and give fewer but more intuitive choices.” Guszcza adds that the same approach can be used in various aspects of the insurance lifecycle—such as using social media behavioural profiles based on “digital breadcrumbs” for contact/channel preferences, claims triage, self-service options and so on.

Last Mile “A lot of this stuff is just coming online. It is early days, but there are all these innovative and tangible ways in which insurance companies can be more customer centric,” Guszcza notes. “That should be the motivation—if you can provide unique services in a way that people find agreeable, you are offering a different kind of value that goes beyond just products and commodities. “With the power of suggestion and the appeal to social norms, some say that behavioural nudging could cross a line sometimes called the “creep factor.” Is it a positive force for ethical decisions or an intrusive form of social engineering? “I think if you do all of this stuff from a product centric perspective, then it could be creepy,” Guszcza says. “If you are trying to think in terms of empathy, customer needs, what would help them in their daily lives, then it is beneficial. It actually gives people prioritized choices. You can call that paternalistic; I frame it as choice architecture and design thinking.” Finding the exact point where data analytics meets behavioural science could be a challenge for an insurance industry that is not accustomed to being on the leading edge of innovation. This challenge is what Guszcza refers to as the “last mile problem.” Nevertheless, there are parallels in other industries—ranging from energy conservation to financial management—that show the power of behavioural insights and the proper use of data can be a potent combination. “You can use understanding of human psychology to create little interventions that have disproportionate effects,” Guszcza concludes. “It is an almost cost-free experiment that can result in millions of dollars in savings and the achievement of a positive social outcome.” Craig Harris is a freelance journalist who specializes in Insurance (P&C + life), Financial Services, including investing and wealth management. February/March 2016

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Monk v. Farmers’ Mutual Insurance Co. (Lindsay): Further Lessons in Policy Language and Interpretation BY MICHAEL S. TEITELBAUM

Introduction In Monk v. Farmers’ Mutual Insurance Co. (Lindsay), [2015] ONCA 911, the Court of Appeal reversed the motion judge’s decision1 that the “faulty workmanship” exclusion applied to both direct and indirect damages. The Court ruled that the motion judge’s interpretation of the exclusion was overly broad and that the damage to the insured’s property was covered by the policy, whether or not the damage constituted resulting damage from faulty workmanship.

Facts The action arose when the insured retained a contractor, Pleasantview Restoration Systems (“Pleasantview”), to perform restoration work on the exterior of her home. At the conclusion of the work, the insured discovered deficiencies in the work done by Pleasantview; namely, stains on the windows, light fixtures, and the carpeting, scratches and marks on the windows, and damage to the wooden window frames. The home was insured by Farmers’ Mutual Insurance Company (“Farmers’ Mutual”) with the insured purchasing a homeowner’s insurance policy through Muskoka Insurance Brokers (“Muskoka Insurance”). The policy covered perils subject to the specified exclusions, two of which are relevant to the case at hand. The first, under the heading “Losses Excluded”, provided: We do not insure: 2. the cost of making good faulty material or workmanship; The second exclusion, under the heading “Property Excluded”, stated: We do not insure loss or damage to: 4. property (ii) while being worked on, where the damage results from such process or work (but resulting damage to other insured property is covered); The insured allegedly went to Muskoka Insurance when she discovered the

aforesaid damage, and was informed that her policy did not cover work done by an independent contractor, and that the contractor hired would be responsible for the damage. Muskoka Insurance denied this. The insured subsequently sued Farmers’ Mutual under her policy and Muskoka Insurance based on an alleged breach of Muskoka Insurance’s contractual and fiduciary duty to her by failing to advise her in a timely way that she had a valid claim against Farmers’ Mutual.

