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Official Journal of the Ontario Insurance Adjusters Association
Vol. 84 • No. 9 • May 2020
Without Prejudice
Follow us on @OIAAOfficial / Find us on / @oiaa_social
Get to know the Northern and Thunder Bay Chapters
The OIAA is a proudsupporter of
An ice breaker on Lake Superior near the Sleeping Giant in Thunder Bay.
Photo courtesy of David Kirychuk, Crawford and Company, Thunder Bay
2
Article #3 Changes
d. Social Members shall be all existing Associate Members holding such designationprior to February 13, 1991 and who continue to retain that designation by paymentof annual renewal dues. Social member shall be defined as an individual who isemployed in the industry with a connection to claims, but not members as definedby the OIAA constitution as set out in the Classification of Membership a, b, c, d,e, f, g. Members shall pay the set membership fee and be required to keep ingood standing. The Social member shall have no voting rights within the OIAAand OIAA chapters, nor are they party to financial information of OIAA or theOIAA chapters. They shall adhere to the governing principles and code of ethics as written in the OIAA Constitution.
f. Retired Members Shall be a retired active member that no longer is employed in the field of adjusting.Retired members have no voting rights.
g. Section 5 – Student Members Shall be students registered and attending an Ontario, post-secondary institutionand be enrolled in a recognized Insurance Program. Student members have novoting rights.
Article #4 ChangesSection 1 b., section 5, shall be removed.
Section 4 shall be replaced with:
Section 4 Social, Retired, Student Memberships
Applicants shall be admitted to Active Membership under the following procedure:a. An application for membership shall be submitted with full information
concerning the applicant upon approved form by the Association;b. The decision to accept or reject a social member shall be determined by
the OIAA Executive Council or the OIAA Chapter Executive for chapter membership.
c. Each application for membership shall be considered by the Executive Council or OIAA Chapter Executive for chapter membership and if passed by a majorityvote of the Executive, such applicant shall be accepted as a member.
d. The approved applicant shall be notified by a member of the executive.
OIAA Constitution ChangesMarch 18, 2020
Stay Connected
3
Official Journal of the Ontario Insurance Adjusters Association Vol. 84 No. 9
May 2020
Regular FeaturesPresident’s Message ......................4
OIAA Executive Council ..............6
Get to Know Your Chapter ....26/34
Out and About .............................52
Final Report ...........................56/58
OIAA Chapter Executive ............60
Advertisers’ Index.......................61
What’s HappeningOIAA Constitution Changes..........................................2
OIAA/CIAA Virtual Seminar Announcement...........24
OIAA Toronto Delegate Election Results ....................28
OIAA 2020 Bursary Announcement...........................29
OIAA Hamilton Chapter COVID Challenge .............32
Calendar of Chapter Events .......................................33
Adjusters’ Training & Education Program.................55
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Visit us at www.oiaa.com
@ OIAAOfficial
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CONTENTS8
18
4636
8
36
46
18
Without Prejudice
SABS Priority Disputes 101: Help!
Recent LAT DecisionsMuddy the IRB Waters
#MeToo in the Claims World
How to Support Clients with Business InterruptionInsurance Claims
4
Leanne B. HardmanPresident, OIAA
President’s Message“Our language has wisely sensed the two sides of being alone. It has created the word loneliness to express the pain of being alone. And ithas created the word solitude to express the glory of being alone.”
Paul Tillich
As I write, we are on day 48 of lockdown by my count. Our world has changedso drastically in such a short period of time. I have spent this time reflecting onwhat was, and how I will move forward after the crisis has passed. I’m excited toreturn to my routine, and have plans for the next few months that I can’t wait toimplement. The solitude has been good for me. I suspect we’ve all taken stock ofwhat’s important and what life will look like for us on the other side of the curve.
The front line workers during this crisis have been nothing short of heroic. Thereare too many to name, we know who they are, and can only imagine what theyhave sacrificed. I’ve asked myself many times if I would knowingly put my life on theline everyday as they have? I hope when this is over they will continue to receive therespect they have garnered during the COVID pandemic. There are no words that I can imagine that could truly convey the gratitude our nation feels for them.
Claims counts are down in my world and we are finding new ways to do busi-ness. Telehealth is our new reality as we endeavor to provide rehabilitative treat-ment to our customers while most clinics are closed during this pandemic. Theresiliency of the Accident Benefits world to respond to meet the needs of ourcustomers in such a short period of time has been fascinating to see! Kudos to our vendors who wasted no time rising to the challenge. Remote workingwhile it appealed to me initially, has become less desirable day by day. I miss thewonderful faces of my team, the conversations, human interaction. While weremain in touch through technology there is something lost in it as well, for howfar we’ve come, there is nothing like being in the company of others.
For those who have suffered loss during this pandemic, my heart and thoughtsgo out to you and your families. I hope you find comfort during this time, andthat we move swiftly over this next phase of the curve, so we may once againcome together and appreciate each other so much more than we ever have.
For the OIAA, much has changed for us this year as well. Our last few meetingshave been through technology, and events that we were looking forward to shar-ing with you cannot occur due to the restrictions in place. We cancelled our AprilSeminar at the Alt Hotel in Mississauga, our June Golf Tournament and the finalmeetings for my term will be held virtually as well. We will bring a virtual seminarto our members in partnership with the CIAA on May 13th in an effort to continueto grow and learn while we respect the distance. You can register to receive thelink for the seminar at www.oiaa.com, see details on page 24. We hope you canjoin us on May 13th and I wish everyone good health as we continue to fightCOVID-19. Stay well, stay positive and respect the distance. We are almost there.
Leanne B. Hardman, BSc.Hons.CIP President, Ontario Insurance Adjusters Association
NEXT MEETING
For more informationplease visit our websitewww.oiaa.com.
Friday, June 5, 2020The OIAA Annual GolfTournamentPostponed until further notice.
Wednesday, May 15, 2020OIAA/CIAA Virtual SeminarBy ZOOMSee page 24 for details.
5
FOR THE MAGAZ INE
JENNIFER BROWNManaging Editor
JOE CUMMINGAssociate Editor
TENA ALLENAdvertising Manager
SARAH GRAVESAssociate Editor/Articles
Official Journal of the Ontario Insurance Adjusters Association
“WP” is published monthly except July and August. Everyreasonable effort is made to ensure accuracy of articles andadvertisements but the Association expressly limits its liabilityto printing of retraction or correction. The opinions expressedin all articles unless otherwise specified represent the viewsof the authors and are not necessarily endorsed by theAssociation, the editorial staff or the Executive Council. Contents of ”WP” are copyrighted and may not be reproducedwithout written consent of the Association.The magazine is distributed free of charge to all active andassociate members of the OIAA. For non-members subscription price: Canada - $75.00 + HST.U.S.A. and other countries - $90.00
For change of address or any enquiries regarding distribution,send address label with updated information to:Jackie Johnston, Business Manager, OIAA, 29 De Jong Drive, Mississauga, Ontario L5M 1B9Tel.: (647) 457-0576 E-mail: [email protected] Website: www.oiaa.com
For information regarding the OIAA Privacy Policy, please refer to our website at www.oiaa.comFor information on advertising specifications, costs, production of ads or ad placement, please contact Jackie Johnston or Tena Allen.For submission of proposed articles please contact Jennifer Brown or Sarah Graves.ISSN 0833-1278 Canada Post Canadian Publications MailSales Product Agreement No. 40064573
CONTR IBUTORS
Adam GianottiRecent LAT Decisions Muddy the IRB Waters (page 18)Adam Gianotti is a senior manager at Davis Martindale. Since 2011,Adam has been providing insurance claim and litigation accounting services to insurers and plaintiff’s counsel across Ontario. Adam hasextensive experience in IRBs and quantifying economic losses. In addition, Adam has presented seminars at various insurance companies and law firms, and presented at the CDL.
Robert Holmes
#MeToo in the Claims World (page 36)Rob Holmes began his career with Crawford in 2008 and joined theNational Global Technical Services team in 2015. Rob specializes in complex sports and recreation liability claims and commercial and professional liability claims. Rob has an honours degree in HumanKinetics and is past president of the Hamilton Chapter of the OIAA.
Tim ZimmermanHow to support clients with business interruption insurance claims (page 46)
Tim Zimmerman is a partner in the litigation and valuation services practice of RSM Canada, a provider of audit, tax and consulting servicesfocused on the middle market.
Jean-Charles Plante
How to support clients with business interruption insurance claims (page 46)
Jean-Charles Plante is a director in the litigation and valuation servicespractice of RSM Canada, a provider of audit, tax and consulting servicesfocused on the middle market.
Daniel StrigbergerSABS Priority Disputes 101: Help! (page 8)The son of a plaintiff lawyer, Dan Strigberger decided early in his careerthat he wanted to work for insurers. He loves coverage. Want to know ifsomething is an “automobile”? Ask Dan. Want to know if a “house” isa “home”? Ask Dan. Want to know the best toppings to cover a pizza?Don’t ask Dan: He can’t eat gluten.
