Ofÿcial Journal of the Canadian Indépendent Adjusters’ Association
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Contents OCTOBER / NOVEMBER 2016 • VOLUME 10 • NUMBER
Cover Feature 12 The Straight Dope The legalization of marijuana in Canada has been making headlines in recent months. The evolution of regulations and laws around use of the drug for both medical and recreational purposes is creating new risks and opportunities for the insurance business, from underwriting to adjusting.
BY EMILY ATKINS
Spotlight 20 A Minor Adjustment T&L Adjusters has changed its name and moved shop while maintaining the same boutique service.
BY EMILY ATKINS
News Features 22 How to be Ready for Make or Break Claims Moments BY DARA BANGA, FCIP, CFEI
24 Donohue vs. Stevenson: How a snail in a bottle helped set the precedent of negligence and the duty of care BY ROCCO NEGLIA
26 The Scope of an Insurer’s Duty to Defend an Additional Insured BY MICHAEL S TEITELBAUM
24 Departments 4 First Notice 28 On The Scene
Columns 10 President’s Message
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• first notice FN New reinsurer view of Canada may influence pricing The higher frequency of billion-dollar-plus natural catastrophe events in Canada is making the global reinsurance community see the country differently, and pricing will need to change to reflect risk, Mark Cloutier, group CEO for Brit Insurance Ltd., said during a panel discussion at the national Insurance Conference of Canada in October. Canada “may have been considered in the past to be more of a diversifie , maybe a little less cat-exposed, other than out here on the West coast,” Cloutier said, speaking during the conference’s Global Leaders’ Panel. Citing the Fort McMurray wildfi e – for which insured losses have been estimated at about $3.6 billion – he suggested a higher frequency of billion-dollar-plus events could make it tougher to think of Canada as a diversifie for reinsurers. “If you think about that size of a loss in the context of the global US$30 billion of major loss total in the first half of the year,” Cloutier said, “to have that kind of a contribution come out of a market this size, I think, does cause some concerns.” When pricing is considered on that basis, he noted. “I think it’s going to have to come back to more technical pricing and more exposure modelling.” Mike Sapnar, president and CEO of Transatlantic Re, agreed it is necessary “to get down to some technical pricing, but there will be value for diversification. The e will be some discounting for that.” “The pricing of those natural perils will naturally change, but it will be done in a way that is based on much better information and a much better understanding of the risk that is now being consid-
ered,” suggested John Charman, chairman and CEO of Endurance Specialty Holdings Ltd. Beyond the estimated losses from Fort McMurray, moderator Peter Hearn, president and CEO of Guy Carpenter & Company, LLC, told attendees that “no one really appreciated or considered the massive concentration of values in such a remote location exposed to the peril of wildfire.” Sapnar said he is not sure why the Fort Mac loss has come as such a surprise. “There is precedent on both modelled and unmodelled losses in non-correlating or cold spots or diversifying areas,” he pointed out. “Of course, there’s going to be rate increases at renewal. I think it’s really not so much the issue of there was a loss, but more an issue of what is your view of risk,” he said. Cloutier noted “if you think about it in the traditional sense, Canada is an imbalanced book. The industry needs to face that challenge, to work with customers and distribution partners to begin to understand and build more balance into the book by having a more honest view of the real risks and the real exposures here,” Cloutier said. “You can’t take a lot of Fort McMurrays if, in fact, a good year is a six or seven percent return,” he told attendees. Despite the challenges, “we’re committed to the Canadian market. I think really all the global reinsurer community is,” Sapnar said. ●
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Risk managers unsure about cyber policies
Intact estimates $170 million in cat losses for Q3 2016
Four in five risk managers said their company has a stand-alone cyber insurance policy, though only three in four reported their policy covers network/business interruption, Risk and Insurance Management Society Inc. said in the 2016 RIMS Cyber Survey, released Monday. There were 272 respondents to the online survey which was in field between August 8 and September 9, 2016. When asked whether their company has a “stand-alone cyber insurance policy,” 80% of respondents said yes, 19.5% said no and 0.5% said they were not sure. Respondents were asked whether their organization’s cyber insurance extends to data stored in cloud servers. More than two-thirds (69%) said yes, 9% said no and 22% said they were not sure. RIMS also asked members which losses were included in their cyber insurance policies. More than nine in 10 (91%) said breach notification costs. About one in four (27%) said theft of trade secrets; 80% said data recovery; 50% said professional liability; 76% said network/business interruption; 78% cyber extortion and 63% said fines and penalties. Among U.S. respondents, 48% the U.S. government should mandate breach reporting. In Canada, the federal Personal Information and Protection of Electronic Documents Act was amended to provide for mandatory breach notification. ●
Intact Financial Corporation (IFC) has announced estimated catastrophe losses, net of reinsurance, of approximately $170 million on a pre-tax basis for the third quarter of 2016. The estimate equates to about $124 million or $0.95 per share for the quarter. Severe weather conditions during the summer months led to numerous events involving hail, wind and rain, which affected communities across the country. In aggregate, eight events in the quarter met Intact’s catastrophe threshold of $7.5 million, mainly affecting the personal lines of business. “Canadians across the country have been impacted by multiple weather events this summer and we are working hard to help our customers get back on track,” said Charles Brindamour, CEO of Intact Financial Corporation. “We are also accelerating our action plans in home and auto to tackle increasing storm activity and cost inflation.” In July, IFC reported a $127 million impact in its second quarter financial results from the Fort McMurray wildfire, bringing its combined ratio to 99.2% for the quarter, including 8.8 points of Fort McMurray cat losses. “We delivered $114 million in net operating income despite the $127 million impact from the Fort McMurray wildfires, the costliest insured catastrophe in Canadian history,” Brindamour said at the time. IFC is the largest provider of property and casualty insurance in Canada, with close to $8 billion in annual premiums. ●
• first notice FN BC government invests in flood mitigation About four months after a substantial rainfall that led to flooding in British Columbia’s Peace Region, the provincial government announced it is providing $2.5 million to the Peace River Regional District (PRRD) to undertake debris removal and preventative work designed to reduce flood risk in the egion. BC Premier Christy Clark toured the region after the event in June and committed to supporting the community during her visit. The funds will support communities in the region with stream-channel restoration, or work designed to address debris buildup that leads to flooding The mitigation work – including debris removal, resloping and revegetation – is expected to begin immediately, before winter weather creates complications with freezing. The total estimated cost of damages from the June Peace River rainfall event could reach close to $100 million, the ministry reported. Ministry of Transportation and Infrastructure crews and contractors have been working since the flood took place to repair roads and open up highways in the area. In total, the province already has invested $15 million for repairs. The “very heavy rainfall event” prompted the mayor of the District of Chetwynd in northeastern British Columbia to declare a state of local emergency in mid-June. The municipality reported at the time that 79 millimetres had fallen in Chetwynd as of noon on June 15, with a further 30 to 50 millimetres expected the following day.
The Peace Region flooding also resulted in the closure of Highway 97 between McKenzie Junction and Chetwynd and at Rolla Road between Highway 49 and Highway 2. To date, all provincial highways have been reopened, except for Rolla Road (Snake Pit) east of Dawson Creek. Work is still ongoing to repair the heavy-haul, dangerous goods route, as crews deal with challenging weather conditions. The province hopes to have the route fully open in the coming weeks. “Following a busy summer of significant rainfall in the Peace, we wanted to show leadership in supporting work that prevents disaster in an area prone to flooding,” said Mike Bernier, MLA for Peace River South, in a release. “In fact, this investment will help to reduce the proven risk for recurring flooding in this region. By investing this money now, we are taking an important step to enhance public safety and reduce the potential for future damaging flooding for all the residents in the region.” The $2.5 million investment is in addition to close to $1 million provided to individuals and approximately $4 million expected to be paid out to local governments in the PRRD through the provincial Disaster Financial Assistance program following the June flooding Through the Flood Protection Program, the province, federal government and local communities have invested $173 million for flood mitigation p ojects in BC since 2007. ●
Matthew damage estimated at up to $US 8.8 bn
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Modelled insured losses from Hurricane Matthew could range from US$2.2 billion to US$6.8 billion for the United States and US$600 million to US$2.0 billion for the Caribbean, notes an estimate issued by AIR Worldwide. Hurricane Matthew affected the Caribbean and the southeastern coastline of the US for almost two weeks. In the US, Florida, Georgia, South Carolina, North Carolina and Virginia were affected, with power outages that affected millions of homes and businesses, and the evacuation of more than 3 million people. In some locations the storm surge was as high as nine feet and as much as 17 inches of rain was reported. Among other things, AIR’s modelled insured loss estimates for the US include insured physical damage to property, both structures and their contents; additional living expenses (ALE) for residential claims; insured physical damage to structures and contents, and business interruption directly caused by storm surge, for commercial lines; direct and indirect losses for insured risks that experience physical loss for business interruption; 100% of storm surge damage for the automobile line; and demand surge. The estimates do not reflect such factors as losses paid out by the National Flood Insurance Program, losses to uninsured properties, losses to infrastructure and losses from hazardous waste clean-up, vandalism or civil commotion, whether directly or indirectly caused by the event. ●
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• first notice FN Manitoba Public Insurance reports lower loss Manitoba Public Insurance (MPI) has reported a net loss of $30.9 million for the six months of its fiscal year ending Aug. 31 – a decrease of $47.4 million over the same time period last year. This includes net loss to the Basic insurance line of business of $52.7 million in the first six months of the 2016/17 fiscal year. Total earned revenue for the first six months was $597.7 million, an increase of $34.7 million from the same period last year. This is mainly due to increases in motor vehicle premium revenue resulting from an increase in the number of motor vehicles insured and the value of these vehicles. “The overall financial picture was affected by an increase of $193.7 million in total claims costs which was offset by an increase of $116.8 million in investment income,” said Heather Reichert, vice president of finance and chief financial officer with MPI. “Total claims costs included a $138.3 million increase in bodily injur y claims and a $53.8 million increase in physical damage claims compared to the first six months of 2016. The bodily injur y increase is primarily due to the interest rate adjustment on unpaid claims, however, an
increase in collision claims is also negatively impacting claims costs.” This past June, MPI applied to the Public Utilities Board for an overall increase of two percent in Basic Autopac rates for the 2017/18 insurance year, citing an “unprecedented” year for comprehensive (non-collision) claims payouts. In addition to an overall two percent increase in Basic Autopac rates for 2017, the corporation further requested that the Public Utilities Board consider introducing an interest rate forecast risk factor, effective March 1, 2017. “The form and magnitude of this (risk factor) is to be developed through a collaborative process with the PUB and intervenors,” said Reichert. Basic Autopac is an all-perils coverage that insures a vehicle and any permanently attached equipment against accidental loss or damage in Canada or the United States. It covers damage from collision, upset (vehicle tips or rollover) and other causes (comprehensive), such as vandalism, theft, hail and fire. MPI said in late June that, if approved, the increase would result in the average passenger vehicle owner paying about $17 more in premium; the average premium for the private passenger vehicle class will be $1,018. ●
