Watch and wait - Canadian Underwriter...Watch . and. wait. Will the sharing economy be a boon or a threat to the Canadian insurance business? The last word in forensic engineering

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PM40063170

Official Journal of the Canadian Indeépendent Adjusters’ Association

June/July 2017

Watch and waitWill the sharing economy be a boon or a

threat to the Canadian insurance business?

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ContentsJ u n e / J u l y 2 0 1 7 • V O L U M E 1 1 • N U M B E R 3

Cover Feature12 Watch and wait The sharing economy has yet to show its true colours as an influence on the insurance industry in Canada BY EMILY ATKINS

Spotlight18 In the knowLocal knowledge is key to success for Algom AdjustersBY EMILY ATKINS

News Features20 How AI is transforming property insurance BY DARA BANGA, FCIP, CFEI

23 Ontario Court of Appeal finds no conflict of interest in split decision BY MICHAEL S. TEITELBAUM

27 What an insured needs to know when defending a defamation actionBY KAREN R. ZIMMER

29 To Admit or Not to Admit -- Expert evidence on trial BY DEBBIE ORTH

12

Departments

4 First Notice

10 Letters

31 On The Scene

Columns

7 President’s Message


27

4 Claims Canada June/July 2017 www.claimscanada.ca

FN• first notice

More than a third (36 percent) of surveyed Canadian firms do not have cyber security insurance, a concerning situation made worse by an incomplete understanding of how premi-ums are priced and failure to do everything possible to guard against breaches, says US-based analytics firm FICO.

Fifty percent of surveyed respondents in the US and 40 per-cent for respondents globally said they had cyber insurance.

While polled Canadian businesses are ahead of some countries with regard to cyber security risk insurance, they “still have a long way to go” to fully protect themselves in the event of a data breach, FICO cautions.

Perhaps more positive, though, is the finding that “these organizations are significantly more responsible than many of their global counterparts when it comes to insurance.”

Just 16 percent of surveyed Canadian organizations report they have no inten-tion of taking out cyber risk insurance, considerably less than the 27 percent of US executives.

“It’s important for businesses to as-sess the strength of their cyber security defences and to make sure they are cov-ered if they are faced with a data breach,” Kevin Deveau, vice president and man-aging director of FICO Canada, said.

“The ripple effect of a breach can be

felt throughout the organization for a very long time, especially now that Canada’s Digital Privacy Act will require organizations to report any breaches to regulators and customers,” Deveau maintained.

Overall, 80 percent of respondents say insurers could do more to help organizational decision-makers understand how risk price structure is calculated. Results indicate that “there is still confusion in Canada and other countries about how cyber security insurance premiums are set,” FICO said.

More than a quarter of respondents, 26 percent, feel the “introduction of an established industry standard to bench-mark cyber security risk would be beneficial.” The observa-

tion reflects the finding that 20 percent of respondents believe “the premiums calculated based on their

business do not accurately reflect their risk profile.”

Even among those who do have cyber se-curity insurance, just 18 percent of respon-dents say they have insurance that covers all likely risks.

The survey involved senior officers and senior security executives at 350 companies

based in Canada, the United States, the United Kingdom and Scandinavia this past March and

April. Respondents represented firms in financial ser-vices, telecommunications, healthcare, retail, ecom-merce and Internet service providers. ●

Companies lack cyber coverage

Wet Spring causes heavy damageSeveral low-pressure systems that brought heavy rainfall

to portions of Ontario, Quebec and the Maritimes last month cost “hundreds of millions” in US dollars and damaged more than 5,200 homes, according to Impact Forecasting’s latest Global Catastrophe Recap for the month of May.

Following a wet April in Eastern Canada, numerous low pressure systems brought further rainfall to portions of On-tario, Quebec and the Maritimes from May 1 to 6, the heavi-est of which fell on May 5 and 6 and resulted in several rivers overflowing their banks. Two people were killed in Quebec, where nearly 2,000 residents were evacuated, and significant flooding was also experienced across Ontario and in portions of New Brunswick and Nova Scotia. Among the worst affected communities were Ottawa and Gatineau, where both the Ot-tawa and Gatineau rivers breached their banks.