Without Prejudice
6
TENA ALLENWindsor DelegateDesjardins General Insurance Group1-866-688-3888 ext. 6324680FAX: 1-800-403-4457E-mail: [email protected]
OIAA - Executive Council Committees 2019 – 2020COMMITTEE CHAIRPERSON COMMITTEE MEMBERS
BENEVOLENT & COMMUNITYBenevolent and Gifts .............Leanne HardmanJohn E.Lowes - Insurance Institute.....Kyle Case
INDUSTRYLicensing................................Ray ProctorIndustry Liaison ....................Leanne Hardman
ASSOCIATION OPERATIONSChapter Liaison......................Leanne HardmanMembership ...........................Terry Doherty............All DelegatesDiscipline ...............................Michael McLeodConstitution/Incorporation.....Rhu SherrardHandbook...............................Frank Castaldo, Ray ProctorMentoring...............................Kyle Case, Joe Cumming, Laura O'HearnNominating ............................Michael McLeodVendor Relations/Sponsorship...Rhu Sherrard
ENTERTAINMENTPast-Presidents’ Night............Cindy Bridge.............Laura O'Hearn, Chris JoliffeHoliday Party .........................Jennifer Brown ...........Carrie Evans, Cindy BridgeGolf Tournament ...................Matt Rienzo...............John Slattery, Carrie EvansSeptember Kick Off ...............Rhu Sherrard ..............Matt Rienzo, Shawna Gillen
John Slattery, Carrie Evans
COMMITTEE CHAIRPERSON COMMITTEE MEMBERS
COMMUNICATIONSWithout Prejudice Editorial........Jennifer Brown .......Sarah Graves, Joe CummingWithout Prejudice Articles .........Sarah Graves...........Jennifer Brown, Laura O'HearnWP Radio & Digital ...................Terry DohertyAdvertising-Sales - WP, Website, Links
Tena Allen ..............Joe Cumming, Sarah GravesMedia Relations..........................Joe Cumming..........Carrie Evans, Shawna GillenWebsite.......................................Chris Jolliffe ...........Ray Proctor, Kelly Peck-McDonnellSocial Media...............................Shawna Gillen ........Carrie Evans, Joe CummingGTA Membership.......................Shawna Gillen ........Carrie Evans, Matt Rienzo, John Slattery
EDUCATIONSpeakers & Meetings..................Leanne HardmanSeminars and Education .............Carrie Evans ...........Jennifer Brown, Frank CastaldoAdjuster Training-DevelopmentKyle Case................Jennifer BrownStrategic Planning.......................Rhu Sherrard...........Mike Bottan, Kelly Peck-McDonnell
Terry Doherty, Kyle CaseBursary .......................................Mike Bottan ............Kelly Peck-McDonnell
CONFERENCES2020 Claims Conference ............Shawna Gillen ........Tena Allen, Mike Bottan2020 Career Fair @ Claims Conference....Simone Cybulski2019 Provincial Claims Conference (Ottawa/TI)........Terry Doherty .....Cindy Bridge2021 Provincial Claims Conference (TBD)....Ray Proctor
OIAA - Executive Council 2019 – 2020
JOE CUMMINGGeorgian Bay DelegateThe Co-operators Insurance(705) 712-1503E-mail: [email protected]
MICHAEL McLEOD, FCIP, CRMPast PresidentCrawford & Company Canada Inc.(519) 593-2620FAX: (519) 571-1896E-mail: [email protected]
SHAWNA GILLEN, CIPToronto DelegateAIG Insurance Company of Canada(416) 596-3060E-Mail: [email protected]
RAY PROCTOR, BA, CIPKawartha/Durham DelegatePinnacle Adjusters Group(416) 362-0800FAX: (416) 362-1808E-mail: [email protected]
SARAH GRAVESThousand Islands DelegateCrawford & Company (Canada) Inc.(613) 389-5209 ext. 21FAX: (613) 389-5990E-mail: [email protected]
LEANNE HARDMAN, BSc. Hons., CIPPresidentUnifund Assurance(905) 764-4958E-Mail: [email protected]
JENNIFER BROWN, CIPKitchener-Waterloo DelegateEconomical Insurance(519) 570-8500 ext. 43375FAX: (866) 239-0231E-mail: [email protected]
FRANK CASTALDOThunder Bay DelegateIntact Insurance(613) 748-3000 ext. 40423FAX: (613) 748-1642E-Mail: [email protected]
CHRIS JOLLIFFE, B.Sc., CIP, CFEINiagara DelegateLeading Edge Claims Services(289) 897-8676 ext.4FAX: (289) 897-8677E-mail: [email protected]
CARRIE EVANS, CIP, CRMToronto DelegateClaimsPro(905) 740-1621 FAX: (905) 671-1889E-mail: [email protected]
RHU SHERRARD, CIPSecond Vice-PresidentClaimsPro(289) 339-1976FAX: (905) 565-0009E-mail: [email protected]
MATTHEW RIENZOToronto DelegateCrawford & Company Canada Inc.(905) 206-5417FAX: (905) 568-7830E-Mail: [email protected]
MIKE BOTTAN, CIP, CFEINorthern DelegateCrawford and Company Canada Inc.(705) 647-6781FAX: (705) 647-6783E-mail: [email protected]
KELLY PECK-McDONNELLLondon DelegateCrawford & Company (Canada) Inc.(519) 432-3747 ext.8407E-mail: [email protected]
SIMONE CYBULSKIFirst Vice-PresidentCrawford & Company Canada Inc.(613) 389-5209Fax: (613) 389-5990E-mail: [email protected]
JOHN SLATTERY, Hon.BA., EGAToronto DelegateSedgwick Canada Inc.1 (905) 671-7849E-Mail: [email protected]
CINDY BRIDGE, CIP, CRMOttawa DelegateDesjardins General Insurance Group1-866-688-3888 ext. 5511194FAX: (613) 692-3381E-mail: [email protected]
KYLE CASE, FCIP, CRMTreasurerThe Co-operators1-877-682-5246 ext. 272453E-mail: [email protected]
TERRY DOHERTY, CFEISecretaryAviva Canada Inc.(613) 386-5513FAX: 1-866-805-8585E-mail: [email protected]
LAURA O'HEARN, M.Ed., CIPHamilton DelegateMaxwell Claims Services Inc.(289) 239-6757E-mail: [email protected]
7
OpportunitiesAwait You
Are you an insurance adjuster actively adjusting claims?
We Want You!
The OIAA is a professional organization currentlyconsisting of 1,000 claims professionals. We provide networking, professional development, inside industry news and support to insurance adjusters across Ontario.
By joining our network of active and associatemembers, you receive a direct introduction toother members; our Without Prejudicemagazine is available online to be viewed on a tablet orSmartphone; knowledge from mixing with seasoned, experienced adjusters and with new, up and coming professionals; and satisfactionknowing that you are an active participant in shaping claims adjustment and risk managementservices in Ontario.
Most compelling of all is the price –just $50 per year, plus HST. The value far outweighs the fee. Can you afford not to join us?
Please visit our website to become a member, and to review our calendar of events, atwww.oiaa.com.
8
SABS Priority Disputes 101:
WP May 2020
9
It’s a Friday afternoon before
a long weekend, of course,
and you’ve just received a
potential SABS priority dispute.
A new Application for Accident
Benefits arrives on your desk
and the claimant alleges that
she was in your insured’s vehicle
at the time of the accident.
Not surprisingly, you have
no record of her under your
insured’s policy.
What now?
By Daniel Strigberger, Strigberger Brown Armstrong LLP
Help!
WP May 2020
What follows is the first of several articles that will cover theA to Zeds of everything you ever wanted to know about priority disputes (but were afraid to ask).
Ontario’s Accident BenefitsPriority Pecking OrderSection 268 (2) of Ontario’sInsurance Act contains a prioritypecking order that determines whichinsurer is responsible and required topay accident benefits to a claimantafter a motor vehicle accident:1. The claimant first has recourse
against their own insurer.2. If they don’t have one, they next
have recourse against the insurerof the vehicle they were in, or inthe case of a non-occupant, theinsurer of the vehicle that struckthem.
10
3. If there is still no insurance avail-able (for example, the vehicle wasuninsured), the claimant next hasrecourse against the insurer of anyother vehicle involved in the acci-dent.
4. If there is still no insurance avail-able, the claimant finally hasrecourse against the MotorVehicle Accident Claims Fund.
Recourse under the first level (asan insured) is available to a namedinsured, spouse of a named insured,dependant of a named insured orspouse, and a person specified in the
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WP May 2020
policy as a driver of the insured auto-mobile. Coverage under this levelcan be quite broad, given that a per-son could conceivably be a namedinsured under one policy, a deemednamed insured on another (a regularuser of a company vehicle might bea deemed named insurer on thecompany’s policy), spouse of anamed insured on another, and evena listed driver on yet another policy.A child/student can also be a depen-dant on one or more policies,depending on their level of careand/or financial needs at the time ofthe accident.
Recourse under the third level canalso trigger coverage under morethan policy, depending on the num-ber of insured vehicles involved in anaccident.
In these scenarios, sections 268(4)-(5.2) provide tie-breaking provi-sions between two or more “equallyranked” insurers. In most situations,the claimant has the absolute discre-tion to choose to which insurer theyare claiming recourse. Once chosen,that insurer has priority. However, ifa person is a named insured, spouse,or dependant under more than poli-cy, and the person was an occupantof a vehicle that insured them assuch, they much claim benefits fromthat insurer.
Priority Dispute ResolutionScheme: Pay Now, DisputeLaterUnder most non-auto insurancepolicies, where an insurer receivesan application or claim under apolicy from someone they don’tcover, the insurer can simply denycoverage and refuse to pay any-thing under the claim. There is nolegal obligation for an insurer toindemnify a claimant under a poli-cy if the person isn’t covered underthe policy. If the person wishes to
8 King Street East, Suite 1500, Toronto, Ontario M5C 1B5
Phone: 416-408-4400 Fax: 416-408-4900
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© Michael Maslin / The New Yorker Collection/The Cartoon Bank
WP May 2020
12
dispute coverage, they must issuean action against the insurer.
However, Ontario’s auto insur-ance scheme and, more specifical-ly, the accident benefits regime isall about consumer protection. Inthe accident benefits world, thismeans making sure that injuredclaimants get the benefits they areentitled to receive as quickly andefficiently as possible.
To meet this objective, theLegislature created a relatively shortRegulation under the Insurance Act, named Disputes BetweenInsurers, O.Reg. 283/95. As thetitle suggests, where an insurerwishes to dispute its responsibility topay benefits on the basis thatanother insurer is responsible to paythem, the insurer must follow theprovisions of the Regulation: It can-not deny the claim and tell theclaimant to “go away”.
In a nutshell, the scheme workslike this:
The Application Stage (s. 2.1)When a claimant contacts an insurerabout a potential claim (in practicethis usually means reporting an acci-dent to the insurer), the insurer mustsend the claimant all the requisiteapplication forms. An insurer cannottake any steps to “deflect” the claimto another insurer. In other words,the insurer cannot interfere with theclaimant’s application by, for exam-ple, suggesting that there is no cov-erage under this policy or againstthis insurer.
The first insurer that receives acompleted application for benefitsmust respond and pay any entitledbenefits pending the resolution ofany priority dispute. Subject to a rareexception (known as the sufficientnexus test, a topic for another arti-
The first insurer thatreceives a completedapplication for benefitsmust respond and payany entitled benefitspending the resolution ofany priority dispute.
WP May 2020
cle), the insurer cannot refuse toaccept the completed application orpay the benefits on the basis thatthey are disputing priority.
This ensures that a claimant is notcaught in a black hole without bene-fits as two or more insurers disputepriority.