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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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I am thrilled to be penning my first message as CIAA president. I would hazard to say that I am sitting as president of the independent adjusters association at a time of tremendous change in both the insurance industry and the adjusting profession. Who would have guessed that 30+ years ago when I entered this industry that we would be talking about the legalization of marijuana and how that will impact claims. Who would have imagined that a small flying object called a drone could provide photographs and measurements of buildings and complete loss sites controlled from the ground. Who would have imagined that facial recognition technology would be used to verify policy holders, that social media such as Facebook and Twitter would play such instrumental and influential roles in major claims catastrophes. Autonomous vehicles, that is a topic unto itself in regard to the impact and changes that they will have on society, regulators and the insurance industry. 95 percent of the Canadian population has Internet access and 28 million have mobile devices—my 80-year-old mother has one of those mobile devices and sends text messages! We are surrounded by technology and changes that are evolving by the minute and we need to look at ways to utilize that technology coupled with adjusting skills to provide a better customer experience. Customers will soon be at a point where they are willing and able to handle less complex claims entirely through digital self- serve channels. We already see that in the life and health space. Customer expectations are being defined outside of the insurance industry. Uber and Amazon are just two examples of where speed and convenience have put those companies in the spotlight and set new standards in delivery. As people interact with other more technologically advanced businesses it increases the pressure on us—the insurance industry—to bring those technologies to bear on improving that customer experience. The possibilities are endless and I believe that we are just seeing the beginning of these exciting and sometimes disruptive technologies. The world is transforming and evolving very quickly and we as adjusters must transform and evolve as well. We are really at a crossroads in the claims and insurance industry. One direction leads to utilizing very technical claims adjusting skills for losses such as cyber. The other direction leads to using technology and data to settle claims. As professionals we need to stay ahead of the trends by investing in training and hiring many disciplines and capa10 Claims Canada
Je suis ravie d’écrire mon premier message en ma qualité de présidente de l’ACEI. Je me hasarderais à dire que j’assume les fonctions de président de l’Association canadienne des experts indépendants dans un contexte où l’industrie des assurances et la profession d’expert en sinistres connaissent des changements importants. Qui aurait pu deviner il y a plus de trente ans, lorsque je suis arrivée dans cette industrie, que nous parlerions un jour de la légalisation de la marijuana et de ses répercussions sur les sinistres. Qui aurait pu imaginer qu’un petit engin volant appelé drone pourrait fournir des photos et des mesures de bâtiments et de sites de sinistres, et ce, tout en étant commandé depuis le sol. Qui aurait pu imaginer que la technologie de la reconnaissance faciale serait utilisée pour vérifier les titulaires de police d’assurance, que les médias sociaux comme Facebook et Twitter joueraient un rôle important et exerceraient une influence sur les sinistres dus aux catastrophes majeures. Les véhicules autonomes, c’est tout un sujet en soit, si l’on tient compte de leur incidence sur la société, les organismes de réglementation et l’industrie des assurances. Quatre-vingt-quinze pour cent de la population canadienne accèdent à Internet et 28 millions de personnes possèdent des appareils mobiles : ma mère âgée de 80 ans en possède un et envoie des messages textuels! Nous sommes entourés de technologies et les changements évoluent de minute en minute. Aussi, nous devons trouver les moyens d’utiliser ces technologies tout en adaptant nos compétences pour assurer une meilleure expérience client. Les clients arriveront bientôt au point où ils ont la volonté et les moyens de traiter entièrement des réclamations moins complexes par l’intermédiaire de canaux numériques de libre service. Nous constatons déjà cette réalité dans le domaine de l’assurance des personnes. Les attentes des clients sont actuellement définies en dehors de l’industrie des assurances. Uber et Amazon sont, entre autres, deux exemples édifi nts qui nous montrent dans quelle mesure la rapidité et la commodité ont permis à ces sociétés de se hisser au-devant de la scène tout en établissant de nouvelles normes dans la prestation des services. Étant donné que les gens interagissent avec d’autres entreprises plus avancées sur le plan technologique, cette situation nous presse fortement, en tant qu’industrie des assurances, d’utiliser ces technologies pour garantir une meilleure expérience client. Les possibilités sont illimitées et je crois que nous assistons seulement au début de ces technologies passionnantes et parfois perturbatrices. Le monde est en pleine mutation et évolue très rapidement. De ce fait, en tant qu’experts en sinistres, nous devons nous adapter et évoluer. Nous nous trouvons effectivement à la croisée des chemins par rapport aux sinistres et à l’industrie des assurances. Une direction nous conduit à utiliser des compétences très techniques d’experts en sinistres pour traiter les dommages, notamment ceux liés au cyberespace. L’autre direction nous conduit à utiliser la technologie et les données pour régler les sinistres. En tant que professionnels, nous devons demeurer à l’avant-garde des tendances en investissant dans la formation et le recrutement d’un plus grand nombre de disciples et de capacités pour faire face aux nouwww.claimscanada.ca
bilities to address new risks. My first official duty as president was attending the Canadian Independent Adjusters’ Association & Canadian Insurance Claims Managers’ Association Saskatchewan Chapter’s Education Conference in Saskatoon on September 28th—a big shout out to Justin Braaten, CIAA Saskatchewan Region President and his organizing committee for putting on an excellent event with top rate speakers. Saskatchewan Region is investing in training and education for the insurance industry and their attendees were both adjusters and claims managers. The event was very well attended and topped off by Greg Johnson the Tornado Hunter sharing stories and phenomenal photographs and video of his storm chasing. Not only does Greg show the wrath of Mother Nature, he also brings home the human element and the devastation that we as insurance professionals are entrusted to resolve. With all of the changes smoldering around our profession I believe that another of the fundamental things that we need to undertake is healthy, transparent conversations. We need to create a stronger dialogue with our customers to better understand their current and future challenges and be in a better position to address these changes. All of these disruptions in technology and changes that we speak, write and read about are not only affecting the adjusting profession, it is affecting the insurance industry as a whole. We must work with our business partners to collaboratively provide solutions to improve the customer experience and be known in the future as the industry that sets the new standards. ■
veaux risques. Ma première tâche offici le à titre de présidente consistait à assister à la conférence sur l’éducation organisée par l’Association canadienne des experts indépendants et la division de la Saskatchewan de l’Association canadienne des directeurs de sinistres d’assurance. La conférence a eu lieu le 28 septembre à Saskatoon. Un grand bravo à Justin Braaten, président régional d’ACEI Saskatchewan et à son comité d’organisation grâce auxquels, cet événement, animé par des conférenciers de haut niveau, a connu un excellent retentissement. La région de la Saskatchewan investit actuellement dans la formation et l’éducation sur l’industrie des assurances. L’auditoire était constitué d’experts en sinistres et de gestionnaires de règlement des sinistres. L’événement, qui a vu une forte participation, a été marqué par la présence de Greg Johnson, le chasseur de tornades. Celui-ci a partagé des histoires et des photographies ainsi que des vidéos époustoufl ntes sur la chasse de tornades. Greg a non seulement montré la colère de dame nature, mais il a aussi dévoilé l’élément humain et la dévastation que nous, professionnels de l’assurance, sommes chargés de résoudre. Compte tenu des changements qui touchent notre profession, nous devons engager des conversations saines et transparentes, car elles constituent, à mon avis, l’une des autres actions fondamentales que nous devons entreprendre. Dans ce cadre, il nous incombe de renforcer le dialogue avec nos clients pour mieux comprendre leurs défis actuels et à venir et pour être mieux à même de résoudre ces changements. Tous ces sujets concernant les perturbations de la technologie et les changements dont nous parlons, que nous écrivons ou que nous lisons, touchent non seulement la profession d’expert en sinistres, mais aussi l’industrie des assurances dans son ensemble. Nous devons collaborer avec nos partenaires d’aff ires pour fournir des solutions nous permettant d’améliorer l’expérience client et de nous faire connaître à l’avenir comme une industrie qui établit les nouvelles normes.. ■
NATIONAL EXECUTIVE 2016 - 2017 PRESIDENT Heather Matthews, CIP, CRM, CIOP 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 1ST VICE-PRESIDENT Monica Kuzyk, FCIP, CRM Curo Claims Services 125 Northfield D . W., P.O. Box 218 Waterloo, ON N2J 3Z9 Ph: (866) 952-2876 • Fax: (519) 888-9704 E-mail: firstname.lastname@example.org 2ND VICE-PRESIDENT Lee Powell Cunningham Lindsey Canada Claims Services Ltd. 1102 – 50 Burnhamthorpe Rd. W. Mississauga, ON L5B 3C2 Ph: (905) 896-8181 • Fax: (905) 896-3485 E-mail: email@example.com SECRETARY Jeff Edge, CIP, CFEI Leading Edge Claims Services Inc. P.O. Box 1399, 78 Highway 20 West Fonthill, ON L0S 1E0 Phone: (289) 897-8676 Fax: (289) 897-8677 E-mail: firstname.lastname@example.org
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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: email@example.com PAST-PRESIDENT Fred R. Plant, AIIC ClaimsPro 85 Englehart Street Dieppe, NB E1A 8K2 Phone: (506) 853-8507 Fax: (506) 853-8501 E-mail: firstname.lastname@example.org 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: email@example.com
DIRECTOR Paul Féron, FCIP, CRM – ClaimsPro 210 – 746 Baseline Rd. East London, ON N6C 5Z2 Ph: (519) 645-6500 • Fax: (519) 645-2250 E-mail: firstname.lastname@example.org DIRECTOR Lorri Frederick – ClaimsPro 120 Adelaide St. W., Suite 2401 Toronto, ON M5H 1T1 Ph: (905) 308-6292 • Fax: (416) 360-7335 E-mail: email@example.com DIRECTOR James B. Eso, CIP, CIOP Crawford & Company (Canada) Inc. 539 Riverbend Drive Kitchener, ON N2K 3S3 Ph: (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 Ph: (902) 468-7787 • Fax: (902) 468-5822 E-mail: Grant.King@crawco.ca DIRECTOR Albert Poon, CIP Cunningham Lindsey Canada Claims Services Ltd. 1102 – 50 Burnhamthorpe Rd. W. Mississauga, ON L5B 3C2 Ph: (905) 896-8181 • Fax: (905) 896-3485 E-mail: firstname.lastname@example.org
DIRECTOR Lee Powell 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: email@example.com DIRECTOR 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: firstname.lastname@example.org DIRECTOR Craig J. Walker, CIP, FCIAA, FIFAA Maltman Group International 2001 Sheppard Ave. East, Suite 810 Toronto, ON M2J 4Z8 Phone: (416) 492-4411 Fax: (416) 492-5657 E-mail: email@example.com DIRECTOR 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: firstname.lastname@example.org
Claims Canada 11
2016-10-26 4:17 PM
â€¢ cover story
BY EMILY ATKINS
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2016-10-26 4:22 PM
Reefer, dope, Mary-Jane, weed, ganga, bud, airplane, Aunt Mary, doob, grass, herb, skunkweed, wacky tabaccy, Miley Cyrus…
ith so many aliases, it’s no wonder the legal issues around the Cannabis sativa plant and its many uses are complex. Used for centuries, and long the subject of silly jokes, the psychoactive plant and its extracts are now a serious business that is attracting much attention as the Canadian government inches towards legalization. With legalization comes opportunity for underwriters and eventually—once the claims start rolling in—adjusters.