Parties Position Farmers’ Mutual and Muskoka Insurance brought motions for summary judgment for dismissal based on the argument that the insured’s claim constituted costs of repairing faulty workmanship caused by Pleasantview, and thus was specifically excluded by the policy. They argued the “faulty workmanship” exclusion is an unqualified exclusion, and does not contain an exception for “resulting damage”. The insured argued that the “faulty workmanship” exclusion should apply only to restoration work Pleasantview was contracted to perform and that the incidental or corollary damage from that workmanship should not be excluded. In addition, the insured argued that her damages constituted damage to “property while being worked on” and that the “resulting damage” exception in the exclusion ought to extend coverage regardless of the wording in the “faulty workmanship” exclusion.

Decision of the Motion Judge The motion judge disagreed with the insured’s arguments. The motion judge applied a plain and simple reading of the policy’s “faulty workmanship” exclusion and ruled that coverage for direct and indirect damage arising from faulty workmanship was excluded. Furthermore, the motion judge found that coverage afforded by an exception to the “property being worked on” exclusion did not provide coverage because the faulty workmanship exclusion trumped the exception. The insured appealed the decision.

Issue on Appeal The main issue on appeal was whether the motion judge erred in concluding that the “faulty workmanship” exclusion also excluded resulting damage.

The Appeal Decision The Court ruled that the “faulty workmanship” exclusion should not be interpreted so broadly as to deny coverage for damages that an “all-risks” policy would otherwise provide. The Court noted that if an insurer wanted to exclude particular coverage, such as resulting damage, it should do so specifically. The Court held that an interpretation of the “faulty workmanship” exclusion that denies coverage for resulting damage is an overly broad interpretation of the exclusion clause. The Court interpreted the exclusion narrowly as excluding coverage from direct damage only and not the resulting damage from faulty workmanship. This was not a matter of reading an exception into that exclusion, but interpreting it narrowly in accordance with established principle. The Court observed that if the “faulty workmanship” exclusion was interpreted as excluding resulting damage in the case at bar, the two exclusion clauses at issue would be in conflict. The “faulty workmanship” exclusion would exclude damage to property caused by faulty workmanship including resulting damage. On the other hand, the “property being worked on” exclusion would specifically preserve coverage for resulting damage to “other insured property.” The Court found that the motion judge erred in saying the “faulty workmanship” exclusion trumped the “property being worked on” exclusion because the exception to that exclusion only preserved resulting damage coverage for a narrow range of events unrelated to faulty workmanship, such as damage caused by accident. This was an overly narrow interpretation of the resulting damage exception. In effect, the Court indicated that the exception to the “property being worked on” exclusion, which is to be construed broadly, should not be interpreted narrowly, so that

1. The motion judge’s decision, [2014] O.J. No. 3509, was discussed in the December 2014 issue of Claims Canada. 28

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the “faulty workmanship� exclusion can be interpreted broadly, when the principle is it should be interpreted narrowly. The Court noted that the motion judge considered it significant that “faulty workmanship� exclusions in insurance policies typically include an exception for resulting damage, which is not the case in the insured’s policy. However, the Court found that this consideration was irrelevant to the interpretation of the policy at hand. The Court went on to find that the motion judge’s suggestion that the absence of an exception for resulting damage from the “faulty workmanship� exclusion is reflective of the insurer’s intention not to provide coverage for such damage is misplaced. The Court stated that an insurer’s unilateral intention is irrelevant to the interpretation of the insurance contract. And, it is not appropriate to interpret the “property being worked on� exclusion in a manner that narrows the coverage it preserves by its exception in order to interpret the “faulty workmanship� exclusion as broadly as possible. The Court therefore concluded that resulting damage to insured property is covered by the policy whether or not that damage is the result of faulty workmanship.

The Court also indicated that following its recent decision of MacDonald v. Chicago Title Insurance Co., 2015 ONCA 842, the standard of review to be applied was “correctness� because this was a standard form insurance contract. Although the “faulty workmanship� exclusion was not standard across the insurance industry, it is standard to Farmers’ Mutual’s customers, and should be interpreted consistently. The action was remitted to the motion judge to decide the question of whether the action is limitation-barred which was not previously addressed because of his decision there was no coverage.