13
The Investigation and NoticeStage (ss. 3-6, 10)Most accident benefits adjusterswould agree that the busiest time inmost claims is right at the beginning.This is when injured claimants aregetting familiar with the process forclaiming benefits and adjusters are
Subject to a rare excep-tion, the insurer cannotrefuse to accept the com-pleted application or paythe benefits on the basisthat they are disputingpriority.
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WP May 2020
busy learning about the new file.Unfortunately, during this time,O.Reg. 283/95 doesn’t make it easyfor these adjusters to start their pri-ority disputes: Any insurer that wish-es to dispute priority against another
insurer(s) must give the insurer awritten priority dispute notice within90 days after they received the com-pleted application for benefits. Thismeans not only does the adjusterneed to adjust a new file during a
Any insurer that wishes todispute priority againstanother insurer(s) mustgive the insurer a writtenpriority dispute noticewithin 90 days after theyreceived the completedapplication for benefits.
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WP May 2020
busy stage, but they also must inves-tigate the claim for priority to see ifthere is another insurer who mighthave priority over them.
The 90-day notice time limit isvery strict. An insurer that gives apriority dispute notice to anotherinsurer could be barred from pro-ceeding with their priority disputeunless they satisfy a two-step test:1. Ninety days was not enough time
in the circumstances to make adetermination that another insur-er had priority; and
2. Reasonable investigations weremade during those 90 days.
The onus is on the insurer who istrying to get past the 90-day noticeto satisfy both steps of the test.Failure to do so bars the disputefrom proceeding. This means aninsurer who isn’t necessarily the pri-ority payor might end up being sad-dled with paying the claim indefi-nitely.
Accordingly, it is very importantthat an insurer investigates priorityand carries out a reasonable investi-gation as early as possible.
Moreover, if an insurer wishes togive notice of a priority dispute tothe Motor Vehicle Accident ClaimsFund, the insurer must first completeits reasonable investigation to deter-mine if there’s another insurer liableto pay ahead of the Fund, and mustalso provide the Fund with informa-tion about the investigations itundertook and their results.
Finally, section 10 of theRegulation mandates that if InsurerA gives a priority dispute notice toInsurer B, and Insurer B wants to dis-pute priority on the basis that anoth-er insurer (Insurer C) has priority overit, Insurer B must give its own priori-ty dispute notice to Insurer C. Thereis no obligation on Insurer A to givea priority dispute notice under sec-
tion 3 to Insurer C.To help insurers investigate priori-
ty, the Legislature has added a valu-able tool: The Examination UnderOath. As of September 1, 2010, theinsurer paying benefits can schedulean EUO of the claimant to reviewpriority issues. Doing so does not“burn” the EUO that is availableunder section 33 of the StatutoryAccident Benefits Schedule (SABS).An EUO can be requested during the90-day notice window or at any timeduring the dispute.
The Arbitration Stage (ss. 7-9)Where the insurers cannot agree onpriority, the dispute must be resolvedin a private arbitration under theArbitration Act, 1991. Neither thecourts nor the LAT has jurisdiction tohear priority disputes at firstinstance.
The onus is on the insurerwho is trying to get pastthe 90-day notice to satis-fy both steps of the test.Failure to do so bars thedispute from proceeding.
Knowledge you need from the people you trust
Alan [email protected]
Janet Olsen [email protected]
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As a claims adjuster, building a strong team is essential to help you fairly assess the losses sustained by injured parties and businesses. We provide enhanced services that insurance professionals depend on as they pertain to:
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WP May 2020
16
(always conducted by telephone)must be scheduled within 120 days.The actual arbitration hearing mustbe scheduled within two-years afterthe start of the hearing, unless theparties consent to extending thattime. However, once the hearingdate is scheduled, it cannot beadjourned unless the arbitratorfinds there is cogent and com-pell ing evidence that justify anadjournment.
AppealsThe Arbitration Act, 1991 allowsparties to appeal decisions to theOntario Superior Court, with leave(permission from the court toappeal), solely on questions of law.However, the Act allows the parties
Unlike section 3, there are no“saving provisions” under section 7if the one-year limitation is missed.Therefore, insurers must make surethey initiate arbitration properly, pur-suant to the Arbitration Act, 1991.
Any arbitration should alsoinclude a proposed arbitrator. Thiscompels the respondent insurer torespond to the arbitration noticewithin 30 days, failing which theinsurer is deemed to accept thejurisdiction of the proposed arbitra-tor. This is important because some-times lawyers will propose an arbi-trator that has already ruledfavourably for their client on theissues in dispute.
Once an arbitrator is appointed,the initial pre-arbitration hearing
Arbitration must be initiated no later than one-year after the insurerpaying benefits gave a priority dispute notice under section 3.
Mediator
Peter Braund
aadadradr@adr@aadr@adadr@adradr@adrcadr@adrchadr@adrchaadr@adrchamadr@adrchambadr@adrchambeadr@adrchamberadr@[email protected]@[email protected]@adrchambers.comadr@adrchambers.comaadadradrcadrchadrchaadrchamadrchambadrchambeadrchamberadrchambersadrchambers.adrchambers.cadrchambers.coadrchambers.comadrchambers.com11.1.81.801.8001.800.1.800.81.800.851.800.8561.800.856.1.800.856.51.800.856.511.800.856.5151.800.856.51541.800.856.5154
Peter has experience resolving insurance issues involving property, casualty, professional
negligence, accident bene ts, and product liability. He also has experience with construction and commercial disputes and is
an umpire and appraiser.
Arbitrator
ZOOM Videoconference and phone options are
available.
17
WP May 2020
to agree in an arbitration agreementthat appeals can be made to theSuperior Court without leave, onissues of law or mixed fact and law.In practice, I have never conductedan arbitration hearing without hav-ing an agreement in place that pre-served the right of appeal to issuesof law or mixed fact and law, with-out leave.
Appeals from the Superior Courtrequire leave from the Court ofAppeal. If denied, the matter endsthere. If granted, the Court ofAppeal wi l l hear and release adecision.
TakeawaysThe most important takeaway fromthis article is to recognize and appre-ciate the very strict timelines in thepriority dispute scheme. It is very dif-ficult to get around the 90-daynotice deadline, and it is pretty muchimpossible to get past the one-yearlimitation to initiate arbitration.
The second important takeawayis that insurers should never refuseto accept a completed applicationfor benefits from a claimant. As Iwill discuss in a future article, thecase law has developed an excep-tion that would allow an insurer torefuse an application only if there isan insufficient nexus between theclaimant and the insurer. But it isvery r isky (and potential ly veryexpensive) to deny an applicationand try to rely on the nexus test. Itis much safer to accept the claimand pursue a priority dispute underthe Regulation.
Stay tuned for our next article inthe series!
Dan Strigberger
The son of a plaintifflawyer, Dan decidedearly in his careerthat he wanted towork for insurers. He
loves coverage. Want to know ifsomething is an “automobile”? AskDan. Want to know if a “house” is a“home”? Ask Dan. Want to knowthe best toppings to cover a pizza?Don’t ask Dan: He can’t eat gluten.Dan is a techie. He was articling inOttawa when the dot-com bubbleburst. He began considering thelegal implications of cyber technolo-gy one night while eating aBeavertail. Over the years, Dan hasbecome a leader when it comes tocyber liability, cyber coverage, cyberrisk, and Cyber Monday.
WP
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THAT’S HENDERSON.We invite you to contact one of our certi ed consultants today.
1.800.263.8537 | www.henderson.ca
18
Recent LAT Decisions Muddy
19
WP May 2020
Income Replacement Benefits
(“IRBs”) for employed individuals
have historically been regarded as
a straightforward calculation for
insurers and/or plaintiff’s counsel.
However, a self-employed individ-
ual who is claiming IRBs can
require a much more detailed
and in-depth calculation.
By Adam Gianotti, CPA, CGA,Senior Manager, Davis Martindale
the IRB Waters
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WP May 2020
Specifically, Section 4(2)1. states: (2) The gross annual employmentincome of an insured person isdetermined as follows:1. In the case of a person referred to
in subparagraph 1 i of subsection5 (1) who was not a self-employed person at any time dur-ing the four weeks before theaccident, the person’s gross annu-al employment income is whichev-er of the following amounts theperson designates:i. The person’s gross employmentincome for the four weeks beforethe accident, multiplied by 13.
ii. The person’s gross employmentincome for the 52 weeks beforethe accident.”
Alternatively, for a self-employedapplicant, Section 4(2)3 of theSABS provided the following guid-ance, “If the person described insubparagraph 2 i was self-employed for at least one yearbefore the accident, the personmay designate as his or her grossannual employment income theamount of his or her gross employ-ment income during the last fiscalyear of the business that ended on
For an employed applicant who was involved in a motor vehicleaccident, Section 4(2)1. of the SABS outlines how to determinetheir gross annual employment income.
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WP May 2020
In the LAT decision, A.M. and TheDominion of Canada GeneralInsurance Company (18-003763/AABS), the applicant argued thatat the date of loss (i.e. December21, 2017), they were solely anemployed individual even thoughthey were self-employed driving forUber during the 7 weeks prior tothe motor vehicle accident. Theapplicant did not report their Uberearnings on their tax return pre-accident, and any earnings theapplicant had earned post-accidentwere also not reported for SABSpurposes. The applicant arguedthat their IRB should be calculatedin accordance with Section 4(2)1.of the SABS (i.e. as an employedindividual only).
The respondent maintained thatsince the applicant was self-employed at the date of loss (inaddition to being employed) that thecalculation would be based on theapplicant’s income from the lastcompleted taxation year (in accor-dance with Sections 4(2) and 4(3) ofthe SABS), regardless if the incomewas reported for SABS purposes.
The tribunal ruled that eventhough the applicant had earnedself-employment income during the7 weeks before the accident and atthe time of the accident, this did notestablish that they were to be con-sidered self-employed. The adjudica-
tor made the distinction that theapplicant’s employment income wasbeing complimented by some self-employment income, and that theself-employment income was notthe only source of their earnings. Assuch, the tribunal considered theapplicant to have solely beenemployed at the date of loss, asopposed to self-employed and
or before the day of the accident.”We point out that Section
4(2)2(i) of the SABS also providesthe applicant with having their pre-accident income calculated during
the 52 weeks before the accident.This assists applicant’s who mayhave not operated their businessfor a complete fiscal year prior tothe accident.