Where there’s smoke Prohibited since the 1920s in Canada, marijuana is listed as a controlled substance, making possession, production and trafficking of the plant illegal. Yet weed is the most popular recreational drug used in Canada after alcohol. Eleven percent of Canadians over the age of 15 reported using grass in
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2013. It’s the younger demographic who are most keen on herb, with 25 percent of those between 14 and 24 years reporting use, versus eight percent of those over 25. All this use is netting organized crime about $7 billion a year in Canada alone. Not even considering the amount expended on chasing down the gangs, law enforcement is allocating vast resources pursuing individuals for possession, with marijuana charges accounting for more than half the police-reported drug offences in 2014. So it’s little wonder the government has decided to take action. In 2015 the Trudeau government’s speech from the throne promised to legalize, regulate and restrict access to marijuana. The government hopes to reduce crime, protect public health, establish a production, distribution and sales system and collect taxes, as well as continuing
to provide a medical marijuana program for individuals with a prescription for its use. At present the marijuana industry in Canada is estimated to be worth between $80 and $100 million.
It’s legal now Canadians can now get prescriptions for the medical use of marijuana. [See sidebar for an examination of the arguments for and against its medical use.] Medical use was made possible the 1990s, when an Ontario court decision determined the constitutional right to a reasonable amount of the drug for personal medical use. At that time the model used by the government to manage medical marijuana allowed home production and personal medical use. Th s expanded to about 40,000 home growers by 2014, with an average of 90 plants each.
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But this model caused signifi ant problems, including increased risk of fi e, theft, and mold and water damage to properties being used as grow houses. Health Canada could not keep up with the inspections needed to ensure safety, and there was increasing concern about illegal sales. So the feds changed the model, adopting the Marihuana for Medical Purposes Regulations (MMPR) that allowed Licensed Producers (LPs) to grow and sell medical marijuana under strict conditions imposed by Health Canada. As of August this year there were 35 LPs across the country. Thanks to a successful court challenge, Allard v. Canada—which claimed the LPs’ product was too expensive—in August 2016 the federal government again allowed medical marijuana users to grow their own at home in limited quantities. The MMPR was repealed and replaced with new Access to Cannabis for Medical Purposes Regulations (ACMPR). The ACMPR allow for reasonable access to cannabis for medical purposes for Canadians who have been authorized to use the plant and its extracts by their health care practitioner.
Where previously there were up to 40,000 home growers in the country, now that number is poised to blossom, with many of the country’s more than 700,000 medical users likely to take advantage of the opportunity to save money by growing their dope themselves, says Eric Nash, a Victoria, BC-based marijuana consultant and current expert advisor to the federal Marijuana Legalization and Regulation Task Force roundtable.
“It’s a new form of risk that I don’t think property insurers are ready to accept yet.”
The risks Even when legalized, the production and distribution of marijuana for medical purposes is a risky business. And on the usage side, signifi ant questions and challenges arise in the areas of liability, auto insurance, life insurance, health benefits, and the list continues.
But property risk is one of the biggest concerns for insurers where marijuana is concerned. For the home grower, the risks can be considerable. Fire is said to be 24 percent more likely in a grow house thanks to requirements for high-intensity lighting, specialized ventilation and the addition of carbon dioxide to speed the plants’ growth. Mold is another risk, caused by the moisture required to grow plants indoors. And the water itself can cause damage, especially if indoor irrigation systems fail. Theft is a huge risk, says Nash. With a product that is worth between $1,800 and $3,000 per pound, and in quantities up to 27 pounds in stock, private growers become a lucrative target for thieves. “Insurance is very important,” Nash adds. Typically, individual growers are able to get coverage as part of their home policy, he notes. Steve Wallace, a partner with law fi m Dolden Wallace Folick, LP in Vancouver points out that the massive growth in the number of new growers could result in an explosion of claims. “It’s an increase in risk to property insurers across the coun-
A catastrophic event A catastrophic event
14 Claims Canada
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try,” he says. “It’s a new form of risk that I don’t think property insurers are ready to accept yet.” Wallace says there are all sorts of thorny legal issues being raised, particularly when it comes to rental units being used for grow ops. Under the new regulations tenants do not have to notify their landlords that they are growing marijuana with Health Canada’s permission. “All these owners of rental properties have no idea that this is going on around them and Health Canada doesn’t have to tell them. So that’s frustrating, I would think, for property insurers having to deal with that,” Wallace says. According to Wallace, there has already been a case in BC in which a homeowner was denied coverage for fi e damage under a grow-op exclusion in her policy for a property she rented out, and she is suing Health Canada alleging the grow-op was not properly vetted and should not have been allowed due to its proximity to a daycare.
The perfect risk It’s a different world for the 35 Licensed Producers.
“It’s the perfect risk,” says Daniel Mason, Senior Business Developer, Specialty Risks, with Burns & Wilcox Canada. “It’s highly regulated, there’s an exceptional amount of security, and construction is state of the art. All of the characteristics we look for in a perfect risk.” Many factors, such as physical capacity (size of building, physical security considerations, number of staff, cultivation technique), sales capacity, and inventory levels
“It’s pretty exciting, actually. It’s a bit like the gold rush.”
are considered before Health Canada will issue a license. “From an underwriting perspective Health Canada has already done the work for us,” Mason says. His company offers a comprehensive Medical Marijuana Program for federally licensed medical marijuana manufacturing and distribution operations. It covers
companies from seedling to stock, from vacant production facilities to fully operational facilities filled with plants, and the fin shed product. Mason says that in the year since they started offering the product, Burns & Wilcox has captured about 40 percent of the LP market. Another company offering a similar product is CHES Special Risk Inc, which includes liability, theft or damage to product or equipment. Mason says Burns & Wilcox is in it for the long haul. Companies have been coming and going from the market as regulations evolve, he says. “It’s a volatile market, and for a client it would drive you crazy not knowing if you’re going to get renewal terms next year. There’s a lot of money invested in these facilities, so there’s a lot of exposure. Our model is not to get in and get out; it’s to be a partner.” So far the business is paying off. They’ve had only one minor claim in the fi st year.
Gaps While the licensed growers may be seen as the perfect risk, there are gaps in what’s available for individuals. Personal
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growers are facing tightening of grow-op exclusions, to the point where insurers are removing any reference to causation in their policies. Wallace says the courts have accepted language that simply says the insurer won’t underwrite any house that has a grow op. Another gap is in liability coverage. Mason notes that standard markets won’t write policies for personal growers. Auxiliary commercial markets are writing policies on a commercial form and “doing the clients a massive disservice”, he says. Instead of getting personal liability, they are getting premises liability on a commercial form. “That’s fine if someone slips and falls on your property, but if you’re out walking your dog and it bites somebody, there’s no coverage, while that would have been covered under a personal form.” Mason also notes that product liability is only being made available by his company on a claims-made form. Without proper scientific evidence of the long-term health impacts, “we
don’t want anything to do with it,” he says. “It really reeks of what happened to tobacco in the 70s and 80s, when people started looking into the science, what the carcinogens in the product were doing to the human body. It wasn’t until then that we started seeing the class action lawsuits.”
Users With use of the product widely permitted now for medical purposes, and further legalization pending in the next year, additional insurance issues are arising. From automobile policies, to life insurance and workplace drug policies, the legal use of a psychotropic drug brings thorny questions to the fore. Some Canadian life insurers have already declared that tokers are not smokers for the purposes of their policy. Questions about legal limits and workplace drug testing will no doubt take centre stage at conferences and in boardrooms as governments and insurers alike wrestle with the implications.
Medical Marijuana: Does it Does cannabis have an impact on any of the myriad symptoms associated with everything from glaucoma and Crohn’s disease to cancer, fibromyalgia, HIV and AIDS to multiple sclerosis, Parkinson’s and Post-Traumatic Stress Disorder? The companies that grow, process, distribute and sell cannabis will give you an unequivocal “yes”. They will tell you that based on anecdotal reports and a “growing body of published scientific study”, cannabis relieves the symptoms associated with many diseases and conditions. But they don’t mention where and how the studies were conducted, who controlled them, the number of patients enrolled or the duration of the trials, let alone quantify measurable results. According to both Health Canada’s report Information for Healthcare Professionals: Cannabis and the Canadian Centre on Substance Abuse’s Clearing the Smoke on Cannabis: Medical use of cannabis and cannaboids the clinical studies that support the drug’s benefits are limited. They note that benefits were observed with medical conditions ranging from HIV/AIDS related weight loss, mood and insomnia to multiple sclerosis-associated pain and spasticity as well as chronic pain and more. However, they also mention that the number of trial participants tended to be low and over the very short term, with little information about adverse effects, different strains and dosages. To date, Health Canada has not received applications for approval of a drug or medicine made from dried marijuana and has not rejected any clinical trial around marijuana for medical
16 Claims Canada
What adjusters need to know Clearly, with the continuing use of the grow-at-home medical marijuana model combined with the licensed grower-distributors, there will be some commonalities with previous policies and the claims arising from them. It’s not a completely new game. As Mason points out, one of his main advisors in underwriting the LP businesses is a lawyer who specializes in property claims related to grow ops. But with the additional of personal, recreational use coming with the Liberal’s legalization legislation, there will be a lot of changes in the pipe for the insurance industry. If the government is going to allow every adult in Canada to grow five to ten plants for personal use in their homes, that’s quite big from an insurance perspective, Nash asserts. “It’s a huge niche industry in terms of the opportunity,” for adjusters he says. “Get in on the ground floor, it’s a growing business, a big business,” Mason advises. There is a lot of discussion going on
work? purposes. In fact, since 2001, Health Canada has approved six clinical trials for dried marijuana in Canada. As importantly, while Canadian courts require reasonable access to a legal source of cannabis for medical purposes when authorized by a physician, Health Canada does not endorse its use. Specifically, Health Canada notes that cannabis is not an approved drug or medicine in Canada and it has not gone through the necessary rigorous scientific trials for efficacy or safety. Meanwhile, the Canadian Medical Association states: “The CMA recognizes that some individuals suffering from terminal illness or chronic disease for which conventional therapies have not been effective may obtain relief with marijuana used for medical purposes. However, clinical evidence of medical benefits is limited and there is very limited guidance for the therapeutic use, including indications, potency (levels of THC, CBD), interactions with medications and adverse effects... The CMA has long called for more research to better understand potential therapeutic indications, as well as its risks.” But whether cannabis is used for therapeutic or recreational purposes, it has recognized effects on everything from motor vehicle crashes and fatalities to increased risk of psychosis among those with pre-existing risk factors, to brain development, lung cancer and respiratory illnesses. In addition, organizations such as the Canadian Centre on Substance Abuse are concerned that allowing cannabis for medical use suggests there is little to no risk, while implying that all cannabis use is safe or beneficial which is likely promote and encourage increased use.