Commentary The Court addressed the conundrum posed by the “faulty workmanship� exclusion being worded differently from other homeowners’ policies by saying that this does not matter, what matters is what this policy provides. And, then, reading the policy as a whole, the Court found that to give the subject exclusions meaning, the fact the faulty workmanship exclusion has no exception means it should be read without one, and interpreted narrowly.

It is arguable that by doing so the Court gave a similar meaning to the two exclusions by holding that both do not exclude resulting damage, one dealing with property being worked on, and the other for faulty workmanship generally. Can it be said this was the intention of the parties? The Court’s reasoning suggests it was not; rather, it was only the insurer’s intention. Ultimately, the Court indicated that Farmers’ Mutual’s attempt to exclude resulting damage by not including an exception in the “faulty workmanship� exclusion was insufficient. The wording used must specifically state there is no coverage for resulting damage in that context. Thus, the Court of Appeal in Monk has indicated the importance of insurers clearly identifying and articulating areas of excluded coverage so as to ensure that they are providing the type of coverage they wish to provide. Michael S. Teitelbaum is a partner with Hughes Amys LLP. Ashley Peacock, an associate with Hughes Amys, assisted with this article. Hughes Amys is a member firm of The ARC Group of Canada, a network of independent law firms across Canada.

Canadian Insurance Claims Education Benevolent Foundation OBJECTIVE UĂŠTo assist with funding needed to further education of Canadian students entered in an insurance claims related discipline.

UĂŠApplicationĂƒĂŠmusĂŒĂŠbiĂŠreceive`ĂŠaĂŒĂŠthiĂŠCIA ĂŠNationaÂ?ĂŠ OfďŹ ĂŠciĂŠbÞÊ ulÞÊ31stĂŠannually. UĂŠAwardĂƒĂŠwilÂ?ĂŠbiĂŠannounce`ĂŠaĂŒĂŠthiĂŠCIA ĂŠAnnuaÂ?ĂŠ GeneraÂ?ĂŠMeeti˜}ĂŠiÂ˜ĂŠAugust°Ê

VALUE UĂŠ ĂŠminimu“ÊovĂŠo˜iĂŠ$1000.0äÊawar`ĂŠannually.

DONORS UĂŠCanadi>Â˜ĂŠ ˜dependenĂŒĂŠAdjusters½Ê ssociation UĂŠCanadi>Â˜ĂŠFederatioÂ˜ĂŠovĂŠ nsuranciĂŠ ClaimĂƒĂŠ ssociations

SUBMISSION UĂŠApplicationĂƒĂŠariĂŠavailabliĂŠaĂŒĂŠthiĂŠCanadi>Â˜ĂŠ IndependenĂŒĂŠAdjusters½Ê ssociatioÂ˜ĂŠNationaÂ?ĂŠOfďŹ ĂŠce: CIAA Centennial Centre, 5401 Eglinton Ave. W., Suite 100 Etobicoke, ON M9C 5K6 Tel: (416) 621-6222 Fax: (416) 621-7776 E-mail: info@ciaa-adjusters.ca

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ANNOUNCEMENT

t PO UIF TDFOF OTS The Alberta government has accepted several recommendations in relation to an independent review of the province’s response to the floods that occurred in the summer of 2013. The report, prepared by MNP LLP, makes 16 recommendations to enhance and improve the province’s emergency response and recovery procedures. “Work on implementing these is under way,” Alberta Municipal Affairs noted in a press release. One recommendation was the development of a new provincial operations centre, which could either be a purpose-built facility or constructed in an existing government building. ●