There are two recent LAT decisions released in 2019 that demonstrate how the Tribunal’s adjudicators can sometimes provide polarizing outcomeswhen it comes to the methodology of an IRB calculation for applicants.
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WP May 2020
employed. This distinction is impor-tant as it would have required thecalculation to be examined in therespondent’s favor.
Given the Tribunal’s findings,the applicant’s pre-accident grossannual income was ultimately cal-culated dur ing the four weeksbefore the accident (a calculationthat is not appl icable to se l f -employed individuals). This result-ed in a greater weekly IRB payablewhen compared to the respon-dent’s calculat ion which solelyconsidered the appl icant’s lastcompleted fiscal year. In addition,since the self-employment incomeof the applicant was not consid-ered, their post-acc ident se l f -employment earnings were alsonot considered. This decision isinconsistent with prior decisionsand is currently being appealed bythe respondent.
In the next decision, A.P. andEconomical Insurance (19-000026/AABS) released on October 8, 2019,the applicant petitioned to be considered as an employee for SABSpurposes. However, the adjudicatorfound that the applicant was a self-employed person, as defined by theSABS. Indicators used in identifyinga self-employed individual, as out-lined from the Financial ServicesCommissions of Ontario (“FSCO”)case Carr and Lombard (FSCO A00-0041, September 11, 2011), weredetermined to apply to the appli-cant’s situation.
Prior to the accident, the applicantwas a hairdresser working 40 hoursand earning $599.46 per week.Subsequent to the accident, theapplicant returned to work, on amodified basis, working approxi-mately 20 hours and earning$299.73 per week. The applicant
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WP May 2020
also happens to be a shareholder ofthe salon with his father.
Section 3(1) of the SABS outlinesthe definition of a self-employedperson as a person who either:a) “Engages in a trade, occupation,
profession or other type of busi-ness as a sole proprietor or as apartner…of a partnership”, or
b) “Is a controlling mind of a busi-ness carried on through one ormore private corporations some orall of whose shares are owned bythe person”.
The applicant argued that he isan employee of the salon whorents a chair and works a set num-ber of hours for a fixed weeklysalary. On this basis, the applicant’sposition is that the IRBs should bebased on their personal income taxreturns and payroll summaries fromthe salon.
Economical argued that the appli-cant is more than an employee, butrather a self-employed “controllingmind” of the salon and that suffi-cient financial information relating tothe operations of the salon had notbeen provided in order to calculatethe applicant’s IRBs.
The adjudicator found that theindicators used in the FSCO case
The applicant argued thathe is an employee of thesalon who rents a chairand works a set numberof hours for a fixed week-ly salary.
Michael Blinick of MartaWatson LLP will be presenting:
Legal Challenges associated with the Automobile Sharing Economy The topics covered will include:• Coverage Priority Issues – When will a driver’s personal auto policycover the driver and passengers or when will the company’s policy beprimary in coverage
• Coverage Limits – Review of liability limits and potential exposure on OPCF 44r coverages
• Issues for Adjusters – Issues for adjuster to consider when investigating the claim
Dan Strigberger of Strigberger Brown Armstrong LLP will be presenting:
Airbnb and Liability(Hosts who rent out their properties through the likes of Airbnb and Homeaway)• What is covered under the host’s home policy and what isn’t covered• What is covered under the program’s policy and what isn’t covered
Bullying – Exposure under homeowners• Coverage Issues – Review of the various parties/policies that may beasked to respond and potential for insurers to deny coverage underthe home owner’s policy
• Defending these Claims – Various defences available and evidence required to advance potential available defences
• Should insurers be selling third party bullying liability policies?
COVID Roundtable Q&A
The OIAA and CIAA are hosting a ZOOM virtual seminar
on May 13, 2020. Register at no cost.
1:30 pm
2:15 pm
3:15 pm
Call or log in for all or some of the presentations.Registration at www.oiaa.com.
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WP May 2020
In addition, given that the busi-ness continued to operate subse-quent to the applicant’s motor vehi-cle accident, there would have alsobeen a deduction for any post-acci-dent income earned by the business,hence why being considered as anemployee would have been moreadvantageous for the applicant.
Although the above two decisionshave provided some confusion whendesignating an individual as self-employed, having a sound and in-depth understanding of an individ-ual’s pre-accident activities is impera-tive in accurately quantifying an IRBfor either a self-employed or anemployed individual, even if the LATdisagrees with your analysis.
Carr and Lombard (FSCO A00-0041,September 11, 2011) in identifying atraditional self-employment situationwere applicable to the applicant asthey are a shareholder of the salon,he reported a consistent salary thatdid not fluctuate during the lastthree years, did not pay employmentinsurance and is able to control hishours of work.
Based on the facts, the adjudica-tor determined that the applicant isboth a shareholder and controllingmind of the salon and therefore,should be considered self-employedfor purposes of calculating his IRBs.Given this, the applicant’s IRBswould have been calculated duringthe 52 weeks before the accidentand/or the last completed fiscal yearbefore the accident (instead of thelast 4 weeks before the accident asthe applicant desired).
Adam Gianotti, CPA,CGA is a senior manager at DavisMartindale. Since 2011, Adam hasbeen providing insurance claim andlitigation accounting services toinsurers and plaintiff’s counsel acrossOntario. Adam has extensive experi-ence in IRBs and quantifying eco-nomic losses. In addition, Adam haspresented seminars at various insur-ance companies and law firms, andpresented at the CDL. Adam can be contacted at: [email protected]
WP
Jessy Hawley CPA, CGA, CFF, CIP Gary Phelps CPA, CMA, CFF, CFE
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Get to know your ChapterGet to know your Chapter
OIAA Northern Chapter
COVID-19! How else could one start any message,discussion, dialogue these days without bringing upthe unprecedented events going on with COVID-19.It’s time like these that our true Canadian finds it wayas people all come together to help one another.Many thanks go out to all of our front-line workerswho put themselves out there while trying to stillmaintain a somewhat normal homestead. Thank you,thank you, Thank you!!
Also, wish to thank CIAA for the ongoing updates,leadership and guidance they have been offering to allthe adjusters out there.
Our 2019 Insurance Open Golf Tournament hostedby OIAA Northern Ontario, The Sudbury & DistrictInsurance Brokers Association and The CambrianShield Chapter of the Insurance Institute of Ontariowas another success selling out yet again.Unfortunately, our 2020 event was slated for Mayand due to COVID-19 all involved made the decisionto reschedule early on. Our new tentative date isschedule for September 24th if all goes well.
Like many organizations, all we can do is take theappropriate precautions and have faith in our medicalsociety and neighbors that we bring this to a soonerthan later end. Along with the golf event, the localcurling event and broker convention were also cancelled with no update as of yet if they will berescheduled or outright cancelled for 2020.
In 2019 one of our long-time board membersCarolyn Lefebvre stepped down from her post andon behalf of OIAA Northern Ontario we wish tothank her for long tenure and commitment to ourorganization.
This past Holiday season, we once again donatedmoney to multiple charity organizations and spreadthe funds out over our Northern Ontario chapter.
Wishing everyone health and safety during thesedifficult times, but remember we are Canadian, andwill get through this together!
F. Giovanni Rocca, CIPPresident, Northern Ontario Chapter
Northern Chapter OIAA Bursary Winner Bailey Shaw.
Northern Chapter donation to Sudbury Food Bank.
Northern Chapter donation to Sault Ste Marie Christmas Cheer.
Northern Chapter donation to Children's Community Network.
27Northern Chapter Golf Tournament donation to Hospice.
28
My name is Carrie Evans and I am excited to be returning for my 5th term as TorontoDelegate. It has been a pleasure to work with such a great and dedicated group of individualsfor the last 8 years. From Adjusters to Brokers to Claims Managers and Vendors you have alltaught me so much personally and professionally. The relationships and friendships are some-thing I will treasure. For those of you that don’t know me I am a Liability Claims Adjuster atClaimspro and have been with them for 12 years. I have been handling City of Toronto claimsfor 10 years which I truly enjoy. Regarding my experience on the OIAA my portfolios haveincluded chairing the claims conference, John E. Lowes, WP, media relations, social media,speakers and education, licensing, GTA membership as well as assisting with the golf tourna-ment. These portfolios have let me grow both professionally and personally. I have enjoyedthese portfolios and look forward to the potential new portfolios in the upcoming two years.
Born and raised in Muscat, Oman to Indian parents and a father who by profession is also aClaims Adjuster. While studying, I worked part time as a claims adjuster and later was involvedwith CAT claims following Hurricane GONU in 2007. Soon after graduating, I moved to Doha,Qatar where I worked for a multinational Claims Adjusting firm for over 7 years. Since my moveto Canada in early 2019, I have had the privilege to work for Crawford and Company (Canada)Inc. as a full time Claims Adjuster. At 32 years of age, I have travelled over 20 countries so farand my passion for travelling continues. I thank you all for giving me this opportunity for theposition of the Toronto Delegate. With my experience of working as a claims adjuster for over12 years in different regions and countries, I also bring with me experience as a team leader,profound interest in Sports / events and last but not the least, a very social person.
I joined the insurance industry in 2012, with TD Insurance in Calgary, and moved with TD toToronto in December 2016. In August 2017 I made the move to AIG Insurance to join theCommercial Auto Claims Department as Level I Adjuster. This past week I was promoted toLevel II Adjuster. Outside of my day-to-day role, I am a member of the Leadership Team for theWomen & Allies Employee Resource Group within AIG. Our team plans and holds events inthe office, for the benefit of our colleagues. Our recent events have included guest speakerson various topics, career-networking across multiple departments, volunteer work and manyothers. I believe that, in our industry, our networks are a vital part of how we ensure we aredelivering to our clients in the most effective way. The OIAA provides many opportunities forus to build relationships across the industry, and I’m excited about joining the council and giving of my time and talent, to ensure these opportunities remain available to all of us.
On April 8, 2020 the OIAA held its annual election for TorontoDelegates. The OIAA executive has four delegate positions that represent the GTA membership and for the 2020-2021 term we hadthree positions open. Unfortunately it was necessary to cancel ourscheduled April meeting and election this year; however, we moved toan online platform and had a tremendous voter turnout. It was anextremely close race and we appreciate all for volunteering to giveback to the industry and the members we serve.