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Where there’s smoke: Global Pot Laws Around the world, governments are approaching the recreational possession and use of marijuana and other drugs very differently. These countries and states are leading the way when it comes to implementing new legislation and adopting more lenient attitudes to help change how the possession and use are perceived. Portugal When: In 2001, Portugal decriminalized the possession and use of all drugs from heroin to marijuana. What: However, drug use and possession is still illegal and criminal penalties will be applied to drug growers, dealers and traffic ers. This means: If a person is found with less than a 10-day supply of any drug, the person is sent to a three-person Commission for the Dissuasion of Drug Addiction. So what: Treatment has increased, drug overdose deaths have decreased and there are fewer new HIV diagnoses among drug users. However, Dr. Joao Goulao, the architect of Portugal’s decriminalization policy, has said: “It’s very difficult to identif a causal link between decriminalization by itself and the positive tendencies we have seen.” Uruguay: When: On December 20, 2013 Uruguay became the first country in the world t legalize and regulate marijuana. What: Drug consumption has never been a crime in Uruguay, but every aspect of cannabis production, sale, possession and consumption of cannabis is now regulated and controlled by the state. This means: Users can grow their own or buy their cannabis from pharmacies, the Ministry of Health or as members of a cannabis club. So what: It’s hoped the new system will give the state more opportunity to control supply and demand. Netherlands When: For 40+ years, authorities have turned a blind eye to the possession of small quantities of soft drugs for personal use although possession is a criminal offence. What: The police will seize more than five grams of cannabis/hash and five c nabis plants, but their owner will not be prosecuted. What: Users may be arrested or ordered to pay a fine if using in certain area . This means: Although the sale of soft drugs is a criminal offence, in practice, coffee shops selling small quantities of soft drugs for consumer consumption on or off site will not be prosecuted. So what: For decades, the Netherlands has enticed marijuana aficionados fro around the world. State of Colorado When: Legalized marijuana for recreational purposes in 2012, allowed the commercial sale of marijuana to consumers on January 1, 2014. What: A person must be 21 years of age and older to buy or use marijuana and can possess up to one ounce of marijuana at a time. This means: It’s a felony to sell, give or share marijuana with anyone under 21. Legal charges and fines may result if anyone 21 and up has more than 1 ounce o marijuana. So what: In 2016, Colorado’s recreational cannabis tax rate is 29%, dropping to 27% in July 2017. The medical rate will stay at 2.9%. In 2015, the state raked in US$113 million with $140 million in cannabis tax anticipated in 2016.
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throughout the country, and it should be easy to join the conversation and soak it all in, he says. “It’s pretty exciting, actually. It’s a bit like the gold rush.” And when the claims start rolling in, Wallace suggests adjusters learn the regulations—fast. “The fi st thing the adjuster should do is really check the licenses closely, especially with the new legislation.” He notes that rules are strict about the locations—not too close to schools or daycares—and the number of allowed plants, and so on. Nash points out that adjusters will need to learn to asses the monetary value of lost product and live plants and equipment in claims where the insureds were growing their own.
Issues to be ironed out Getting the legalization legislation passed and implemented is not going to be a “quick slam-dunk” for the Trudeau government, Nash says. The legislation is scheduled for introduction in 2017, but he figu es it won’t pass before 2018. There are many issues to be sorted out, from dealing with international treaties that require Canada to criminalize the production, sale and possession of cannabis for non-medical use, to the parameters of allowable use, to the distribution system. The latter question requires the involvement of all the provinces and territories, as each must implement its own system. There are also dozens of interested stakeholder groups the government must listen to before it moves forward. To that end the federal Task Force on Marijuana Legalization and Regulation is scheduled to report in November, and its recommendations will form the basis for government action going forward. As the government plants the seeds of this leafy legislation, now is a great time for adjusters to cultivate their knowledge of Cannabis in Canada. Get the straight dope on doob, and get ready for reefer madness. • More information: Steven Wallace is offering a webinar through the IIC on December 8, 2016, for example, for those curious about the future. Health Canada: http://tinyurl.com/ HCMJ-Resources Federal Task Force: http://tinyurl.com/ MJ-TaskForce
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• spotlight S A Minor Adjustment
New name, same service for T&L Adjusters BY EMILY ATKINS
A ‘Mom & Pop’ atmosphere “Over the years we’ve maintained a ‘Mom and Pop” atmosphere,” he says. 20 Claims Canada
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“We’ve always maintained that boutique feel. We’ve got a really good client base that we work with and some of them have been with us since the doors opened back in 1980. We’ve had relationships with some of those clients for 35 years now.” The longevity of those relationships is testament to the service ethic at T&L. Zambo is certain the company’s success is due to the work staff do to keep client relations strong.
We’ve got a “really good client
base that we work with and some of them have been with us since the doors opened back in 1980.
hanging a company name can be risky, but for T&L Adjusters it was simply a matter of formalizing what everybody called them anyway. The company, formerly known as Townsend & Leedham Adjusters, is based in Edmonton, Alberta, and in addition to changing its name also moved to a new location in 2015. Although that’s a fair bit of upheaval, it’s not the first name change for the firm, which was started in 1980 as Dobie Townsend Adjusters Ltd by partners Dave Dobie and Bud Townsend. When Dobie retired in 1991, the name became Townsend & Leedham Adjusters Ltd, reflecting the two partners at the time, Townsend and Mike Leedham. In 2010 Townsend retired, and now Leedham has given up his partnership and is trying to work less, although “that’s difficult as he’s in so much demand”, says Chris Zambo, the company’s current managing partner. There are six partners with equal stake in the firm now, Zambo says. They are Morris Blatz, Dean D’Agostini, Cory Gilliam, Blair Richmond, Chris Twardzik, and Zambo himself. T&L considers itself a boutique firm even though it has expanded from the original partners to the current staff of 18 adjusters. They manage T&L’s files on automotive and property/liability claims, spanning the province of Alberta. They are split, with 11 working automotive and seven on property, although Zambo notes “there are a few people that will walk in both worlds,” with the expertise to cross over when needed.
“It’s something that we’ve worked hard to maintain over the years. I think it’s something you always have to work hard to maintain, but it’s those relationships that I think have made us as successful as we’ve become.”
What makes a good adjuster Ultimately the company’s success comes down to the people who work there, and Zambo readily identifies the qualities those people need to have. Energetic and curious are the first two words he mentions, but those are just the prerequisites. “You can teach anybody to investigate a loss, to take a statement from someone. There are spreadsheets and there are ques-
tionnaires that someone can go through,” he asserts. “But a good adjuster, an experienced adjuster, is someone who will go through a statement with an insured or a claimant for instance, and be aware of any inconsistencies, red flags that pop up that require further investigation. “If somebody just answers questions one through twenty-six, that’s not really what we’re looking for. I’m looking for somebody who’s going to dig a little deeper and get to the reasons behind the claim, and find out what really happened. A good adjuster is somebody who looks at a situation and asks questions and wants to understand why and how things happened.”
Diversification Although the firm has already been through signifi ant changes with the move and name change in the past couple years, the leadership team has its sights set on a few plans. Primarily, Zambo says, they are looking to deepen their relationships with some of less traditional partners within the insurance business. “We always work to maintain a relationship with our clients, but that has changed over the years just by the fact that claims have been relatively hard to come by over the past few years,” he says. “So we find ourselves talking to organizations that we haven’t spoken with before, specifi ally the broker community. And we’re finding that the brokers, in many cases, take an active role in the claims of their clients. They’re looking for information, they’re looking for guidance.” He says that they are getting a good response to this initiative, and it has fostered some strong relationships with the broker community. “We can assist them on behalf on their clients. Sometimes www.claimscanada.ca
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Seated, from left to right: Dean D’Agostini, Blair Richmond, Morris Blatz. Standing, from left to right: Chris Zambo, Cory Gilliam, Chris Twardzik
clients are just looking for some, some information about claims. Those are services we can offer outside the traditional insurance company relationship that we fostered in the past.”
A bigger community For T&L Adjusters the CIAA is key to gaining information about what’s going on in the claims world. “The biggest benefit for us is sharing information, being part of a larger collective,” Zambo says. “I think sometimes we get the impression that we’re out here alone doing what we do. But getting together as a group with other like-minded individuals and similar organizations, you realize that many of them face the same type of challenges that we face on a daily basis.” Zambo says it’s not uncommon to get a call from another adjuster or even someone on the insurer side “asking to run a scenario by, just to see what your thoughts might be with respect to some aspect of a claim. In the end we’re all working towards a common goal; sure there’s comwww.claimscanada.ca
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petition there but I don’t think it has to be to the point where we’re trying to run anybody out of business. I certainly know that’s not our intent. So we share information together.” He credits the association for making a lot of this collaboration possible, as “an organization that’s looking to better the industry as a whole.” To that end he also notes that in Alberta the association was recently asked by the government to offer comments and suggestions on a review of the automobile accident benefits policy. “I’m impressed with the fact that the government asked the CIAA for their thoughts on something as important as coverage under the auto policy,” he notes.
Weather permitting In conclusion, Zambo returned to the true key to his company’s success. Because the adjusting business depends so much on outside factors, with weatherrelated events determining the business cycle—especially in Alberta—Zambo believes that success really does come back
to ensuring the company has the right people “with experience and good work ethic, they’re the ones that are important in our industry.” And he counts on his people to foster and maintain great relationships with their clients. “We truly live by those commitments. We fostered those relationships over years to the point where there has to be a certain amount of trust between us; they have to have the confidence that we have their best interests in heart, that we’re going to do a proper investigation, a proper coverage review, a proper assessment of the claim and the quantum associated with it, and that doesn’t come overnight,” he says. That trust has to be fostered over many years and it’s something that T&L takes great pride in. And the customers have followed through changes to the company name and location. “That gives us the comfort level to work with our clients and I think it gives them the comfort to know that their claim is in good hands,” Zambo concludes. •
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How to Be Ready for Make or Break Claim Moments BY DARA BANGA, FCIP, CFEI
Last May, someone in remote Alberta started a wildfire that swept through Fort McMurray, took out the power grid, destroyed more than 2,000 homes, traveled 590,000 hectares to Saskatchewan, halted regional oil production, and raged for roughly three months before being brought under control. According to CBC News, the Fort McMurray fire was by far the costliest disaster in Canadian history. During its first month, it was projected to cost insurers $9 billion, and had already displaced 80 thousand people. This tragic event serves as important reminder of the need for on-call adjusting expertise to extend your team. In the aftermath of such a disaster, claims volume swells rapidly, ballooning as if to burst. The onslaught is too much for in-house adjusters. When disaster strikes, you need a pool of on-call independent adjusters to manage the overflow. That said, you can’t settle for just any independent adjusting firm. You need more than warm bodies to put your best foot forward. After all, this is a make or break moment for your company. Many policyholders have been paying their insurance premiums for years based on the blind faith that you’ll be there for them in moments such as this. This is no time for a mediocre performance. Now is the time to live up to the marketing promises. 22 Claims Canada
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Your on-call independent adjusting firm should prescreened, vetted, and used even in routine times so the process of working together is well-known before disaster strikes. What should you look for, other than claims adjusting experience? Insist on the five essential qualities below to ensure you’re putting your best foot forward.
1. Responsiveness Your independent claims adjusting firm should be able to act within 24 hours’ notice or less. The firm should have an airtight method of receiving and responding to after-hours claims. Look for firms that use an answering service combined with a consistent on-call adjuster process. In addition, choose a firm with geographic spread across multiple cities. This ensures that a qualified adjuster is always within driving distance of the claim location. Furthermore, the firm should make contact with the insured immediately using a variety of communication methods – from text messages, to email and phone calls. If possible, information about what to expect should be conveyed in advance of the adjuster’s arrival on site. This helps manage expectations and make the first on-site visit more productive.