In April, southern portions of British Columbia experienced prolonged periods of rainfall, leaving several rivers well above normal for the time of year. Further heavy rainfall on May 5 led to several of these rivers overflowing their banks. At least two people were killed and hundreds were evacuated as flooding

impacted BC’s Southern Interior. Significant damage to infra-structure and agriculture was reported, said the report from Impact Forecasting, Aon Benfield’s catastrophe model devel-opment team. Economic losses were anticipated in the tens of millions in US dollars.

Later in the month of May, a powerful low-pressure system brought strong winds and storm surge flooding to southern portions of BC on May 23 before tracking into Alberta and Sas-katchewan on May 24. Numerous trees were downed and sig-nificant property damage was reported in all three provinces. The report noted that nearly 200,000 customers were without power at the storm’s peak, with flooding reported along por-tions of BC’s coast and in the Okanagan region. Economic loss was estimated in the tens of millions in US dollars.

South of the border, the US economy took a US$4 billion hit from severe weather in May, with insurance payouts approach-ing $3 billion, according to Aon Benfield. The most prolific event occurred in the Denver, Colorado region, where dam-age from up-to-softball-sized hail led to insurance payouts of more than $1.4 billion in the state alone. ●

www.claimscanada.ca June/July 2017 Claims Canada 5

FN• first notice

A disputed property insurance claim arising from a fire in Ottawa will not be heard by the Supreme Court of Canada.

In a ruling released December 6, 2016, the Court of Appeal for Ontario ruled in favour of Intact, which wrote a policy that included replacement cost. After the fire, the owners wanted to construct new, larger buildings and claim from the insurer the replace-ment cost of the original buildings.

The building own-ers unsuccessfully sued Intact for $2.43 million, which was the differ-ence between the actual cash value that Intact paid and the replace-ment value they were claiming, plus building-code upgrades. The court agreed that Intact did not owe the insureds the cost of building code up-grades and only owed them actual cash value.

The Court of Appeal upheld a 2015 Ontario Superior Court of Justice decision. In February, 2017, the owners applied for leave to appeal to the Supreme Court of Canada, which it denied on June 1.

See Claims Canada, April/May 2017 page 18, for a full description of the case and its implications. ●

An agile and flexible response is needed in light of the new and little-understood risks expected to emerge with the an-ticipated increase in drone activity over the next few years, SCOR experts write in a recent technical newsletter.

“Sales of drones for private use have exploded in the last few years but now, in addition, commercial drone activity is growing exponentially,” note co-authors Hans Kubli, senior un-derwriter, Aviation & Space Treaties, and Andrea Sommerlad, chief underwriting officer, Aviation & Space Treaties for SCOR.

Current uses of drones include disaster relief,

inspecting and ex-ploring inacces-sible places, pre-cision agriculture,

claims handling and logistics.

Kubli and Sommerlad emphasize the need for a safety-first approach by drone op-erators. “To guarantee safe operation, authorities and drone manufacturers must respond fast to changes due to the rapid development of capabilities and the ever-increasing air traffic at low altitude,” they write.

Pointing out that a very limited history of operation, reli-ability and actual claims is currently available, the newsletter notes, “insurers have taken a proactive approach to fill the gaps in knowledge and to offer a comprehensive cover for all stakeholders. They will play a vital role in making drones a prominent part of our future.” ●

The global insurance industry’s ability to confront struc-tural and technological changes is now the greatest risk it faces, according to a new survey of insurers and close ob-servers of the sector.

The Centre for the Study of Financial Innovation’s (CFSI) Insurance Banana Skins 2017 survey, conducted with sup-port from PwC, surveyed 836 “insurance practitioners and industry observers” in 52 countries, including 38 in Canada and 23 in the United States, to find out where they saw the greatest risks over the next two to three years.

The survey identifies the risks, or “banana skins,” facing the global insurance industry in the first half of 2017. Re-spondents were asked to score each of the 22 topical risks in the survey from one to five, where five is the most severe. Change management is at the head of a cluster of operating risks, which have jumped to the top of the rankings.