The OIAA is very pleased to announce the election of three TorontoDelegates for the coming term: Carrie Evans – Claims Pro, EmilyFeindel – AIG Insurance Company of Canada and Zohair Nassur –Crawford & Company(Canada) Inc. Carrie and Emily will fill two yearterms and Zohair a one year term. Congratulations and welcome tothe OIAA executive team!
2020 OIAA Toronto Delegate Election
Zohair Nassur
Emily Feindel
Carrie Evans
Michael McLeod, BA, FCIP, CRMNominating Chair, OIAA Past President
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2020OIAA
BURSARY
The OIAA bursary offers financial assistance in the form of 3 awards inthe amount of $1000.00 each. The applicant must be pursuing full timepost-secondary studies at a College or University.
Selection is based on financial need, contribution to school, community lifeand/or other meaningful pursuits, major accomplishments and strong indication of academic promise. Eligible applicants will be a child orgrandchild of an active OIAA member, who has been a member ingood standing for a year and is a current member in good standing for 2020-2021.
The deadline to apply is September 30, 2020 at 5:00 pm.Visit our website www.oiaa.com for further details.
Do you have a child or grandchild enrolling or enrolled in Post-Secondary School?
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OUR DIGITAL REACH
FACEBOOK FOLLOWERS
TWITTER FOLLOWERS
UNIQUE WP RADIO LISTENERS
LINKEDIN CONNECTIONS
AND GROWING...
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OIAA HAMILTON CHAPTER
COVID CHALLENGETOGETHER WE CAN RAISE FUNDS TO DEFEAT COVID AND HELP PROTECT OUR FRONT-LINE HEALTH CARE WORKERS
Friends, we know you’re all doing your part in staying home whenpossible and physically/socially distancing to “flatten the curve” to protect one another. We hope that you and your families stay safe andhealthy during these precarious times. Your OIAA Hamilton Chapterwants you to know that we are doing our part for our community;
We are donating $5,000.00 of OIAA funds to Hamilton Health Sciences.
We are issuing a CHALLENGE to all of the OIAA CHAPTERS todo the same for your communities. Can you match us? Beat us?Any amount will do.
We extend this challenge to those of our members and colleaguesthat can afford to contribute as well. We do understand that these aredifficult times for our business operators and we ask this of only thosewho are in a position to do so.
Donations can be made directly to the Hamilton HealthSciences at https://www.hamiltonhealthsciences.ca/covid19/
It is our goal that we collectively raise $50,000.00 in the fight against COVID
It is imperative that we ensure that our health-care workers are protected and that all citizens have access to the medical equipmentthat they need. Did you know that one ventilator costs $50,000.00?
TOGETHER, WE CAN DO THIS
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ChapterNEWSChapterNEWS Jennifer Brown, CIPEconomical InsuranceE-mail: [email protected]
For upcoming Chapter Events around the Province
OIAA Calendar of Events around the Province
6
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4 5 7 8
15141211
18 19 20 21 22
2925 26 27 28
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THURSDAYMONDAY TUESDAY WEDNESDAY FRIDAY
MAY
VICTORIA DAY
Due to COVID 19, all scheduled OIAA events have been cancelled or postponed until further notice.
Please visit www.oiaa.com for further information.
Chapter Contact Info Website
Georgian Bay Joe Cumming: [email protected] www.oiaagb.com
Hamilton Laura O’Hearn: [email protected] www.oiaahamilton.ca
Kawartha/Durham Ray Proctor: [email protected] www.oiaakawarthadurham.com
Kitchener-Waterloo Jennifer Brown: [email protected] www.kw-oiaa.ca
London Kelly Peck-McDonnell: [email protected] www.londonclaimsassociation.com
Niagara Chris Jolliffe: [email protected] www.oiaaniagara.com
Northern Mike Bottan: [email protected]
Ottawa Cindy Bridge: [email protected] www.ovaa.ca
Thousand Islands Sarah Graves: [email protected] www.wearetiaa.com
Thunder Bay Frank Castaldo: [email protected] www.oiaatbay.ca
Windsor Tena Allen: [email protected] www.oiaawindsor.ca
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Get to know your ChapterGet to know your Chapter
OIAA Thunder Bay Chapter The new board of the Thunder Bay Chapter is very excitedto bring our membership new and exciting events this year.We have had a tough number of years but this last yearhas seen an amazing resurgence of our association. Themembership here in Thunder Bay craves new information,learning, and networking which this Chapter has dedicat-ed itself to providing.
Our current board includes President Alisa Hainrich, VicePresident Andy Connell, Treasurer Kim Lepere, SecretaryClaire Richardson, Director David Kirychuk, Delegate FrankCastaldo, and Social Directors Karen Schmidt and MichelleTurner. Last year this amazing team put together a stellarcollection of events. We had a lunch and learn sessionwhere we spoke to a Thunder Bay Police Officer about thechanges involving cannabis and its new legal status. Wehad an excellent spring BBQ to kick off the warm weatherand rolled that into a revival of our much-loved summergolf tournament and dinner. The Holiday Party broughteveryone together to debrief after a long year of claimsand we raised $600 towards our sponsored charities!
This year we have already hosted a joint seminar withthe IBANWO where we brought in Lori Festarini, VP atStantec, to discuss mould, asbestos, and environmentallosses. Co-hosting the seminar with the Broker Associationmeant we could bring in a wonderful speaker and offerthe event to our membership free. Seriously, it was free.
We look forward to future collaborations with the IBAN-WO as well.
Our regular ‘lunch and learn’ events are back, followedby the spring BBQ and then summer golf. Our holidayparty will close out the year and we have a few new ideasthat should take these events up a notch. We hope ourmembership enjoys the fresh new take.
Our own Frank Castaldo has taken on the project ofrevamping our Chapter website. We hope it will be anexcellent source of information for our membership andcan't wait to show you when it’s ready. This new board isexcited to bring the Thunder Bay Chapter into the 2020's.We would love to hear from anyone with new ideas anddon’t forget to sign up to be a social member for dis-counted rates on our events.
Alisa HainrichPresident, Thunder Bay Chapter
35See more photos from the Thunder Bay Chapter on page 59.
#MeToo
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#MeToo in theClaims World
By Robert Holmes, CIP, CRM, Senior General Adjuster, Global Technical Services, Crawford & Company (Canada) Inc.
On October 15, 2017 a worldwide
conversation about sexual harassment
and assault was ignited with two
simple words: #MeToo.
WP May 2020
The hashtag was tweeted nearly one
million times in 48 hours and had
roughly 12 million interactions on
Facebook within 24 hours.
WP May 2020
38
However, the real impact went beyond social media and spurred public debate, community initiatives, and created
unprecedented awareness about the prevalence of sexual assaultand harassment in society.
The Impact It is difficult to track the directimpact the movement has had oninsurers and the claims world as noone has taken steps to compile thedata. However, anecdotally, it seemsinsurers are facing an increasingnumber of these suits each year. In an effort to explore the impact of the movement on the Canadianclaims landscape, we can look at several indicators starting with statistics surrounding police-reported sexual assaults.
39
Statistics Canada published a studyin November, 2018 which examinedthe number of police-reportedassaults in the three months afterthe #MeToo movement in compari-son to the prior year. Overall,Canada experienced a 13% increasein reporting, representing the mostreports filed since 1998. The resultswere heavily localized with Quebecexperiencing the highest increase inreporting at 61% (Ontario’s was19%). What’s more, the movementdid have an acute impact as the2018 numbers showed a further15% increase in reporting.
Of particular interest to insurersare the statistics surrounding assaultsoccurring at institutions such as col-leges and universities. Althoughthese occurrences represented asmall proportion of overall incidents(5%), the number of reported inci-dents within these institutions nearlydoubled (87%).
The study also revealed anincrease in reports of historical casesthat followed the #MeToo move-ment. Although, historical cases rep-resented a small proportion of over-
all incidents, assaults which occurredover a decade ago saw a 92%increase in reporting in the threemonths following the #MeToomovement. This is a significant find-ing when you consider there is nolimitation period for claims of sexualassault in Ontario. Historical claimsalso create a litany of challenges forinsurers managing reserves andinvestigating claims.
The second indicator we can lookat is the Canadian Human RightsCouncil which publishes annual sta-tistics. The 2018 report showedapproximately 3000 complaintapplications filed, representing a25% year over year increase and a40% increase over ten years. Ofthose 3,000 applications, 1,129complaints were accepted forreview; 18% of which related tosexual harassment.
While we do not have any claims-specific data, indicators suggest ahigher volume of victims coming for-ward and taking action. Whetherthis goes beyond the criminal isunclear and may be worth trackingas an industry.
Follow OIAA on
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WP May 2020
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Investigating Claims Claims of sexual assault present avariety of challenges to insurers froman investigation standpoint. First,there are three sides of the equationto consider: the victim as plaintiff,the perpetrator as defendant andthe institutional defendant who isbeing sued for not preventing theassault or abuse from occurring. Therole of the claims adjuster is to actfor the insured institution; however,the scope of the investigation mustfactor in all sides of the equation.
Generally, the investigation can bebroken down in to three segments: 1. Establishing the facts, 2. Determining whether the institu-
tion is vicariously liable and, 3. Determining whether the institu-
tion is independently negligent
In a majority of cases the criminal
proceedings will flush out the factssurrounding the assault or abuse.However, if the matter was not triedcriminally or the authorities werenever involved then the scope of theinvestigation into the facts broadenssignificantly.
The first step in the investigationshould be developing an investiga-tion strategy in consultation withstakeholders. These investigationsare not being done in a vacuum andthe adjuster will need to considerwhat other parallel investigations aretaking place and what effects theadjuster’s actions might have.Generally speaking, the best practicefor adjusters is to stay in their laneand conduct an independent investi-gation. Bear in mind the privilegednature of the adjuster’s investigationas well as the scope. Most otherinvestigations are only concerned
The role of the claimsadjuster is to act for theinsured institution; how-ever, the scope of theinvestigation must factorin all sides of the equation.
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WP May 2020
defence. Unfortunately, insurers arequite low on the priority list whenit comes to productions so knowingwhat evidence may be availableand the proper channels to accessit is key.
If there is no criminal case to relyon then it is up to the insurer toweigh the evidence objectively andappropriately. When considering the
with whether the assault took placewhile the insurer’s investigation mustalso consider the obligations of theinsured institution.