2. Empathy Insurance adjusters—especially CAT adjusters—aren’t just number-crunchers. They interface with human beings
who may have just experienced a traumatic, possibly heartbreaking event. While on paper the adjuster’s job is to investigate circumstances and damages, take statements, determine the amount of loss, negotiate settlements and prepare reports, their interpersonal duties are no less vital. “As first responders, CAT adjusters witness emotional and physical disaster in a way few of us can imagine,” said Eric Gilkey at Claims Management. “They find insureds at their worst, pick them up, and then come back for more.” Make sure your independent adjusting firm hires experienced individuals who have worked disasters in the past, and know how to interface with people in crisis. Look for adjusters who know how to relate to others, diffuse stressful situations and instill calm and hope in the face of chaos.
3. Extraordinary Service Forty-one percent of policyholders are likely to switch insurers within 12 months of filing a claim, according to Accenture, which surveyed 8,000 auto and home insurance customers across 14 countries. Interestingly, attrition happened even among customers who were satisfied with the way their claim was handled. Those who filed a claim were nearly twice as likely to switch insurers than those who didn’t. This isn’t to say that policyholders will inevitably jump ship after a disaster, and www.claimscanada.ca
2016-10-26 4:41 PM
there’s nothing you can do about it. Rather, it’s to inspire a higher level of customer care. To increase retention during a time of crisis, when the glue between insurer and insured has become more fragile than ever, it’s not enough to provide sufficient service. To maintain the relationship, service must be excellent. Your claims adjusting firm should not only meet the bar for policyholder service, but raise it. Look for a firm that proactively measures customer satisfaction. Adjusters should know the vital role they play in customer retention and embrace the opportunity to represent you well.
need to have real-time information from your claims adjusting firm, so you can provide up-to-the-minute information to your policyholders.
Understanding the Grave Importance of the Work to Be Done
be needed. To achieve these goals, you need to be ready with more than a few extra adjusters – you need a highly professional independent adjusting firm with experienced adjusters who appreciate the grave importance of the work to be done. Start recruiting now before the next Fort McMurray. •
If you’re in Manitoba, this is considered an automobile.
What we’re really talking about here is performing when it matters most. We’re talking about rising to the occasion when disaster strikes, and being prepared even when we have no idea that we’re about to
Dara Banga, FCIP, CFEI, is the President of DSB Claims, headquartered in Brampton, ON.
Surprised? ARC isn’t.
Claims must be handled as promptly as possible; that’s critical. Moreover, the policyholder must feel confi ent that they’re in capable hands, that their point of contact is trustworthy and profi ient. Policyholder satisfaction cannot emerge without clear communication and a sense of partnership between insurer and insured, however. With this goal in mind, your independent adjusting firm should be skilled at outlining and communicating next steps and following through judiciously. At any given time, policyholders must have the sense that things are moving forward. When claim recovery stagnates, policyholder satisfaction takes a nosedive. Ambiguity leads to unhappiness. Therefore, your independent adjusting firm should have a proactive method for keeping insureds informed at every step of the process.
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5. Transparency Accenture also found that process transparency played an important role in shaping customer loyalty following a claim; in fact, 94 percent of those surveyed considered it “a key expectation.” An additional 90 percent said it was important as well to be able to contact their insurer at any time to check the status of their claim in real time. Sixty-one percent said they preferred digital channels for that purpose. More than half (53 percent) said they would not recommend an insurer to friends and family if digital channels were not available. In fact, 44 percent said they would switch insurers themselves in the absence of a digital channel. Clearly, electronic files are a necessity Network of Independent Law Firms forA National any insurance adjusting firm doing business in the twenty-first century. You
ARC Group Canada is a national network of independent law firms, each intimately connected to their local market. Insurance and risk management experts. Regional strength. National scope. Go to AskARC.com
The ARC Legal Reporter Winter Issue – Article #1 A National Network of Independent Law Firms
When is a medical examination considered a second examination under Rule 36 of the New Brunswick Rules of Court?
The ARC Legal Reporter v. Crowther and Kelly Case: Winter IssueReported – Article #1 Blyth 2009 NBCA 80 Citation: At Issue:
When both the plaintiff’s physical and mental condition are in issue in an action, and the plaintiff undergoes a physical examination, will a subsequent application for a psychiatric examination be considered an application for a second medical examination?
When is a medical examination considered a second examination Should medical examinations that are ordered as part of the discovery process be characterized as ‘independent’ medical examinations? under Rule 36 of the New Brunswick Rules of The Court? www.claimscanada.ca October/November 2016 Claims Canada 23 Court of Appeal of New Brunswick Court: ARC_Fleet ad_1/2 page.indd 1
Reported Case: Citation: At Issue:
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Judgment Rendered: Factual Summary:
October 13, 2009 (Reasons delivered November 2015-02-14 26, 2009) 1:05 PM The plaintiff suffered injuries in a motor vehicle accident and commenced an action seeking damages. Both the plaintiff’s physical state and mental state were in issue in the action. The plaintiff submitted to a physical examination by the defendant’s expert, but subsequently refused to submit to a psychiatric examination.
Blyth v. Crowther and Kelly 2009 NBCA 80 When both the plaintiff’s physical and mental condition are in issue in an action, and The adefendant made a motion requesting an order2016-10-26 that the plaintiff to the the plaintiff undergoes a physical examination, will a subsequent application for 4:41 submit PM
psychiatric examination. The motions judge granted the order. The plaintiff appealed,
Donoghue v. Stevenson
How a snail in a bottle helped set the precedent of negligence and the duty of care BY ROCCO NEGLIA
As we approach the 85th anniversary of arguably the most influential decision in the history of the law of torts, we should refl ct on the groundbreaking precedent the British House of Lords established on May 26, 1932, in the case of Donoghue v. Stevenson. Canadian jurist A.M. Linden described Donoghue v. Stevenson as “a seed of an oak tree, a source of inspiration, a beacon of hope, a fountain of sparkling wisdom, a skyrocket bursting in the midnight sky.” Sometimes referred to as the “snail in the bottle” case, the incident dates back to August 1928 when the plaintiff, Mrs. Donoghue, and her friend were in a café in Paisley, Scotland. Donoghue’s friend purchased a ginger beer manufactured by Mr. Stevenson that came in a dark opaque glass bottle sealed with a metal cap and bearing the Stevenson label. The café owner poured the ginger beer into a tumbler for Donoghue. A while later when her friend was replenishing Donoghue’s tumbler, a decomposed snail poured out of the ginger beer bottle, sending Mrs. Donoghue 24 Claims Canada
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into shock. She also contracted severe gastroenteritis. Donoghue sought £500 in damages from Stevenson for shock and gastroenteritis that she believed were caused by the incident. The case found its way to the House of Lords to decide if a duty of care existed. In May 1932, the Law Lords issued their judgement. By a majority of three to two, the Law Lords agreed that Donoghue was owed a duty of care under what became known as the “neighbour principle” and that she could bring an action against Stevenson. Donoghue faced legal hurdles before getting her favourable decision. Weeks before she took action against Stevenson, the very same court had decided on two similar cases contrary to her position. In Mullen v. AG Barr & Company and Oribine v. Barr & Company, Mrs. Mullen purchased a ginger beer from a retailer. The product was manufactured in Scotland by Barr & Company. The ginger beer was also sold in a dark glass bottle. Mrs. Mullen took home the bottle of ginger beer and her two children drank the contents, after which a dead mouse was noticed at the bottom of the
bottle. The children took ill as a result of consuming the bottle’s contaminated contents. The Mullens brought an action against the manufacturer, seeking £75 in damages for each child. The suit was dismissed against Barr & Company. The Mullens appealed to the Court of Session. During the same period, Mrs. Oribine’s son purchased a ginger beer for her, which was also manufactured by Barr & Company and sold in a dark glass bottle. After consuming part of the contents, Mrs. Oribine noticed a dead mouse in the bottle. She too became ill, and brought an action against the manufacturer. Unlike the Mullen’s case, Mrs. Oribine was successful in her suit. The manufacturer appealed to the Court of Session. Both appeals were consolidated and heard at the same time in March 1929. The plaintiffs in both cases were not successful. The Court held that negligence had to be proven. The facts that mice were in the bottle did not in and of itself prove negligence, meaning negligence cannot be inferred since the Court concluded that the manufacturer had an industryleading bottle cleaning system. The www.claimscanada.ca
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Court went further by stating that even if the plaintiffs had established negligence on the part of the manufacturer, no duty was owed to the Mullen children or to Mrs. Oribine, as neither party had purchased the ginger beer. The other challenge the Donoghue suit had to overcome was Winterbottom v Wright—the leading case in product liability at the time—involving a mail driver who was injured while driving a coach owned by the defendant. The plaintiff ’s employer had a contract with the defendant to provide horses and drivers. The plaintiff was not successful against the defendant, even though the defendant provided a faulty coach. The Court found there was no duty outside a contract owed to the plaintiff. In other words, there was no contractual privity between the parties. In referencing Principles of Law of Negligence, published in 1889, Matthew Chapman in his book, The Snail and the Ginger Beer: The Singular Case of Donoghue v Stevenson, notes that at the time there were 56 different duties of care which had previously been recognized. It is this legal context that makes Donoghue such a pivotal case in the historical evolution of the tort of negligence. There are predominately two legal issues that emerge from analyzing the Donoghue case. The fi st involves whether a manufacturer of products is liable in negligence for damages suffered by a consumer with whom it had no direct relationship. In a threeto-two majority decision, the House of Lords answered this in the affirmative, which overturned the decision of Winterbottom v Wright, i.e. an action can only arise within the confi es of a contract. As a result of Donoghue, the law of negligence in the area of product liability established that negligent manufacturers owe a duty of care to all foreseeable consumers. A secondary legal issue in Donoghue was the development of the ‘neighbour principle’ as a means of dealing with the general duty of care. The combination of the primary issue (does a manufacturer owe a duty to the ultimate consumer? ) coupled with the secondary issue (situation-to-situation www.claimscanada.ca
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versus a general approach to the duty of care) is what defi es Donoghue as a foundational case in the history of negligence. It took some 30 years for Donoghue to gain traction as a viable principle in establishing the applicability of the duty of care. Donoghue also brought in similar adaptability of the neighbour principle to other Common Law jurisdictions. In Canada, the current approach, established in Cooper v Hobart
 3 SCR 537, states that if a case falls within a previously recognized duty, a prima facie duty is found. And so viva Donoghue, 85 years later the neighbour principle continues to play a defini g role on our conduct as we go about our daily activities. • Rocco Neglia is Vice-President, Claims at Economical Insurance, and current LLM student.