ĞŶŶŝƐ E ^ĐŚĞŵďƌŝ /W͕ & / Patti M. Kernaghan FCIP, CRM, FIFAA President & CEO of Kernaghan Adjusters is pleased to announce the appointment of Dennis Schembri as VP Ontario Operations and a new member of our Corporate Senior Management Team. Dennis is a wellͲknown and highly respected contributor to the insurance industry. He has over 35 years of experience in the independent adjusting field. He founded Vanler Insurance Adjusters Ltd in 1993, which spanned across Ontario with over 50 employees. As the Managing Director for McLarens Canada, Dennis was involved in senior management level marketing, sales and operations. Dennis was appointed Executive Vice President, Client Management in 2011 for all divisions of Granite Global Solutions. In addition, to his many professional accomplishments and his executive adjusting expertise, Dennis has a respected reputation for philanthropy and dedicated community involvement. ĞŶŶŝƐ ^ĐŚĞŵďƌŝ͛Ɛ ŽŶƚĂĐƚ /ŶĨŽƌŵĂƚŝŽŶ d s c h e m b r i @ k e r n a g h a n . c o m d 647.729.0817 416.617.2532

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A national working group should be established to address the problem of distracted driving, the Traffic Injury Research Foundation (TIRF) suggests in a recent report announced by The Co-operators Group Ltd. The Co-operators reported this past December that it plans to provide funding to TIRF to establish a working group on distracted driving. “Because distracted driving is still an emerging issue, and one that falls under provincial jurisdiction, bringing together stakeholders to help develop a strategic plan at a national level will be very valuable work,” says Kathy Bardswick, president and chief executive officer of The Co-operators, in a statement. TIRF’s report is titled Distracted Driving in Canada: Making Progress, Taking Action. TIRF plans to work with Drop It And Drive — a British Columbia-based distracted driving educational campaign — to form the working group. ● Insurers that contract with the United States National Flood Insurance Program (NFIP) should be allowed to write their own polices, Marsh & McLennan Companies Inc. suggests. Insurers are permitted to market, sell and service NFIP policies “under their own name in exchange for an administrative allowance from the NFIP,” Marsh & McLennan states in the report, “Reforming the National Flood Insurance Program” released December 9, 2015. Those policies are dubbed write-your-own (WYO). “Any claims payments that are made by WYO companies are reimbursed by the NFIP,” notes Marsh & McLennan, adding that NFIP should share risk with private industry. “By opening up private market participation, the NFIP can help improve the program’s sustainability by providing expertise and market stability.” ● The median annual base salary for Canadian risk management professionals responding to the RIMS Risk Management Compensation Survey 2015 was $104,000 as of June 1, 2015. Base salaries varied by job title. For Canadian respondents indicating their roles and responsibilities most closely matched chief risk officer or vice president of risk management, the median salary was $174,000. For respondents who function as claims managers or workers compensation claims managers, the median salary was $72,500. The survey, released in December 2015 by RIMS, was based on 1,145 respondents (999 of whom were employed as risk management professionals in the U.S. as of June 1, and 146 of whom were Canadians in the same occupation). The margin of error for the 95% confidence level is 2.8 percentage points for U.S. respondents and 7.5 points for Canadians. ● SCM Risk Management Services (RMS) has launched a Canadian solution for property inspection replacement cost valuations. Called rmsPrecise, the property replacement cost inspection valuation tool is designed to be responsive to the detail and customization of specific and unique features of a building captured during the inspection process, thereby helping to accurately gather the diverse characteristics on expected loss costs. The tool is imbedded in RMS’s residential inspection process. ● ClaimsPro will continue to expand its coverage in Western Canada with the opening of a new branch in Fort St. John, B.C. Located in Northeastern B.C., approximately 90 minutes from the Alberta border, Fort St. John serves as a hub for many other communities in the north. This new branch services communities along the Alaska Highway including Dawson Creek, Fort Nelson, Chetwynd, and Hudson’s Hope. At present, ClaimsPro has more than 30 offices in British Columbia. ● www.claimscanada.ca