A comprehensive investigationwill certainly include interviewingthe plaintiff, defendant and wit-nesses. However, much of the focussurrounds the productions and howthey support the allegations or
www.oiaa.comYour Networkfor Success
A comprehensive investigation will certainlyinclude interviewing the plaintiff, defendantand witnesses.
42
WP May 2020
evidence of the plaintiff it is impor-tant not to allow inconsistencies orvague recollection to cloud yourjudgement. It is important to be cog-nizant of the fact that this may notbe reflective of a credibility issue butrather a symptom of the trauma suf-fered by the victim. The key is cor-roborating the evidence to the bestof your ability. When it comes to theperpetrator defendant, considerwhether a pattern of behavior exists.Same or similar-fact evidence carriesa lot of weight in these cases.
Vicarious Liability People tend to think that if abuseoccurs at work or school then liabili-ty will automatically flow through tothe employer. This is not always thecase and is very fact-specific. There isnot much precedent to rely on inCanada but the Supreme Court has
weighed in with the following guid-ance taken from Bazley v. Curry(1999): “Employers are vicariouslyliable for authorized employee actsAND for unauthorized acts so con-nected with an employee’s job dutiesthat they are regarded as an improp-er way of doing an authorized work-related act.”
From an investigation standpoint,we are essentially looking to deter-mine what services the institutionprovided to the community andwhether the assault or abuse wascommitted in the course of perform-ing those services. In the Bazley casethe institution provided residentialcare which included total inter -vention in the residents’ l ives.Employees performed tasks a parentmight do and it was in the course ofthese services that the abuse wascommitted. In the end, the institu-
People tend to think that if abuse occurs atwork or school then liability will automaticallyflow through to theemployer. This is notalways the case and isvery fact-specific.
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VANCOUVER • CALGARY • EDMONTON • WINNIPEG • LONDON • HAMILTON • TORONTO • KINGSTON • OTTAWA • MONTREAL • HALIFAX
Gerry Bouwman, CPA, CMA, CFF | [email protected]
Brad Ebel, CPA, CA, CFE, CFF | [email protected]
Matt Mulholland, CPA, CMA, DIFA, CFF | [email protected]
Mark Gain, CPA, CA• IFA, CBV, CFF | [email protected]
Toronto: 416. 366.4968
Martin Pavelic, CPA, CMA, CFF | [email protected] Hamilton: 905.523.6363
Matt Mulholland, CPA, CMA, DIFA, CFF | [email protected]: 613.389.3176
Matt Mulholland, CPA, CMA, DIFA, CFF | [email protected]: 613.366.6008
Sheri Gallant, CPA, CMA, CFF | [email protected]: 519.432.1123
43
WP May 2020
Find OIAA on
tion was held vicariously liable byunanimous decision from theSupreme Court.
Conversely, in Jacobi v. Girffiths,the Supreme Court found that abuseoccurring between a camp directorand campers off site did not imposevicarious liability. Although theemployment afforded opportunityfor the perpetrator to build rapportwith the victims, the court held thatthe institutions aims and services didnot go beyond this relationship.
Institutional Liability Plaintiffs will generally assert twoallegations of negligence againstinstitutions in these cases. The first isthat the institution knew or ought tohave known what was going on. Inthis day and age most organizationshave mandatory reporting and com-plaints procedures in place.However, the key here is whetherthe policies were accessible, encour-aged and enforced. It is not enoughto have a binder collecting dust on ashelf. Institutions need to validate
that employees are being trained,reporting is being encouraged andcomplaints are being investigated.
The second allegation is that theinstitution was negligent in the hir-ing and supervision of the perpetra-tor. In order to address these allega-tions, the investigation needs toestablish that the screening, hiringand supervision protocols were rea-sonable and commensurate to therisk inherent with the job duties.Again, validation that the protocolswere followed is key.
Historical Cases Historical claims of sexual assaultpresent several hurdles to investiga-tion. The first issue that arises iswhether evidence of coverage canbe produced. The onus is on thepolicyholder to produce evidence ofcoverage; however, this is easier saidthan done when losses occurreddecades ago. Precedent shows thatcourts have accepted other sourcesas confirmation of evidence. Thisincludes items such as membership
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WP May 2020
dues, premium payments and bro-ker statements. Another considera-tion from a coverage perspective islocating additional policies torespond. This might include addi-tional policy periods if the abuseoccurred over multiple years. Theremay also be claims-made coverageavailable depending on the allega-tions raised.
A second hurdle in the investiga-tion is tracking down defendantsand witnesses that are missing ordeceased. If this is the case thenyour investigation strategy shifts toalternate sources of information. Inaddition to accessing typical produc-tions, this might include retrievinginvestigations that took place at thetime (criminal, human resources, dis-ciplinary committees, etc.). Othersources might also include additionallitigation, media, or year books toname a few.
Finally, the biggest hurdle in thesecases is establishing that the institu-tion’s historical policies and proce-dures met the standard of care ofthe day. For the most part judgesand juries will look at historical stan-dards with the scrutiny of today’slens which makes assessing the lia-bility picture complex. As part ofyour investigation you will need toestablish what the standard of carewas at the time, if it has changed,why? and, how the institution’s poli-cies and procedures compare.
Conclusion Claims of sexual assault present sig-nificant risk to insurers and their pol-icyholders. Joint and several liabilityis a major concern as the perpetra-tor’s likely have no insurance backingor assets to rely on so the awardmay land with the insured institu-tion. Moreover, the awards for these
As part of your investiga-tion you will need toestablish what the standard of care was at the time, if it haschanged, why?
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cases have risen dramatically inrecent years. But most importantly,because of the personal and sensi-tive nature of these claims, it isimperative that investigations beimpartial, unbiased, fair and factual.Improper findings can have devastat-ing consequences to all partiesinvolved.
The #MeToo movement has shonea light on the prevalence of sexualabuse in society. However, we haveyet to see a trend toward deter-rence. From an insurer and institu-tional perspective the shift should betoward risk mitigation and manage-ment. Institutions and governingbodies have taken steps to revisetheir policies and procedures but thestruggle now becomes disseminationand implementation. How can insur-ers and institutions incentivize strictcompliance? How can institutionssafeguard their members and pro-tect them against backlash fromspeaking out? There is a lot of workto be done still.
Rob Holmes beganhis career withCrawford in 2008and joined the
National Global Technical Servicesteam in 2015. Rob specializes incomplex sports and recreation liabili-ty claims and commercial and pro-fessional liability claims. Rob has anhonours degree in Human Kineticsand is past president of the HamiltonChapter of the OIAA.
WP
Please Contact: Tena AllenTel: 1-866-688-3888 ext. 6324680 • Fax: 1-800-403-4457
E-mail: [email protected]
FORYOURADYOURIN THIS MAGAZINE
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How to SupportClients with Business InterruptionInsurance Claims
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WP May 2020
By Tim Zimmerman, Partner and Jean-Charles Plante, Director,RSM Canada
(October 24, 2019, 12:20 PM EDT) —
The Maritimes are still recovering from
the damages caused by Hurricane Dorian,
which approached the region as a
category 2 hurricane in September.
Over 450,000 residential and commercial
properties incurred property damage
and lost power in Nova Scotia, New
Brunswick and Prince Edward Island.
Many of the affected business owners
likely accessed their insurance policies
to see if they had business interruption
coverage that could help them
recover any losses during the period
of interruption.
Photo by Coastal Elite at https://flickr.com/photos/29442760@N00/48714768762, cc-by-sa-2.0.
A construction crane lies on a building on South Park Street in Halifax, Nova Scotia, Canada, after having collapsed on September 7, 2019 due to heavy winds from Hurricane Dorian.
WP May 2020
Given the complexity of insurance policy wording and the range of coverages available, it may not be easy for a business owner to know the extent
of coverage available or even if it makes sense to submit a claim.
In some cases, losses for a shortduration can be significant to theoverall profitability of a companyand investigating whether to makean insurance claim is a worthwhileendeavour.
As climate-related business inter-ruptions — such as the onesdescribed above, as well as fires andfloods — may become more preva-lent, this article aims to help show-case what lawyers need to know tohelp their clients navigate the worldof business interruption insurance,with the support of a forensicaccountant.
Outside assistance Clients may have concerns aroundthe costs associated with bringing inoutside legal or accounting expertiseto help support the claim. Manybusiness interruption policies includecoverage for professional fees, whichallows a policyholder to engage theirown expert to assist with measure-ment of their claim for businessinterruption, stock loss, extraexpense and other covered losses.
When choosing a forensicaccountant, clients should look for aprofessional who has experience inquantifying business interruptionlosses and has a track record ofpreparing defensible reports for theindustry in which your client’s busi-ness operates.
In general, engaging a forensicaccountant early in the claim is idealso they can assist with gathering andorganizing information to file aclaim, and can act as a supportingliaison with the insurance carrier’sforensic accountant.
Profits, losses calculated The insurance policy will dictate theappropriate measurement of theloss. The steps typically involve: 1. Determining the loss period; 2. Projecting sales during the loss
period that would have occurredbut for the incident;
3. Deducting the actual sales in theloss period, if any, to determinethe sales shortfall;
4. Determining the rate of grossprofit earned on the sales shortfall;
5. Adding any increase in the cost ofworking (costs incurred toreduce/mitigate the loss); and
6. Deducting any saved expenses.
Business interruption case law Several cases have shed light on vari-ous issues that may arise in the busi-ness interruption claims process. Afew highlights are listed below forfurther reference: • Boyce v. Co-operators Insurance
2013 ONCA 298: Limitation periodfor business interruption claims.
• J.I.L.M. Enterprises & InvestmentsLimited v. Intact Insurance 2017ONSC 357: Insurance carrier’s delayin paying out a building loss claim.
• Pereira v. Hamilton TownshipFarmers Mutual Fire InsuranceCompany 2006 12284 (ON CA):Arson allegation by insurer withvarious allegations of denial includ-ing material misrepresentation asto status of business activities.
• Le Treport Wedding & ConventionCentre Ltd. v. Co-operators GeneralInsurance Co. [2019] O.J. No.2595: Claim denial due to interpre-tation of Trial Judge; decision is
Tim Zimmerman is a partner andJean-Charles Plante is a director inthe litigation and valuation servicespractice of RSM Canada, a providerof audit, tax and consulting servicesfocused on the middle market.