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The Scope of an Insurer’s Duty to Defend an Additional Insured BY MICHAEL S. TEITELBAUM
Two recent Ontario Court of Appeal decisions have, to a considerable extent, clarifi d the obligations of an insurer that has agreed to provide liability coverage to persons or entities as additional insureds. In Carneiro v Durham (Regional Municipality), 2015 ONCA 909, which involved a winter maintenance contract, the Court reversed a motion judge’s decision limiting an additional insured’s right to a defence. Instead, the Court found that the insurer is obligated to provide a full defence to the additional insured. Although some of the plaintiffs’ allegations against the additional insured fell beyond the scope of the insurance policy’s coverage, the insurer was still responsible for defending from the outset, and providing independent counsel to the additional insured. The allocation of costs attributable solely to the defence of uncovered claims, or that exceed the reasonable costs of the defence of the covered claims, are to be addressed at the end of the proceedings. And, in Seidel v. Markham (Town), 2016 ONCA 306, another winter maintenance contract scenario, the Court of Appeal set aside the motion judge’s decision, and found an agreement had been reached regarding the defence and indemnity of an additional insured, Markham, in a slip and fall action. The reasons set out the three options available to the insurers of an additional insured; either refuse to defend and indemnify, agree to defend but not indemnify because coverage is only for the insured contractor’s negligence, and defend the insured and additional insured separately, or agree to both defend and indemnify. The Court found that because the same defence counsel represented both the additional insured and the insured after the agreement was reached, this indicated that the insurer had agreed to both defend and 26 Claims Canada
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indemnify notwithstanding the nature of the policy coverage. Th s article focuses on the Carneiro decision.
Background On February 8, 2013, Antonio Carneiro Jr. (“Antonio”) died as a result of a motor vehicle accident on Brock Road in the Regional Municipality of Durham. During a heavy snowfall, Antonio’s car slid on a patch of ice, he lost control, and slid down a hill into oncoming traffic The plaintiffs Carneiro’s family, sued, among others, Miller Maintenance Limited (“Miller”) and the Regional Municipality of Durham (“Durham”). Durham and Miller also crossclaimed against each other. Miller was contracted by Durham to perform the plowing, sanding and salting of the area where the accident took place. The contract required Miller to obtain an insurance policy for third party Bodily Injury and Property Damage liability in the amount of $5,000,000, and to name Durham as an additional insured “in respect of all operations performed by or on behalf of ” Miller. That policy was issued by Zurich. The contract also limited Miller’s indemnity obligations to Durham by stating that it would not fully indemnify and save harmless Durham if the damages were caused by the negligence of Durham or its employees. By way of a third party claim, Durham sought a declaration that Zurich had a duty to defend Durham in the action, to pay for Durham’s counsel of choice, and to indemnify it for any amounts for which Durham may be found liable to the plaintiffs
Durham’s Position Durham argued that because the plaintiff ’ claims alleged a failure of Durham to remove snow and/or ice from where the accident occurred, Zurich’s policy should protect Durham as this type of work fell within the mandate of Durham and Miller’s contract. Alternatively, Durham argued that the allegations of negligence not covered by
Zurich are so intertwined with the allegations of negligence against Miller that it would be impossible to parse out the costs of defending the covered claims versus the uncovered claims. Furthermore, because the agreement of indemnifi ation between Durham and Zurich was in dispute, Zurich had a confli t of interest and Durham would require its own counsel to defend the main action. If the plaintiffs demonstrated that their damages were caused by Durham’s negligent acts alone, then Zurich would not have to cover Durham. As a result, Durham alleged that Zurich had an incentive to favour one defendant over another.
Zurich’s Position Zurich asserted it did not have a duty to defend Durham because some of the allegations of negligence against Durham were beyond the scope of the policy. Although Zurich acknowledged that some claims against Durham were covered by the policy, Zurich argued that by defending Miller, Zurich was, by extension, protecting Durham from those claims simultaneously. Thus, Zurich submitted that Durham must defend against all claims on its own accord; the allocation of defence costs would ultimately be decided at a future time—should the need to do so arise.
Ontario Superior Court’s Decision In reviewing the plaintiff ’ claims, Justice Lemon found that he could not determine from the pleadings what the “true nature” of the action was. Nonetheless, some of the plaintiff ’ claims clearly fell beyond the scope of Zurich’s policy. These allegations, some of which pre-dated Miller’s involvement, were independent claims, and did not obligate Zurich to defend Durham. In quoting Justice McLachlan (as she then was) in Nichols v. American Home Assurance,  1 SCR 801, Justice Lemon found that to the extent the claims overlap, Zurich should not be defending a position that was not in their best interwww.claimscanada.ca
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ests. Thus, the insurer should defend only those claims that potentially fell under the policy, while the insured should obtain its own counsel for claims that clearly fell beyond the policy’s terms. As far as defence costs were concerned, if Miller were found liable, and Durham not, then Zurich would be required to compensate Durham for the complete costs of defending the action. Therefore, Justice Lemon ordered Zurich to only defend Durham in respect of those claims involving Miller, leaving Durham’s own counsel to defend all other causes alleged in the Claim.
Issues on Appeal The principal issue was whether the motion judge erred in dismissing Durham’s motion for an order requiring Zurich to defend the claims made against Durham. A secondary issue was whether Zurich needed to pay for Durham’s defence costs from the outset, or at the end of the proceedings after liability was addressed.
The Ontario Court of Appeal’s Decision The Court determined that Zurich was obligated to pay the reasonable costs for Durham’s defence of covered claims, even if it incidentally furthered Durham’s defence of uncovered claims. Ultimately, Durham will have to pay for the costs of defending any claims not covered by the policy. However, because of its “unqualifi d contractual undertaking to defend Durham”, Zurich would have to pay for all the defence costs from the outset and wait until the end of the proceedings to determine the appropriate apportionment of defence costs. Further, because of the confli t between the interests of Durham and Miller, and Durham and Zurich, Durham is entitled to independent counsel at Zurich’s expense. The Court outlined its conclusions with five concise points: First, the allegations trigger Zurich’s duty to defend Durham. As was clearly stated in the Supreme Court of Canada’s decision in Monenco v. Commonwealth, 2001 SCC 49, the mere possibility that a claim may fall within the policy was sufficie t to trigger the duty to defend. The pleas directly related to Miller’s obligations under the contract, thereby engaging Zurich’s duty to defend Durham. Second, Zurich’s duty to defend Durham was an unqualifi d obligation requiring Zurich to defend the action not just the covered claims. The Ontario Court of www.claimscanada.ca
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Appeal in Hanis v. Teevan, 2008 ONCA 678, addressed a similar situation and stated that the insurer must pay all reasonable costs associated with the defence of claims that fall under the policy, even if those costs further the defence of the uncovered claims. The insured only has to cover costs solely associated with the defence of claims not covered by the policy. Thi d, Zurich’s argument that by defending Miller, Zurich was satisfying its obligation to defend Durham, has been rejected by the Court in prior cases. To accept this would be to render Durham’s independent rights as an additional insured meaningless.
The Court also reiterated that the defence duty must be determined expeditiously on the basis of the allegations in the underlying litigation read with the insurance coverage.
Fourth, the motion judge inappropriately gave preference to Zurich’s interests over Durham’s. By deciding it was not in Zurich’s best interests to defend Miller when both insured and uninsured claims existed, the motion judge disregarded Zurich’s contractual duty to defend Durham. Finally, the contract promised Durham a defence, and Zurich must abide by that contractual pledge from the outset. It was irrelevant that Durham might be able to eventually recover costs at the end of the proceedings if it was not found liable. The duty to defend is a separate contractual obligation, and would be “hollow” if the only obligation is to indemnify an insured at the end of the day. In conclusion, the Court ordered Zurich to defend Durham, to provide Durham with independent counsel at Zurich’s expense, and to reimburse Durham for reasonable defence costs incurred to date. However, at the end of the proceedings,
Zurich is entitled to seek an apportionment of the defence costs to the extent they dealt solely with uncovered claims, or exceed the reasonable costs associated with the defence of the covered claims. The Court also reiterated that the defence duty must be determined expeditiously on the basis of the allegations in the underlying litigation read with the insurance coverage.
Commentary Th Carneiro decision appears to have defin tively determined what the defence obligations are of an insurer that has afforded additional insured coverage. However, arguably, an issue still remains. If Durham had its own insurance, and was being defended by its own insurer until a defence was sought from Zurich, then there may have been two competing primary policies, with the obligations of each to be determined by the Supreme Court of Canada’s Family v. Lombard decision. Subject to this, and without making a distinction between defence duty cases in which coverage is for the insured directly, compared to an additional insured, the Court is defin tive in saying that if one is insured as an additional insured under a policy, and some of the allegations attract a defence obligation, then a full defence must be provided, with the obligation to do so expeditiously, subject to the potential for allocation of defence costs that are not covered under the “additional insured coverage” policy. Further, given the allocation issue, and although it is independent counsel who is defending the additional insured, one presumes that the insurer should be able to ask that detailed dockets be kept of what was being done so that allocation can be more easily addressed at the end of the litigation. Where there are two competing insurers, each with a defence obligation, there may be other possible avenues in terms of the provision of a defence, (particularly if we are correct about determining overlapping coverage), but this will be for another day. • 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. Many thanks to Adon Moss, a studentat-law with Hughes Amys LLP’s Toronto office during the 2015-16 articling term, for his excellent assistance in the preparation of this article.