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CIAA New Members ClaimsPro Adam Dickens Cara-Leigh Cox Dennis Hanson Don L. Routley Doug Schmidt Fraser Bowles Jim Johnson Michael Murphy Rachel Taylor Teresa Zimmer Carter Bowles Mark Smith Alexander Burton Christopher Orr Dave Desautels James Orr Kelly Smith Linda Belfry Lorna Rabinovitch Michael Miles Robert Orr Terence McCarthy Blair McGregor Dan Braithwaite Daryl Schroh David Fulljames Eric Renteria Jason Illes Jed Muir Larry Lamontagne Mark Sherwood Tyler Ducheminsky James O`Connor Jonathan Adamo Kirk Vardy Robert Collette Christopher Stewart Werner de Jager Danielle Thompson Pat Prefontaine Shawn Johnson Cindy Menzies Jodi Benson Karen Turpin Rick Rowe Dale Rogoza Carrie-Anne Lewis Clinton Schadlich Julie Van Dusen Tom Rixon Gary McAvena Brett McAvena

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Dale Campbell J. Brady Ives Ross Stenmark Trent Buchanan Kelly Lewis Michael Montpetit Luke Moilliet Nettie Wagner Sarah Klassen Nancy Johnston Courtenay Stewart Leona Ashcroft Robert Phillips Carson Fong Cheryl Martin Craig Segaric Jaime Kallstrom Kathy Kwan Kelly Brewer Mark Misirlis Michael Parsons Ramona Nobert Christine Leung Martin Moon Susan Durnin Brent Serediak Ashley Parsons Donald Abney Tammy R. Virr Cindy Heard Darlene Tomkinson Ken Bielert Shanna Carmichael Jacqueline Linke Robert Stanhope Alan Sloman Andrew Joubert Andrew Mitchell Beata Bulic Bob Sidhu Douglas Miller Eric O`Dell Holly Laderoute James Godfrey Jo Kinasewich Mark Thomas Pierre Chavigny Robert Donay Russell Sorsdahl Teena Molson William Cole Emily Schollen Martin Clingwall

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To be continued in the April May 2016 issue of Claims Canada. www.claimscanada.ca

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t PO UIF TDFOF OTS IN MEMORIAM It is with a great sense of sadness and sense of loss that the Canadian Independent Adjusters’ Association (CIAA) announces the passing of E. Brian Gough, FIIC, FCLA, FCIAA on February 5, 2016. Brian gave generously of his time and expertise serving the association unconditionally in a wide variety of roles and responsibilities at all levels of the organization. Brian served as CIAA National President 1996/97 and was recently granted the prestigious Honourary Life Member award in recognition of his tireless efforts in furthering the objectives of the association on behalf of the Independent Adjusting fraternity and the industry at large.

Brian Gough

Giffin Koerth co-founder and senior principal, Ron Koerth, has relinquished his role in the day-to-day management and operations of the firm, and the existing shareholders have purchased his ownership interest in the company. Ron will continue to serve as a consultant with the firm on forensic and remediation projects. Said chairman and CEO, Chris Giffin, “Ron’s contributions to Giffin Koerth since its inception have been immeasurable; whether in assisting in growing the firm, bringing engineering excellence to our clients, or serving as a mentor to our staff, the organization has benefitted greatly over the years. As the firm continues to build the centre of excellence in forensic engineering and sciences, our current leadership team, principals and staff look forward to working with Ron in his new role.” Headquartered in Toronto, the firm serves clients around the globe. ●

Sam Mercanti

Greg Smith

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February/March 2016

A true statesman in the P&C industry, Brian began his distinguished insurance adjusting career with Marsh Adjustment Bureau in Halifax in 1974, serving as its President from 1995 – 2015. Known for his honesty, loyalty and utmost integrity, Brian merited the admiration and respect of all who had the privilege of working with him. Please join us in a moment of reflection to honour the memories and influence of this true gentleman to our Industry and the many people touched personally and professionally by his wonderful legacy. ●

Specialized Property Evaluation Control Services Limited (SPECS) unveiled a new logo; and bid a fond farewell to the visual identity that has served the firm well for more than two decades. The new logo marks the beginning of a corporate identity refresh. “SPECS has undergone an impressive 20-year evolution. We knew it was time to update our corporate identity to better reflect what we had become, as well as how we plan to grow in the future. We wanted a polished, modern logo that represents our sophisticated and often layered services in a simple, effective way,” said SPECS director of sales and marketing, Lucy Railton. “SPECS may have a new logo but; our independent, impartial approach to property, contents, and complex loss appraisals and consulting services remains unchanged,” she added. ●