Overall, the climate for insurers is becoming more chal-lenging, according to respondents. The 2017 index, which measures the level of anxiety in the industry, is at a record high, while the industry’s preparedness to handle these risks has fallen from 2015.

“The report raises concerns about the industry’s abil-ity to address the formidable agenda of digitization, new competition, consolidation and cost reduction it faces, es-pecially because of rapidly emerging technologies which could transform insurance markets, such as driverless cars, the ‘Internet of Things’ and artificial intelligence,” PwC said.

Cyber risk follows close behind, with anxiety rising about attacks on insurers themselves as well as the costs of un-derwriting cybercrime. Other major concerns include the adequacy of insurer’s internal technology systems and new competition, particularly from the ‘insurtech’ sector.

After the technology risks, the next cluster of high-rank-ing risks — interest rates, investment performance and mac-ro-economic risk — shows that concern about economic in-stability remains high.

“For the first time in six editions of this survey, operating risks pose the greatest threat to insurers,” said David Las-celles, survey editor, in the statement. “Structural and tech-nological changes to the industry could upend traditional business models. At the same time, insurers are grappling with a very difficult economic climate, which helps explain why anxiety is at an all-time high.” ●

Supreme Court won’t hear fire case

Insurers feeling anxious about change

Drone activity to increase risks

continued on page 6...


FN• first notice

Internet of Things market boomingThe global market for the Internet of Things (IoT) is expect-

ed to grow from US$170.57 billion in 2017 to $561.04 billion by 2022, according to a new report published by Marketsand-Markets.

The market research firm said the IoT market size is expect-ed to grow at a compound annual growth rate of 26.9 percent between 2017 and 2022. The major force driving the market

includes the adoption of cloud platform-as-a-service (PaaS).

“The advent of advanced data analytics and data processing is also fuelling the growth of the IoT market, as advanced analytics and data processing are useful in deriving results from the high volumes of data collected using the machine-to-machine commu-

nication,” MarketsandMarkets said.North America is expected to

hold the largest market share in the IoT market during the forecast period. “The countries in this re-gion have established economies, which empowers them to strongly invest in [research and development],” Marketsand-Markets noted. Rapid digitalization across industry verticals, the increasing adoption of smart connected devices, and tech-nological advancements have further fuelled the growth of the IoT market in this region. ●

continued from page 5...

Autonomous driving will cause a new “passenger economy” to emerge to sup-port the idle time when driv-ers become riders, an econ-omy that will be more than twice the size of the “sharing economy.”

The findings were con-tained in a new study released by Intel Corporation, Accelerat-ing the Future: The Economic Impact of the Emerging Passenger Economy. The study predicts these new lines of business will grow from US$800 million in 2035 to US$7 trillion by 2050 “as autonomous vehicles become mainstream,” Intel said.

Highlights of future scenarios explored in the study include:“Car-venience”: “From onboard beauty salons to touch-

screen tables for remote collaboration, fast-casual dining, remote vending, mobile health care clinics and treatment pods, and even platooning pod hotels, vehicles will become transportation expe-rience pods”;

Movable movies: Media and content producers will develop custom content formats to match short and long travel times; and

Location-based advertising: This will become more keenly rel-evant, and advertisers and agencies will be presented with a new realm of possibilities for presenting content brands and location. ●

Intel predicts “passenger economy”


HEATHER MATTHEWS

Summer in Canada. The season of hot, steamy days and nights, patios, BBQs — and for some in the industry — it is catastrophe (cat) season. Storm season arrives, particularly on the prairies and Alberta, with its infamous hail and Ontario throws in some violent thunderstorms and the odd tornado. We also have hurri-cane season that heats up south of the border and occasionally our friends in Atlantic Canada get to bear that wrath as well.

Each year we in the industry talk about cat planning, and for independent adjusters the key component is resources and mak-ing sure that we have enough of those key resources that can be mobilized quickly to address our clients’ needs.

A well-prepared cat plan enables efficient handling of high-vol-ume claims and results in higher customer satisfaction with fewer complaints, policyholder retention, positive brand awareness and better indemnity and expense control.