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• on the scene OTS The Canadian Independent Adjusters’ Association is pleased to announce that Heather Matthews, CIP, CRM, CIOP was inaugurated as the association’s 32nd president. Matthews assumed the role from outgoing president, Fred Plant, during the CIAA Annual Conference held September 22 – 25, 2016 in St. AnHeather Matthews drews, New Brunswick. “My involvement in CIAA has been a fast initiation and thanks to such a dedicated executive team and the confidence of the membership I look forward to advancing the key strategic initiatives necessary for CIAA’s continued relevance and stature in today’s marketplace” Matthews said during the annual General Meeting. “Heather is dedicated to the advancement and promotion of the Independent Loss Adjusting profession and she holds CIAA’s culture of fostering cooperation and collaboration in the highest regard. Under her capable leadership the Association looks forward to fulfilling the changing needs of the adjusting community” said Patricia Battle, Executive Director. Matthews’ affinity with the loss adjusting profession began in 1984 and today she is Senior Vice President National Claims Management Centre, Crawford & Company (Canada) Inc. ●
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Deborah Sherren has been appointed senior casualty claims adjuster at Vericlaim Canada. Deborah is now fully managing all lines of casualty claims, accident benefits and bodily injury claims for commercial and personal lines, as well as municipal accident benefits claims. She provides unique specialization in Ontario accident benefits and meDeborah Sherren diations/arbitration. Having worked in the industry since 1990, Deborah brings depth of experience in accident benefits and municipal liability claims for large claims and insurance organizations. Her previous responsibilities included developing training materials for catastrophic claims management, conducting claims investigations and subrogation, and mentoring junior staff. Deborah also has served as a rehabilitation consultant, and provided on-site workers’ compensation consulting for the Ford Motor Company. Deborah is a 2013 CIP graduate of The Insurance Institute. She also completed interdisciplinary training courses at Seneca College and Sheridan College. ●
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SCM Health Solutions, a provider of Independent Medical Evaluations and related services, appointed Jennifer Foster, BA, MBA, PMP, as Chief Operating Officer (COO), effective September 6th, 2016. Jennifer works closely with SCM Health Solutions’s leadership and management teams across the country. A seasoned operationJennifer Foster al leader who is both Six-Sigma Black Belt and LEAN certified, Jennifer gained extensive expertise from her work in a variety of roles. She previously held the position of Interim Chief Operating Officer for Hannam Fertility Centre, served as Executive Director, Client Experience and Outcomes for Toronto Central Community Care Access Centre, and was Executive Director, Patient Safety, Quality, Risk & Medical Ethics for Kingston General Hospital. Her work in the medical services industry began with Johnson & Johnson Medical Products, where she held the position as Vice President, Operations, and Chief Information Officer. Jennifer is based out of SCM Health Solutions’ Head Office in Mississauga, Ontario. ●
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EFI Global is pleased to announce the official opening of their newest office in Moncton, New Brunswick, effective July 15, 2016, led by Bryan Wattie, BEng, EIT. Bryan is a junior engineer with a Master’s degree in Bioresource Engineering. His MSc work included modification and characterization of natural fibres for oil absorption, with an academic background in a number of environmental disciplines such as environmental assessments, remediation, hydrology and frameworks for sustainable engineering. For the past eight months, he has been working in New Brunswick and has a good understanding of the regulatory process as well as practical experience in field response work including transportation and property related spills, initial containment, prevention/mitigation of adverse impact to sensitive receptors and remediation of impacted soil/groundwater and restoration of impacted sites. Formerly with EFI Global’s Montreal operations, he is bilingual in both English and French. ●
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: firstname.lastname@example.org
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• on the scene OTS
The Canadian Independent Adjusters’ Association is pleased to announce their newly elected Executive for the 2016 – 2017 term. Heather Matthews, CIP, CRM, CIOP was inaugurated as the association’s 32nd President taking over from outgoing President, Fred Plant, AIIC during the CIAA Annual Conference held September 22 – 25, 2016 in St. Andrews, New Brunswick. Pictured from L – R: Front row: John Seyler, Treasurer; Monica Kuzyk, 1st Vice President; Heather Matthews, President; Lee Powell, 2nd Vice President; Jeff Edge, Secretary Back row: Fred Plant, Immediate Past President; Gary Ellis, Director; Jim Eso, Director; Marie Gallagher, Director; Patricia Battle, Executive Director; Lorri Frederick, Director; Grant King, Director; Paul Féron, Director Absent: Albert Poon, Director; Craig Walker, Director CIAA is the national voice of Independent Adjusters in Canada, providing leadership through advocacy, education and recognized professional standards. ●
Albert Poon, President, Cunningham Lindsey Canada Claims Services Ltd (“CLC”) announced Katherine Hanratty, MBA, has joined CLC as Chief Operating Officer. Katherine will be providing leadership to the Canadian operations in addition to developing and executing corporate strategic initiatives. “I know I speak Katherine Hanratty on behalf of everyone here at CLC that we look forward to working with Katherine and supporting her in this important role,“ Albert said. “Katherine is a dynamic and respected leader with extensive experience of the insurance industry and brings with her a strong operational background that will allow us to strategically grow across all of our service lines.” Katherine has over 20 years of experience across all core insurance functions. She has held a number of senior level positions with prominent Canadian insurance carriers and has earned her Executive MBA from Rotman School of Management, University of Toronto. ● 30 Claims Canada
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Vericlaim Canada—a subsidiary of Sedgwick Claims Management Services, Inc., has acquired the assets of RGM Claims Services, Inc., a licensed, independent adjusting company based in Mississauga, Ontario, specializing in municipal, automobile, product and environmental liability, as well as property, casualty and cargo losses. Founded in 2003 by industry veteran Ross Macdonald, RGM is an especially strong player in the Canadian municipality and condominium claims markets. As part of the transaction, Macdonald and his colleagues have joined Vericlaim Canada’s growing team. “Investing in the continued expansion of our Canadian operations with acquisitions like RGM and opening new branch offices in the central and western provinces supports our national development strategy and ensures we are optimally positioned to provide responsive, best-in-class services for customers across Canada,” said Michael Holden, president of Vericlaim Canada. “Together, we can offer unparalleled claims solutions and bring our ‘caring counts’ philosophy to new markets.” “With Sedgwick and Vericlaim’s star on the rise in Canada, it is an especially exciting time for us to join forces,” Macdonald said. “Combining our capabilities and expertise results in one of the strongest adjusting programs in the Canadian market today.” ● ClaimsPro/IndemniPro plans to further strengthen and support its Quebec coverage by making organizational changes within that region. Following recent acquisitions like the integration of Allen & Fugère earlier this year, ClaimsPro/IndemniPro seeks to bolster existing Quebec coverage, unify operations, streamline procedures, simplify regional divisions, and use existing resources more effectively. Effective immediately, the Quebec Region is now divided into two regions, East and West. Leadership changes are as follows: Quebec East includes the following branches and leadership changes: Pierre Boulianne will lead as the Regional Manager of Quebec East. Serge Nadeau is Branch Manager of the Sherbrooke office. Ghyslain Morinville remains Branch Manager of the Trois-Rivières office. The areas in the Quebec East Region are: Québec City, Trois-Rivières, Sherbrooke, Thetford Mines, Saguenay, Baie-Comeau, BasSt-Laurent, Gaspé and Îles-de-la Madeleine. Quebec West includes the following branches and leadership changes: Michel Lacelle will lead as the Regional Manager, Quebec West. Christopher Tirrell is the new Branch Manager for the Montreal and Westmount offices. Michel Malette is Branch Manager of the Gatineau office. The areas included in the Quebec West Region are: Montréal, Westmount, St-Bruno, St-Jérôme, Joliette, Valleyfield Gatineau, Mont-Laurier and Val-D’Or. In addition to the organizational changes resulting from this new structure, ClaimsPro/IndemniPro has announced significant additions to its leadership team. JeanYves Bernier has recently been appointed Regional Vice President, Quebec Specialty Risk Division (SRD). In addition, André Soucisse has also recently joined ClaimsPro/IndemniPro as Vice President, Business Development, Quebec. He will report to Jeff Sutton, ClaimsPro/IndemniPro’s Senior Vice President, Sales. ● www.claimscanada.ca
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CIAA REGIONAL PRESIDENTS 2016 – 2017 NEWFOUNDLAND & LABRADOR TBA
NOVA SCOTIA Michael Connolly, BA, CFEI, CIP ClaimsPro 238 Brownlow Avenue, Suite 300 Dartmouth, NS B3B 1Y2 Phone: (877) 514-6269 Fax: (902) 425-9918 E-mail: email@example.com
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: firstname.lastname@example.org
QUEBEC/AESIQ Michel Lacelle, PAA/CIP ClaimsPro 255 Crémazie Est, 2e étage Montréal, QC H2M 1M2 Phone: (514) 340-8959 Fax: (514) 342-5474 E-mail: email@example.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: firstname.lastname@example.org
MANITOBA Craig Shanks, BA, CIP Wheat City Claims Services Ltd. 64 Regent Cres. Brandon, MB R7B 2W9 Phone: (204) 725-7436 Fax: (204) 725-7437 E-mail: email@example.com
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: firstname.lastname@example.org
WESTERN M. Doreen Lennon, CIP T&L Adjusters Ltd. #309, 5227 55 Avenue NW Edmonton, AB T6B 3V1 Phone: (780) 463-7776 Fax: (780) 462-1280 E-mail: email@example.com
PACIFIC Stacy Phillips, B.Comm., CRM, FCIP ClaimsPro 600, 1111 Melville Street Vancouver, BC V6E 3V6 Phone: (888) 681-6331 Fax: (604) 681-6388 E-mail: firstname.lastname@example.org
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National Standing Committees 2016-2017 ADVISORY Monica Kuzyk, FCIP, CRM Curo Claims Services 125 Northfield D . W., P.O. Box 218 Waterloo, ON N2J 3Z9 Phone: (866) 952-2876 Fax: (519) 888-9704 E-mail: email@example.com Lee Powell 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: firstname.lastname@example.org Fred R. Plant, AIIC ClaimsPro 85 Englehart Street Dieppe, NB E1A 8K2 Phone: (506) 853-8507 Fax: (506) 853-8501 E-mail: email@example.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: firstname.lastname@example.org Lorri Frederick ClaimsPro 120 Adelaide St. W., Suite 2401 Toronto, ON M5H 1T1 Phone: (905) 308-6292 Fax: (416) 360-7335 E-mail: email@example.com James B. Eso, CIP, CIOP Crawford & Company (Canada) Inc. 539 Riverbend Drive Kitchener, ON N2K 3S3 Phone: (519) 578-5540 Fax: (519) 578-2868 E-mail: Jim.Eso@crawco.ca 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 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: firstname.lastname@example.org 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: email@example.com Craig J. Walker, CIP, FCIAA, FIFAA Maltman Group International 2001 Sheppard Ave. East, Suite 810 Toronto, ON M2J 4Z8 Phone: (416) 492-4411 Fax: (416) 492-5657 E-mail: firstname.lastname@example.org CIAA NATIONAL INSURANCE INDUSTRY ADVISORY BOARD Patti M. Kernaghan, FCIP, CRM Kernaghan Adjusters Limited 300 - 1445 West Georgia Street Vancouver, BC V6G 2T3 Phone: 1-800-387-5677 Fax: 1-800-387-5644 E-mail: email@example.com Heather Matthews, CIP, CRM, CIOP 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 D . W., P.O. Box 218 Waterloo, ON N2J 3Z9 Phone: (866) 952-2876 Fax: (519) 888-9704 E-mail: firstname.lastname@example.org
Fred R. Plant, AIIC ClaimsPro 85 Englehart Street Dieppe, NB E1A 8K2 Phone: (506) 853-8507 Fax: (506) 853-8501 E-mail: email@example.com Patricia M. Battle Canadian Independent Adjusters’ Association/L’Association Canadienne des Experts Indépendants Centennial Centre, 5401 Eglinton Ave. West, Suite 100 Etobicoke, ON M9C 5K6 Phone: (416) 621-6222 Toll Free: 1-877-255-5589 Fax: (416) 621-7776 E-mail: firstname.lastname@example.org 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: email@example.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: firstname.lastname@example.org Craig J. Walker, CIP, FCIAA, FIFAA Maltman Group International 2001 Sheppard Ave. East, Suite 810 Toronto, ON M2J 4Z8 Phone: (416) 492-4411 Fax: (416) 492-5657 E-mail: email@example.com Ian Frost, FCIP Wawanesa Mutual Insurance Company 191 Broadway Winnipeg, MB R3C 3P1 Phone: (204) 985-3886 Fax: (204) 942-7724 E-mail: firstname.lastname@example.org Tim Guernsey RSA Canada 18 York Street, Suite 800 Toronto, ON M5J 2T8 Phone: (416) 366-7511 Fax: (416) 367-9869 E-mail: email@example.com 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: firstname.lastname@example.org Glen Hopkinson XL Insurance Company SE 100 Yonge Street, Suite 1200 Toronto, ON M5C 2W1 Phone: (647) 277-8650 E-mail: email@example.com Dan Langer CICMA Ontario Chapter President c/o CIAA 5401 Eglinton Ave. W., Suite 100 Etobicoke, ON M9C 5K6 Phone : (416) 621-6222 Fax : (416) 621-7776 E-mail: firstname.lastname@example.org Justin MacGregor Highgate Insurance Brokers Inc. 151 Rose Glen Rd. Port Hope, ON L1A 3V6 Phone: (905) 885-1551 E-mail: email@example.com Penny McCune, SGI Canada 2260 11th Avenue Regina, SK S4P 0J9 Phone : 844 855-2744 E-mail : firstname.lastname@example.org Alex Walker, CIP Aviva Canada 2206 Eglinton Ave. E. Toronto, ON M1L 4S8 Phone: (866) 692-8482 E-mail: email@example.com