WP
Jean-Charles Plante
Tim Zimmerman
under appeal. • Fletcher v. Manitoba Public Insur ance
Co. [1990] S.C.J. No. 121: Insurancebroker’s negligence.
• Walsh v. Nicholls (2004), 273N.B.R.(2d) 203 (CA): Potential per-sonal liability of adjuster as a con-sequence of breach.
Experiencing a business interrup-tion, with a consequent loss ofincome and unexpected expenses,can be a stressful time for any busi-ness owner or manager. Having todeal with business interruption insur-ance can add to that stress — so ithelps to have a qualified profession-al, who is experienced in this area, tohelp clients get back to normal.
48
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Your injured client needs more than a settlement.
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WP May 2020
WP - Call for ArticlesSubmit an article to WP Magazine for publication consideration. Share your industry knowledge and information with more than 2,500 active adjusters.
Accompany your article with advertising to effectively maximize your business opportunities. Full-time WP advertisers will get the benefit of a rolling banner on our OIAA website. All advertisers will get the added bonus of one shout-out on each of our OIAA social media networks being Facebook, Twitter and Instagram for each month
they put an advertisement in the WP.
Any inquiries and information regarding promoting your business while supporting the OIAA, please contact: Jennifer Brown, WP Managing Editor/Articles at [email protected] Allen, WP Advertising Manager at [email protected]
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51
• The WP Magazine is the official journal of the OIAA (Ontario Insurance Adjusters Association).
• We have over 1,000 members.
• WP is fully digital and available to everyone.
• We have 4,000 followers on social media and growing (Facebook, Twitter and LinkedIn).
• The cost to advertise in WP magazine to reach a large group of potential clients is extremely reasonable - see below.
Please give consideration to advertising in WP and contact me if you have a question or visit our website atwww.oiaa.com.
I look forward to hearing from you.
Tena AllenWP Advertising ManagerPhone: 866-688-3888 ext. 6324680E-mail: [email protected]
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Official Journal of the Ontario Insurance Adjusters Association
52
Georgian Bay Chapter Curling 2020On February 14, 2020, The GeorgianBay Chapter hosted a curling eventat The Barrie Curling Club. Prizesdonated by the Georgian BayChapter, Larrek Investigations, Arcon Forensic Engineers, R&F DKI,On Side Restoration, Carroll HeydChown LLP, & Pinchin Ltd.
OUT
ABOUT Joe Cumming – Georgian Bay DelegateAND
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WP May 2020
54
LCA 2020 Curling FunspielOn February 26, 2020, the London Claims Association hosted a CurlingFunspiel at the Highland Country Club in London.
OUT
ABOUT Joe Cumming – Georgian Bay DelegateAND
55
The ‘Understanding’ Series for AdjustersTo meet the needs of today’s p&c industry and advance your career…you must stay on top of industry best practices.
The ‘Understanding’ Series for Adjusters provides deeper insights to improve the servicing of claimants—resulting in better-adjusted claims.
Developed in collaboration with the OIAA, this series of four programs includes case studies and applied industry knowledge from subject matter experts. The series has been designed speci�cally for adjusters but also has high applicability to other industry roles.
Understanding Property Claims Investigation | One day Utilize the best practice steps needed to lead a fulsome claims investigation and coverage analysis—resulting in better handled claims, minimized leakage costs, and more satis�ed clients.
Understanding Serious Injury | Five-day dispersed format Better manage the recovery of injured claimants, and gain a broad perspective on accident bene�ts and bodily injury with a focus on the injured person.
Understanding Case Law | Two days Acquire in-depth knowledge and skills to expertly source, interpret and apply case law to prepare a comprehensive �le for negotiation, settlement and litigation.
Understanding Bodily Injury | Two days Learn how to more e�ectively manage bodily injury claims through an in-depth look at the main principles and concepts, including presenting the claim, investigating exposures and more.
To learn more and see the schedule of courses and locations, visit www.insuranceinstitute.ca/AdjustersTraining
56
Final Report
As mentioned in our NorthernChapters president’s message weare living in remarkable times.The North and better said theworld has been within the gripsof this global pandemic. I amsure everyone has been con-
sumed with news broadcast, water cooler chats, and apopular topic of conversion with friends and family.Consumed to the point of saturation perhaps. For one I do stand on guard and it is of primary concern for the health and welfare of all staff, customers, generalpublic and families. Who needs yet another repeat ofwhat has already been said time and time again. Forthat reason I chose to focus on the great people in theNorth. People helping People. Finding joy with our day!Perhaps a lighter topic of pleasantries rather than thegloom of our daily news consumption of fear, specula-tion of the unknown.
Well spring has final ly arrived in the North.Temperatures are consistently above freezing. It hasbecome common place now, with neighbor standingthe required 2 meter distance, to speak with excitementand joy that the snows are receding at a rapid pace.Comments like “Snow has dropped 8 inches in the last5 days.” Smiling folks sitting in the warm sun shine andabsorbing the welcomed vitamin D. The still cool lightbreeze adds a refreshing breath of fresh air. Folks puttering around their properties beginning the springcleanup ritual, stopping more often than needed totake in the day.
I stepped outside this morning at 5:30 am, the sunhad still not yet risen over the horizon. The smells ofspring loomed in the air. So quiet, so peaceful in theearly morning hours. No sounds of traffic, no sirensscreeching in the back ground, no motors starting upfor the day’s work. No one to be seen. Soon the quietof the early morning began to break as the song birdsstarted their early morning call. I am not sure what itwas but for some reason my morning coffee just tastedthat much better today.
Mike Bottan, CIP, CFEI, Northern Chapter Delegate
As my morning unfolded I have to say with pride therewas nothing unusual. I took notice that across the streetJoe was having a delivery from another neighbor of dailygroceries. You see Joe is wrapping up his 14 day quaran-tine as a returning snow bird. On the other side of meagain a neighbor is sweeping off another’s front porch.Everyone was smiling and happy to help out. Following atypical Northern winter with neighbors helping neigh-bors, I had enjoyed the exercise in snow blowing twodrives ways. In turn a third neighbor does mine while Iam away for work. Work is underway preparing gardensfor some and a helping hand is always offered knowingthey will share the bounty of fresh home grown vegeta-bles. Just neighbors helping neighbors.
A popular winter sport is ice fishing. The season nowcomplete, shacks removed from the lakes it is alwaysinteresting to see the small impromptu work partiesformed helping each other repair and store the ice hutsfor the season. Somewhat comical as they consciouslykeep their social distance. At the same time, outcomethe ATV’s, an array of Argos and all forms of all terranevehicles. Preparation for a busy summer season. Justpeople helping people.
Today I had 3 phone calls, all having to do with some-one having a great idea on how they can do somethingnice for another in the community and receiving overwhelming support. From helping with fixing a patiodeck, to putting in another’s dock at the cottage tohelping out with yard work. Just neighbors helpingneighbors.
Amidst the hustle and bustle of these times, the emer-gency responses of corporations dealing with the pan-demic, the scramble of remoting employees, the fear ofthe unknown, the down turn in the economy, it stoodout to me, life is going on. We still enjoy the sweetspring day, neighbors continue to help neighbors, andpreparations for the change of seasons go on. The sunwill rise, the birds will sing. Today was a great day.
Make the time to find joy in your day. It is contagious!
WP
57
With 2020 on the horizon, and the world entering a new decade, the OIAAshouldn’t be left behind, which is why this is the perfect time to launch newprojects and ventures. One major addition to the OIAA in the last couple yearsis WP Radio, and it’s still moving forward with new ideas.WP Radio is being turned into a podcast network, which will host under onefeed five separate shows, all with different topics, themes and engagements.The podcast in the last couple years has been a great opportunity for people inthe industry share stories and ideas, and WP Radio continues to build on thatand give people a larger platform to do so. The list of shows launching as partof the network are:Out & About Presented by Genesis RehabThe Case Law Show Co-Presented by Templeman LLP and Dye & Russell LLPAudio Articles & Event Keynotes Presented by SCM Group of CompaniesChapter Check-in Presented by WINMAR LanarkThe OIAA Trivia Show Presented by Arcon Forensic EngineersWe are so excited to be working with these great companies, who support theOIAA and can’t thank them enough for their support.The next 12 months of the WP Radio Podcast Network will be filled with stories,engagement and interviews from people coming from all walks of life to giveour listeners the best possible experience. That’s why, as long as you’ve beenlistening, the OIAA Trivia Show will give you the opportunity to win tickets toyour favourite sporting events, just for listening to all previous episodes. Themore you know about each episode, the better chance you have of winning.Thank you to all of our supporters and listeners of the WP Radio, and we lookforward to kicking off the new year with all of you!
58
I have had the honour of being involved onthe OIAA executive since 1991 with contin-uous service right through my year of beingthe OIAA President in 2003 – 2004 with myfinal year being Past President in 2004 –2005. I thought after putting in 14 years onthe OIAA executive they would want tosend me out to pasture. Unfortunately forme or the executive they managed to getme to return 4 more times as a chapter del-egate which is my present position for thisfinal term on the OIAA executive, at least Ithink so.
When they look at me at the executivemeetings, I know one of two things isgoing to happen. I need to change withthe times which are all these social mediasI know nothing about nor can I provide anyadvice, or they want to know about thepast and why we did things that way.That’s when I can tell them anything I wantbecause they wouldn’t know if I was rightor wrong. That is not true I would neverknowingly provide any false information toanyone because we would never learnfrom each other. What I am trying to sayhere even though I have been on the exec-utive for 18 years if my math is right and Ihave had 38 wonderful years mainly inclaims, in the Insurance Industry we neverstop learning.
When I started in the Insurance Industryin the north, I counted on others to helpme learn the business and the OIAA alsoplayed a big role in that learning curvethrough the many seminars they put onwhich I took every opportunity to attend. I
Frank Castaldo, Thunder Bay Chapter Delegate
have made many connections through theInsurance Industry throughout Canada butparticularly in Ontario that have help meadvance in my career. We are now faced witha lot of Insurance Professionals retiring andwe all need to pass our experience onto thenew up and coming staff in our industry.
Even though some us Dinosaurs need toget with the times we also need to pass onour knowledge to others, because at onetime we were not Dinosaurs we were thosenew hires. I remember one particular adjusterin Thunder Bay that we all called for advice asthis adjuster knew it all really there wasn’t aclaim, he hadn’t been involved in.