The frequency and severity of natural disasters over the last 20 years has led to an increase in the number of independent adjust-ers with staff dedicated to handling cat claims both in the field and at the desk. In some firms, that is all that they do.

With large cats and a busy hurricane season, high demand for independent adjusters may make it difficult to find enough ad-justers to handle all of the increased volume. It is important early in the year to have discussions with insurers to converse over re-sources, fee schedules, process and procedures to ensure that there is a mutual understanding and plan to execute when the cat oc-curs. It is no longer “if’ we will have a cat, it is now just when and where.

In the planning process the insurers can also forecast staffing and claims needs based on their policies in force in storm-prone areas of the country. Another recommendation would be for in-surers to advise their brokers of their cat plan and any changes to the claims management process when a cat occurs. A pre-mortem with key stakeholders is always a good strategy to examine what can go wrong and how that can be mitigated before the storm and subsequent chaos hit.

We would be remiss in discussing cat season, planning and resources without touching on licensing requirements. Each prov-ince has its own distinct requirements for the licensing of inde-pendent adjusters. If and when the IBC declares a cat, those pro-vincial borders are opened up for adjusters from other provinces and or countries to enter and manage claims.

In situations where there is a cat declared the borders open up but still with some administrative burden and work on our parts. For example, some regulators will accept online background checks while others refuse to recognize them as legitimate. Physical

L’été au Canada. La saison des journées et des nuits chaudes et humides, des patios, des BBQ et, pour certains dans l’industrie, c’est la saison des sinistres. La saison des tempêtes arrive notamment dans les prairies et l’Alberta avec sa triste-ment célèbre grêle, alors que de violents orages et même d’improbables tornades menacent l’Ontario. Nous avons aussi une saison des ouragans qui s’intensifie au sud de la frontière, une colère qui frappe occasionnellement nos amis du Canada atlantique également.

Chaque année, dans l’industrie, nous parlons de planification des sinistres. Pour les experts en sinistres indépendants, la clé consiste à disposer de ressources, et à avoir l’assurance de disposer de suffisamment de ces ressources qui peuvent être mobilisées rapidement afin de répondre aux besoins de nos clients.

Un plan de sinistre bien préparé permet une prise en charge efficace d’un vo-lume élevé de réclamations et se traduit par des clients plus satisfaits, des plaintes moins fréquentes, une grande rétention des personnes assurées, une sensibilisa-tion positive à la marque, une meilleure indemnisation et un meilleur contrôle des dépenses.

La fréquence et la gravité des catastrophes naturelles, au cours des 20 der-nières années, a mené à une augmentation du nombre d’experts en sinistres indé-pendants comptant sur du personnel attitré au traitement des réclamations en cas de catastrophe – sur le terrain comme derrière un bureau. Dans certaines firmes, c’est tout ce qu’ils font.

Lors d’importantes catastrophes et de forts ouragans, une demande accrue d’experts indépendants pourrait entraîner une incapacité de trouver suffisamment d’experts pour prendre en charge la totalité de la hausse de volume. Il est impor-tant, en début d’année, d’avoir des discussions avec les assureurs pour discuter des ressources, des listes de frais, des processus et des procédures afin de s’assurer qu’il existe une compréhension mutuelle et un plan à exécuter lorsque la catastrophe survient. La question n’est plus de savoir «si» une catastrophe va survenir, mais plutôt où et quand elle surviendra.

Au cours du processus de planification, les assureurs peuvent également pré-voir les besoins de recrutement et de réclamations en fonction de leurs politiques en vigueur dans les régions propices aux tempêtes à travers le pays. Une autre recommandation serait que les assureurs avisent leurs courtiers de leur plan en cas de catastrophe et de toute modification du processus de gestion des réclama-tions lorsqu’un sinistre survient. Un pré-mortem avec les principaux intervenants constitue toujours une bonne stratégie pour examiner ce qui est susceptible de mal aller, et comment cela peut être atténué avant que la tempête ne survienne et que le chaos qui en découle ne frappe.