Mark Weir CIAA NIIAB c/o CIAA 5401 Eglinton Ave. W., Suite 100 Etobicoke, ON M9C 5K6 Phone: (416) 621-6222 Fax: (416) 621-7776 E-mail: firstname.lastname@example.org
Heather Matthews, CIP, CRM, CIOP 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
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: email@example.com
Fred R. Plant, AIIC ClaimsPro 85 Englehart Street Dieppe, NB E1A 8K2 Phone: (506) 853-8507 Fax: (506) 853-8501 E-mail: firstname.lastname@example.org
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: email@example.com 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: firstname.lastname@example.org
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, RF Network Adjusters Ltd. 67 Folkestone Blvd. Winnipeg, MB R3P 0B4 Phone: (204) 897-5793 Fax: (204) 897-5797 E-mail: email@example.com
Fred R. Plant, AIIC ClaimsPro 85 Englehart Street Dieppe, NB E1A 8K2 Phone: (506) 853-8507 Fax: (506) 853-8501 E-mail: firstname.lastname@example.org
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: email@example.com
CONSTITUTION & RULES Paul Féron, FCIP, CRM ClaimsPro 210 – 746 Baseline Rd. East London, ON N6C 5Z2 Phone: (519) 645-6500 Fax: (519) 645-2250 E-mail: firstname.lastname@example.org
NOMINATING Fred R. Plant, AIIC ClaimsPro 85 Englehart Street Dieppe, NB E1A 8K2 Phone: (506) 853-8507 Fax: (506) 853-8501 E-mail: email@example.com
Heather Matthews, CIP, CRM, CIOP 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
DESIGNATION/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: firstname.lastname@example.org Robert V. Pearson, CLA, FCIAA CIAA Honorary Life Member c/o CIAA National Offic 5401 Eglinton Ave. W., Suite 100 Etobicoke, ON M9C 5K6 Phone: (416) 621-6222 Fax: (416) 621-7776 E-mail: email@example.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 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: firstname.lastname@example.org 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: email@example.com
Lorri Frederick ClaimsPro 120 Adelaide St. W., Suite 2401 Toronto, ON M5H 1T1 Phone: (905) 308-6292 Fax: (416) 360-7335 E-mail: firstname.lastname@example.org 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 2001 Sheppard Ave. East, Suite 810 Toronto, ON M2J 4Z8 Phone: (416) 492-4411 Fax: (416) 492-5657 E-mail: email@example.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: firstname.lastname@example.org PROFESSIONAL PRACTICES Fred R. Plant, AIIC ClaimsPro 85 Englehart Street Dieppe, NB E1A 8K2 Phone: (506) 853-8507 Fax: (506) 853-8501 E-mail: email@example.com
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The Canadian Independent Adjusters’ Association (CIAA) is a non-profit association representing the collective interests of 1650 members to government, the property & casualty insurance industry, the independent adjusting industry as well as the public on a national level. The CIAA provides members with advocacy, the ability to expand their knowledge through continuing education, professional development and market-leading designation opportunities. CIAA leads in the development of a defined code of ethics and fair practice policies supporting trust and confidence with the public and ensuring the highest quality of work with its stakeholders.
We are currently recruiting for a
Chief Executive Officer (CEO) to join our team.
• Do you have the skills to see what’s next and stay ahead in this fast paced industry?
Leadership • Participate with the Board of Directors in developing a vision and strategic plan to guide the organization. • The Chief Executive Officer, reporting to the Board of Directors, will be responsible for the overall daily operation while ensuring the organization is in line with the mission and values of CIAA • Act as Project Manager of the organization’s strategic plan ensuring successful implementation, execution and evaluation of strategic initiatives • In addition to the Chair of the Board, act as a spokesperson for the organization liaising between members, stakeholders, government and media • Develop a public relations policy ensuring consistency in messaging • Develop and execute all communication initiatives/campaigns including a social media presence promoting the organization and its membership • Identify, assess, and inform the Board of Directors of internal and external issues that affect the organization. • Act as a professional advisor to the Board of Director on all aspects of the organization’s activities. • Foster effective team work between the Board and the CEO and between the CEO and staff. • Conduct official correspondence on behalf of the Board as appropriate and jointly with the Board when appropriate. • Represent the organization at industry activities and on related industry boards to enhance the organization’s industry profile.
Operational planning and management • Develop an operational plan which incorporates goals and objectives that work towards the strategic direction of the organization.
• Are you flexible, able to work with ambiguity, and change ready? • Ensure the operation of the organization meets the expectations of its Members, Board and Stakeholders. • Are you excited about the future and able to • Draft policies for the approval of the Board and prepare procedures drive renewal within an organization?
If this sounds like you, consider joining the CIAA team. As a member of the CIAA team your responsibilities include:
to implement the organizational policies; review existing policies on an annual basis and recommend changes to the Board as appropriate. • Provide support to the Board by preparing meeting agendas and supporting materials.
CIAA is an equal opportunity employer and encourages applications from all qualified individuals.
Program planning and management • Oversee and support the planning, implementation and evaluation of the organization’s programs and services. • Ensure the programs and services offered by the organization contribute to the organization’s mission and refl ct the priorities of the Board. • Oversee the planning, implementation, execution and evaluation of special projects.
Industry relations/advocacy • Communicate with stakeholders to keep them informed of the work of the organization and to identify changes in the industry served by the organization • Establish good working relationships and collaborative arrangements with industry groups, Regulators, Government and other organizations to help achieve the goals of the organization • Act as the organization’s advocate to Government to influence legislation and to Industry on matters impacting the profession • In addition to appearing at offi al events, act as a liaison between the organization and a range of external stakeholders. • Develop relationships with related industry leaders and government cultivating long-term strategic partnerships to increase the organization’s effectiveness and profile
In addition to the above, the following qualifications, experience and skills a e required: • A Bachelor of Arts; Business Degree (B.B.A., B. Comm.); or equivalent insurance designation (CIP, FCIP, CLA, FCLA). • Skilled public speaker • Relationship management capability supported by strong fi ancial acumen • Ability to add value through strong communication and collaboration • Senior leadership experience within the adjusting a/o property casualty insurance industry • Senior leadership role within a not-for profit or for profit organization
If you are interested in this opportunity, please submit your resume in confidence to the Canadian Independent Adjusters’ Association by November 25th, 2016. Canadian Independent Adjusters’ Association 5401 Eglinton Avenue West, Suite 100, Etobicoke, ON M9C 5K6 ATTN: P. Battle Alternatively: E-mail your resume to: firstname.lastname@example.org Website: www.ciaa-adjusters.ca
We thank all applicants for showing an interest; however, only candidates selected for an interview will be contacted.
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â€˘ on the scene OTS To help kick off the 2016 RIMS Canada Conference in Calgary, Sedgwick and Vericlaim hosted their guests at the James Joyce Authentic Irish Pub on September 10th. The drinks were plentiful and the fare was exceptional. The event also provided great networking opportunities. â—?
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FirstOnSite Restoration hosted their annual RIMS Canada ‘Meet & Greet’ cocktail reception on September 11th at Craft Beer Market in downtown Calgary. Guests were treated to great food and cocktails. ●
With over 40 offices on 5 continents, over 30 language fluencies, 18 distinct professional designations and a work history that spans more than 130 countries and 800 industries, we are truly world-class experts with a global reach. To work with a member of our respected team contact any one of our Canadian offices or visit us at mdd.com.
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Charles Sabourin First General North America is pleased to welcome V. Charles Sabourin as Vice President, Business Development. Based in Quebec, Charles will also act as liaison for Quebec and the Maritimes and Atlantic provinces.
• on the scene OTS SCM Insurance Services hosted its annual RIMS Canada Conference ‘Customer Appreciation’ party at the beautiful Teatro Ristorante in Calgary on September 10th. Guests enjoyed a wide selection of cocktails and fine hors d’oeuvres. l
In his role Charles will focus on business development and operations, assist with the implementation of the regional, national and global catastrophe plans and liaise with afﬁliates in Eastern Canada and Quebec. He has experience developing and marketing networks within the disaster restoration industry. Charles also brings operations experience and bilingualism to our team at First General. Charles is a a ChAD certiﬁed trainer for CEC’s and a Certiﬁed Risk Manager from McGill University with a full roster of IICRC courses. He lives in Laval with his wife Germana where he enjoys being outdoors and spending time with his family. Charles’ contact information is: charles.sabourin@ﬁrstgeneral.ca (416)665-6680
First General has been the leading choice for property damage restoration services of insurers, property owners, policyholders and property managers for more than 30 years during times of crisis and insurance claims. With more than 80 ofﬁces across North America, First General Services’ members honour their commitment to you, our customer, because meeting your expectations is what matters.
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2016-10-27 10:09 AM
Cunningham Lindsey Canada held its annual RIMS Canada Conference dinner on September 10th at Murrieta’s Westcoast Grill. Located in downtown Calgary and within the historic Alberta Hotel building (c.1890), guests experienced an evening of fine food, libations and conversation. l Nino Calabrese Xpera, Canada’s leading provider of Risk Mitigation & Investigation is proud to announce that Nino Calabrese has rejoined the fi m as Director of Investigations, Toronto. Mr. Calabrese, who was with Xpera since 1987 under the company’s former name of CKR Global, has returned after a brief sabbatical to oversee day to day operations in Xpera’s Toronto office. A versatile professional, Mr. Calabrese brings over thirty years of experience in both corporate and insurance claims investigations with a reputation for providing exceptional litigation support to the insurance and legal community. A licensed investigator since 1984, Mr. Calabrese is the fi st Canadian to receive the prestigious Dennis A. Noggle Award which is given based upon several factors including response time, method and quality of reporting, fl xibility, and consistent excellence and loyalty. “Xpera is proud to welcome Nino Calabrese back to our team,” states Paul McParlan, Vice President for Xpera Risk Mitigation & Investigation. “Nino’s breadth of experience and extensive expertise help makes our team stronger and affirms Xpera’s position as a leader in our industry.” Nino Calabrese is excited to bring his knowledge and skills back to Xpera Risk Mitigation & Investigation. He can be contacted at email@example.com or by telephone at 416 449 8677.
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â€˘ on the scene OTS As a warm-up for the 2016 RIMS Canada Conference in Calgary, Crawford and Company (Canada) Inc. held their annual RIMS Canada Conference dinner party on September 10th at Market Restaurant. Invited guests enjoyed wonderful food, beverages and industry conversations. â—?
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More than 70 companies and organizations providing products and services to the risk management community filled the Telus Convention Centre Exhibit Hall at the 2016 RIMS Canada Conference in Calgary, held September 11 to 14. â—?
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8/12/16 4:46 3:50PM PM 2016-08-25
Published on Oct 27, 2016
Canada’s national claims and loss adjusting magazine, the official publication of the Canadian Independent Adjusters’ Association.