One day he called me and jokingly saidnow I am calling you for advice, I think it istime for me to retire, about two years laterhe did retire but was still available to answerquestions. So please pass on all the informa-tion you can to fellow Insurance Professionalsbefore the information we gained in ourcareer is lost in the wind.
In Thunder Bay we are getting moreyounger adjusters involved in the OIAA inparticular the local chapter but at the sametime we need to provide them with the infor-mation on how to run the chapter and makeconnections with contacts who can providetraining locally. This will be my next goal tohelp all our colleagues who work in ThunderBay and the surrounding area, so they canhave the same opportunity to gain experi-ence as I have had over the years.
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Final Report
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WP May 2020
Thunder Bay Chapter 2019 Holiday Party
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OIAA 2019-2020 Ontario Chapter Executive OfficersGeorgian Bay (Barrie)President: TERESA MITCHELL, FCIP, CRM, FCLA, FCIAA, FIFAA Crawford & Company (Canada) Inc. BarrieVice- GREG DOERR, CIPPresident: Doerr Claims Services Inc. BarrieTreasurer: MARY CHARMAN, CIP Crawford & Company (Canada) Inc. BarrieSecretary: KAYLA GUY Crawford & Company (Canada) Inc. BarrieDirector: LORNA PRICE, CIP The Co-operators BarriePast LESLIE GUERETTEPresident Cunningham Lindsey BarrieChapter JOE CUMMING, FCIP, CRMDelegate: The Co-operators Barriewww.oiaagb.com
HamiltonPresident: JENNIFER ALLAN Brant Mutual Insurance Co. BrantfordVice- AIDAN McCARDLEPresident: Crawford & Company HamiltonTreasurer: SAMANTHA QUINN Sedgwick Claims HamiltonSecretary: ALYSON HARPER, CIP Sedgwick Claims HamiltonDirector: JANICE BROOKS Dumfries Mutual SheffieldPast JANICE BROOKSPresident: Dumfries Mutual SheffieldChapter LAURA O’HEARNDelegate: Maxwell Claims Services Hamiltonwww.oiaahamilton.com
Kawartha/DurhamPresident: HELEN SINCLAIR, CIP, ACS The Commonwell Mutual Insurance Group LindsayVice- BOBBI-JO STEPHENS,CIP,ACSPresident: The Commonwell Mutual Insurance Group LindsayTreasurer: BOBBI-JO STEPHENS,CIP,ACS The Commonwell Mutual Insurance Group LindsaySecretary: SLOANE HILLIS, CIP L.V. Walker & Associates OshawaDirector: JEFF STINSON, BA, FCIP ClaimsPro PeterboroughPast RAY PROCTOR, BA, CIPPresident: Pinnacle Adjusters Group UxbridgeChapter RAY PROCTOR, BA, CIPDelegate: Pinnacle Adjusters Group Uxbridge
www.oiaakawarthadurham.com
Thousand IslandsPresident: SHARI HAMILTON PCA Adjusters, BellevilleVice- KERRI AMEY, CIP, CFEIPresident: Intact Insurance KingstonTreasurer: DUNCAN SOUTHALL PCA Adjusters, BellevilleSecretary: ERIN SHEARD ClaimsProDirectors: BEN BALDWIN, BA CIP Travelers Canada MATT CYBULSKI Aviva Canada Inc.Past BRAD WILSON, BBA, CIPPresident: Crawford & Company (Canada) Inc. KingstonChapter SARAH GRAVESDelegate: Crawford & Company (Canada) Inc.www.wearetiaa.com
Thunder BayPresident: ALISA HAINRICH Wawanesa Mutual Ins. Co.Vice- ANDY CONNELLPresident: Wawanesa Mutual Ins. Co.Treasurer: KIM LEPERE ClaimsProSecretary: CLAIRE RICHARDSON SedgwickDirectors: DAVID KIRYCHUK, BA,CFEI Crawford & Company (Canada) Inc. MARK SULLIVAN SedgwickChapter FRANK CASTALDODelegate: Intact Insurancewww.oiaatbay.ca
WindsorInterim GREG STEED, BAPresident: The Co-operators WindsorTreasurer: TENA ALLEN, BScL Desjardin General Ins. Group WindsorSecretary: MELISSA ROB, BS, CIP Bartlet & Richardes LLP WindsorDirectors: CHRIS RENAUD, BA ClaimsPro Windsor JENNIFER OLSON, BA, CIP Crawford & Company (Canada) Inc. WindsorPast ROB QUEEN, CIPPresident: Sedgwick WindsorChapter TENA ALLEN, BScLDelegate: Desjardin General Ins. Group Windsorwww.oiaawindsor.ca
NiagaraPresident: BOB MCCORD, FCIP, CFEI, CRM Leading Edge Claims Services FonthillVice- CHAUSSIE LAWSON, FCIP, CRMPresident: Portage Mutual Insurance Co. St. CatharinesTreasurer: CODY HULLEY, CIP Portage Mutual Insurance Co. St. CatharinesSecretary: MICHAEL RAGONA, CIP Sedgwick Canada Inc. St. CatharinesDirectors: JEFF EDGE, CIP, CFEI Leading Edge Claims Services Fonthill CHRISTINE ANDREWS,FCIP,CRM Sage Claims Solutions Inc. Hamilton CRAIG OZOG, CIP, CFEI Leading Edge Claims Services Fonthill TYLER SUTHERLAND Leading Edge Claims Services FonthillChapter CHRIS JOLLIFFE, B.Sc.,CIP,CFEIDelegate: Leading Edge Claims Services Fonthillwww.oiaaniagara.com
NorthernPresident: GIOVANNI ROCCA, CIP G. Rocca & Associates Consulting Inc. SudburyVice- BLAIR BOILARD, CIP, CFEIPresident: Crawford & Company Canada Inc. Elliot LakeTreasurer: MARK BORGOGELLI, CIP,CRM,CFEI Aviva Canada Inc. SudburySecretary: AUDREY TAILLON Claims Pro Inc.Directors DAVID K. MARSHALL Crawford & Company Canada Inc. Sault Ste. MarieChapter MIKE BOTTAN, CIP, CFEIDelegate: Crawford & Company Canada Inc. New Liskeard
OttawaPresident: RYAN REISS, FCIP, CRM, CFEI Economical Insurance Company LondonVice-President: TBATreasurer: CONAR MARCOUX, BA, FCIP, CFEI Crawford & CompanySecretary: SARAH SMITH, ACIP, CRM Economical Insurance CompanyDirector: PATRICIA MARTIN, BA(Hons), B.Ed, CIP Economical Insurance CompanyPast CINDY BRIDGE, CIP, CRM.President: Desjardins General Insurance Group, OttawaChapter CINDY BRIDGE, CIP, CRMDelegate: Desjardins General Insurance Group, Ottawawww.ovaa.ca
Kitchener-WaterlooPresident: JAIME RENNER, CIP Economical Insurance WaterlooVice- ELLIE CELESTINE, BA, CIPPresident: The Co-operators General Ins. CambridgeTreasurer: JEFF CRONK, BBA,FCIP,CRM Curo Claims Services WaterlooSecretary: KAYLA HELMOND Crawford & Company (Canada) Inc. WaterlooDirectors: STEPHANIE KLAGES Crawford & Company (Canada) Inc. Waterloo LISA DOBSON The Co-operators General Ins. CambridgePast CARRIE KEOGH, BA HonsPresident: Gore Mutual CambridgeChapter JENNIFER BROWN,BSc,B.Ed,CIPDelegate: Economical Insurance Waterloowww.kw-oiaa.ca
LondonPresident: KATE BOYLE, B.A. (HONS), CIP McKillop Mutual Insurance Co. SeaforthVice- President and Treasurer: LINDA PEREIRA Lambton Mutual Insurance Co. WatfordSecretary: PAMALA CECCHIN, CIP,CRM Crawford & Company (Canada) Inc. LondonDirectors: HEIDI BRONNENHUBER, B.A., CIP ClaimsPro Inc. London MICHELE FIELD, FCIP Trillium Mutual Insurance Co. Listowel MACKENNA FRANK, CIP Crawford & Company (Canada) Inc. London AMANDA GAUDET, CIP Frank Cowan Company Princeton JORDAN TREMBLAY ClaimsPro Inc. LondonChapter KELLY PECK-MCDONELL,CIPDelegate: Crawford & Company (Canada) Inc. Londonwww.londonclaimsassociation.com
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Our thanks to these companies who find our magazinea useful tool in their marketing programs. We appreciate your support.Advertisers’ IndexAdvertisers’ Index
ADR Chambers................................................................16
Advantage Forensics Inc..................................................22
AutoLux ...........................................................................39
BDO Canada ....................................................................15
Blakeney Henneberry Murphy .............................................11
Brown & Beattie ..............................................................50
Burke’s Restoration .........................................................45
Davis Martindale..............................................................25
Di Scipio Associates ........................................................45
Global Resolutions...........................................................21
Henderson Structured Settlements ...........................17
Hrycay Consulting .................................................44
Leda Restoration .........................................................43
MDD..............................................................................42
McKellar Structured Settlements Inc.....................49
Pinchin Ltd.............................................................14
Pinnacle Adjusters Group ......................................23
Relectronic-Remech Inc. ............................................40
Servicemaster.........................................................12
Williams & Partners...............................................61
Subscribe to our new WP Media channel and you will find videos as well as WP Radio podcasts on the
WP Digital Channelwww.youtube.com/channel/UCMZ7YF3T6ErcQJpsyHrq6vw
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WP MAGAZINE GOES DIGITAL
WP Magazine is going digital, and wewant everyone to have a copy!
Starting this year, the magazine willhave all ten issues online, available toeveryone. This is going to completelyexpand the reach of the articles published, and the advertisements!
We want everyone to have access to education and information about the industry, and in turn grow theorganization as a whole!
The OIAA is looking forward to another great year and we hope to see you all soon!
![Without Prejudice · 2015-02-13 · without prejudice auguSt 2008 legal ServiceS commiSSioner v diane ivy mcKern [2008] nSWadt The Commissioner commenced proceedings against Ms McKern](https://img.dokumen.tips/doc/110x75/5e7d436f4b20b71a8b3f1d52/without-2015-02-13-without-prejudice-august-2008-legal-services-commissioner-v.jpg)