Nous serions négligents d’aborder la saison des sinistres, la planification et les ressources sans toucher aux exigences en matière de permis. Chaque province a ses propres exigences en ce qui a trait à l’octroi de permis d’experts indépendants. Si et quand le BAC déclare une catastrophe, ces frontières provinciales sont ou-vertes aux experts d’autres provinces ou pays pour qu’ils entrent et s’occupent de réclamations.

Dans le cas où un sinistre est déclaré, les frontières s’ouvrent, mais il reste en-


Message from the PresidentLa Plume du président


police checks can take upwards of three weeks to process, de-pending on the jurisdiction; this, obviously, does nothing to ad-dress the immediate need for adjusters.

If the event is severe, in that people’s lives and safety are threatened, the paperwork and fees are exempt, for example, in the case of forest fires. If a cat has been declared but lives/safety are not threatened the paperwork and fees are required, for example, in the event of hail damage. In both scenarios ad-justers are required as soon as possible and we need to continue, as an industry, to drive the regulators for efficient, streamlined, multi-jurisdictional licenses. Where an additional challenge oc-curs is in high volume situations that are not a declared cat but the volume still stretches our resources.

The CIAA continues to push government regulators for streamlined licensing. The Atlantic Provinces have now moved to a harmonized license for adjusters for Nova Scotia, New Brunswick, Newfoundland and PEI. This will allow for speedy dispatching of qualified insurance adjusters to provide services to Atlantic Canadians in a severe weather or catastrophic event that requires a quick insurance response. The Atlantic Superin-tendents have agreed and recognized the protocols for adjusters’ mobility in these events. We are hopeful that this Atlantic move will now help to set precedent and acknowledgement across the country that this same practice is required on a national basis.

Wishing everyone a safe, healthy and happy summer with a well-executed cat plan! ■

NATIONAL EXECUTIVE 2016 - 2017NATIONAL EXECUTIVE 2016 - 2017PRESIDENTHeather Matthews, CIP, CRM, CIOPCrawford & Company (Canada) Inc.539 Riverbend Dr.Kitchener, ON N2K 3S3Phone: (519) 578-5540Fax: (519) 578-2868E-mail: [email protected]

1ST VICE-PRESIDENTMonica Kuzyk, FCIP, CRMCuro Claims Services125 Northfield Dr. W., P.O. Box 218Waterloo, ON N2J 3Z9Phone: (866) 952-2876Fax: (519) 888-9704E-mail: [email protected]

2ND VICE-PRESIDENTLee PowellVericlaim Canada5915 Airport Road, Suite 201Mississauga, ON L4V 1T1Phone: (905) 671-7834Fax: (905) 671-7819E-mail: [email protected]

SECRETARYJeff Edge, CIP, CFEI Leading Edge Claims Services Inc.P.O. Box 1399, 78 Highway 20 WestFonthill, ON L0S 1E0Phone: (289) 897-8676Fax: (289) 897-8677E-mail: [email protected]

TREASURERJohn D. Seyler, CIPIntegrated Insurance Resources5080 Timberlea Blvd., Suite 214Mississauga, ON L4W 4M2Phone: (905) 238-4985 Fax: (905) 238-2735E-mail: [email protected]

PAST-PRESIDENT Fred R. Plant, AIICClaimsPro85 Englehart StreetDieppe, NB E1A 8K2Phone: (506) 853-8507 Fax: (506) 853-8501E-mail: [email protected]

EXECUTIVE DIRECTORPatricia M. BattleCanadian Independent Adjusters’ Association/L’Association Canadienne des Experts IndépendantsCentennial Centre,5401 Eglinton Avenue West, Suite 100Etobicoke, ON M9C 5K6Phone: (416) 621-6222Toll Free: 1-877-255-5589Fax: (416) 621-7776 E-mail: [email protected]

DIRECTORPaul Féron, FCIP, CRMClaimsPro210 – 746 Baseline Rd. EastLondon, ON N6C 5Z2

Phone: (519) 645-6500Fax: (519) 645-2250E-mail: [email protected]