CARSTAR Automotive Canada Inc., a network of independently owned collision and glass centres, has been acquired by Driven Brands Inc. of Charlotte, North Carolina, which previously acquired CARSTAR’s operations in the United States. The Canadian operation of CARSTAR will remain under the current management, with Sam Mercanti, chief executive officer of CARSTAR Canada, serving as chairman and Michael Macaluso continuing as president. CARSTAR Canada’s three staff members, Larry Jefferies, Lisa Mercanti-Ladd and Dennis Concordia, have decided ‘’this was the right time for them personally to step aside in order to provide opportunities for the existing team to thrive,” Mercanti says. ● Crawford & Company (Canada) Inc.’s Greg Smith and Gary Gardner have taken on new responsibilities. Smith, former senior vice president of key account management, is the company’s new senior vice president of administration, while Gardner, senior vice president of global client development, will oversee the key account management team and sales and marketing department. With 19 years of service at Crawford & Company Canada, Smith will oversee many of the claims management provider’s head office departments that support business operations across the country, including information and communication technology, human resources and administration services. Gardner, with the company for more than two decades, will use his extensive knowledge and insight of the independent adjusting and insurance industry, as well as his strong relationships with key clients, in carrying out his new duties. ●

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APPOINTMENT

Maeve Davis is bringing her 25 years of insurance experience to Insurance Search Bureau of Canada, which supplies source documents and retrieval services to the property and casualty claim industry. She will serve as ISB Canada’s new vice president of client services. ●

Maeve Davis DKI Canada announced the addition of Golden Triangle Restoration DKI to the organization. Golden Triangle Restoration has provided property restoration services in Cambridge, Kitchener/Waterloo and surrounding areas for almost 10 years. Adam Wood, president of Golden Triangle Restoration stated, “We are proud to service the Cambridge, Kitchener/Waterloo and surrounding areas for all their restoration needs. We look forward to growing as a business with a beneficial partnership with DKI Canada.” “We are very excited at DKI Canada with Golden Triangle joining our group, they are a great organization that will strengthen our team in Southern Ontario,” said Adam Tzarik, director - Central Region. ●

Emily Atkins Emily Atkins is the new editor of Claims Canada magazine. A professional journalist, Atkins has been editor of MM&D, Canada’s Supply Chain Magazine for 13 years, and continues in that role. She is also a freelance automotive reviewer with work frequently published in the Toronto Star’s Wheels section.

ClaimsPro/IndemniPro has acquired one of Quebec’s leading loss adjusting firms, Allen & Fugère Inc. Allen & Fugère has been providing adjusting services for more than 55 years. The company boasts an impressive roster of 10 preeminent insurance professionals and has developed a stellar reputation across Quebec for its Special Investigations Unit. The Unit works to identify and investigate fraudulent claims through preliminary interview and statementtaking techniques. This capability both complements and enhances ClaimsPro/ IndemniPro’s existing service offering, and positions ClaimsPro/IndemniPro as an expanded presence in Trois-Rivières while increasing its geographical footprint within Quebec. The addition of the Allen & Fugère team means ClaimsPro/ IndemniPro now has 140 Adjusters working throughout the province. René Paillé and Ghyslain Morinville, senior adjusters and presidents of Allen & Fugère, will continue to provide the expert services their clients have come to know. René will still lead the Special Investigations Unit in Quebec and report to Suzie Godmer, ClaimsPro/IndemniPro’s senior vice president, Quebec. Ghyslain will serve as Branch Manager in Trois-Rivières and report to Pierre Boulianne, ClaimsPro/ IndemniPro’s regional district manager, Quebec. ●

Atkins is an accomplished writer, interviewer and researcher, and is experienced moderating panels and roundtables, as well as writing whitepapers, blogs and marketing material for her corporate clients.

One of Crawford & Company (Canada) Inc.’s long-standing and most valuable executive leaders, John Sharoun, has been appointed to the position of executive general adjuster/senior consultant. After working with the aviation, energy, forensic accounting and Global Technical Services (GTS) teams in an executive management role across the Americas since July 2013, John has decided to return to the Canadian marketplace. He will pursue his interests in major and complex loss management but will still be involved with Crawford projects across the Americas. John will work closely with the Canadian executive leadership team and the Canadian GTS team, and will be based in the Toronto office. ●

Atkins holds a Masters degree in international relations with an award-winning thesis, and a BA in political science.

Most recently she was awarded the Betty Jo Turner prize for making Ontario’s own Provinz magazine the best in the Porsche Club of America. Atkins was the volunteer editor of Provinz for three years. She got her start in journalism at the Kingston Whig Standard, with a brief detour into the federal government and non-for-profit sector. She worked overseas in both Hong Kong and Saudi Arabia, as a journalist and in corporate communications.

In her spare time, Atkins is a successful amateur racecar driver. She can be found most summer weekends at a racetrack somewhere in southern Ontario or Quebec, racing her 1982 Porsche 911 against other beautiful vintage automobiles. She looks forward to hearing from you. emily@claimscanada.ca

Claims Canada Wants You! Claims Canada magazine wants you to send us your company news, appointments and event photos for possible inclusion within our ‘On the Scene’ department. Please help us share your items with the claims industry across the country. For more information, please email: emily@claimscanada.ca

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t PO UIF TDFOF OTS ORIMS (Ontario Chapter of RIMS) held its Christmas Luncheon on December 10, 2015 at the Westin Harbour Castle in Toronto. With more than 700 guests in attendance, ORIMS continued with the spirit of giving by raising funds for The Daily Bread Food Bank. In all, $10,000 and more than 230 pounds of non-perishable food plus gift cards was collected to help the food bank in its fight to eliminate hunger in and around Toronto. â—?

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Indemnipro (the name for ClaimsPro in Quebec) welcomed approximately 140 clients and partners from across the insurance and claims industries on November 27, 2015 at the Hotel Gault in Old Montreal for a festive and friendly event – its 2nd annual holiday client cocktail – to ring in the holiday season. ●

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t PO UIF TDFOF OTS Hundreds of insurance claims industry guests attended the 10th Annual Post CICMA/CIAA Joint Conference Cocktail on February 2, 2016. Entitled The Big Mingle, the event is hosted by Giffin Koerth Forensic Engineering and Blouin Dunn LLP and is held at The Fifth Social Club in Toronto. â—?

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t PO UIF TDFOF OTS More than 150 exhibitors from across Canada showcased their works at the Ontario Insurance Adjusters’ Association’s (OIAA) Professional Development and Claims Conference in Toronto on February 3, 2016. The event featured a trade show and seminars covering a wide variety of timely claims topics. ●

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Ann nouncing the

QUARTER CENTURY CLUB 57th Annual Reception Wednesday, May 11th, 2016

The Albany Club 91 King Street East Toronto, ON, M5C 1G3 Reception p – 12:00 p.m. Cost - $75.00 57th Annual Reception Committee: John Cherrie - 416-737-7525 John Sharoun - 416-957-5001 Ford Blow - 416-457-7072

Send Contact Info and Cheque Payable to (or VISA, provide exp. date):

Featuring… ‘The Roasting of Brad Ebel’

John Sharoun Quarter Century Club c/o Crawford & Company (Canada) Ltd. 123 Front St, Suite 300 Toronto M5J 2M2 Email: John.Sharoun@crawco.ca Phone hone: 416-957-5001

Thank you for the support of these generous event sponsors:

Once again this year, the Quarter Century Club plans to continue to make a donation to the Insurance Institute Scholarship Fund, in memory of our claims colleagues Design and Space Compliments of:

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