DIRECTORLorri FrederickClaimsPro120 Adelaide St. W., Suite 2401Toronto, ON M5H 1T1Phone: (905) 308-6292Fax: (416) 360-7335E-mail: [email protected]

DIRECTORJames B. Eso, CIP, CIOP Crawford & Company (Canada) Inc.539 Riverbend DriveKitchener, ON N2K 3S3Phone: (519) 578-5540 Fax: (519) 578-2868E-mail: [email protected]

DIRECTORE. Grant King, BA, B.Ed., CIPCrawford & Company (Canada) Inc.120 – 237 Brownlow AvenueDartmouth, NS B3B 2C7Phone: (902) 468-7787Fax: (902) 468-5822E-mail: [email protected] Poon, CIPCunningham Lindsey CanadaClaims Services Ltd.1102 – 50 Burnhamthorpe Rd. W.Mississauga, ON L5B 3C2


DIRECTORMarie C. Gallagher, FCIP, CRMKernaghan Adjusters Limited602 – 1 St. Paul StreetSt. Catharines, ON L2R 7L3Phone: (289) 786-1074Fax: (289) 723-1979E-mail: [email protected] DIRECTORCraig J. Walker, CIP, FCIAA, FIFAAMaltman Group International2001 Sheppard Ave. East, Suite 810Toronto, ON M2J 4Z8Phone: (416) 492-4411Fax: (416) 492-5657E-mail: [email protected] DIRECTORGary Ellis, BBA, FCIP, RF, FCLA, FCIAA, FIFAAAMG Claims Inc.P.O. Box 20102 SherwoodCharlottetown, PE C1A 9E3Phone: (902) 628-9091Fax: (902) 628-9093E-mail: [email protected]

core un fardeau administratif et du travail de notre part. Par exemple, certains experts accepteront la vérification des antécédents en ligne, alors que d’autres refusent de re-connaître cette pratique comme légitime. Les enquêtes physiques de la police peuvent prendre plus de trois semaines à traiter, selon la juridiction; cela, évidemment, n’aide en rien la demande immédiate d’experts.

Si l’événement est grave en ce sens que la vie et la sécurité des personnes sont me-nacées, la paperasse et les frais sont exonérés, par exemple dans le cas d’un feu de forêt. Si un sinistre est déclaré mais que la vie et la sécurité ne sont pas menacées, la paperasse et les frais sont requis, par exemple dans le cas de dommages causés par la grêle. Dans les deux scénarios, des experts sont nécessaires le plus rapidement possible et nous devons continuer, en tant qu’industrie, à insister auprès des organismes réglementaires pour obtenir des permis multi-juridictionnels efficaces et simplifiés. Un défi supplé-mentaire survient dans les situations de volume élevé qui ne sont pas dues à un sinistre déclaré, mais qui requièrent tout de même l’essentiel de nos ressources. L’ACEI continue de faire pression auprès des organismes de réglementation gouvernementaux pour un octroi simplifié des permis. Les provinces de l’Atlantique ont aujourd’hui adopté un permis harmonisé pour les experts de la Nouvelle-Écosse, du Nouveau-Brunswick, de Terre-Neuve et de l’Île-du-Prince-Édouard. Cela permettra l’envoi rapide d’experts en sinistres qualifiés pour offrir des services aux Canadiens de l’Atlantique lors d’intem-péries violentes ou d’événements catastrophiques nécessitant une réponse rapide. Les surintendants de l’Atlantique ont approuvé et reconnu les protocoles facilitant la mobi-lité des experts lors de ces événements. Nous espérons que cette décision de l’Atlantique aidera à établir un précédent et à faire reconnaître dans l’ensemble du pays qu’une telle pratique est nécessaire à l’échelle nationale.

En vous souhaitant à tous un bon été en santé, en sécurité et avec un solide plan en cas de sinistre! ■

...continued from page 7


National Standing Committees 2016-2017NEWFOUNDLAND & LABRADORGejapathy Gopal, CRMClaimsPro27 Duffy Place,P.O. Box 8686, Station ASt. John’s, NL A1B 3T1Phone: (866) 726-7815Fax: (709) 726-6106E-mail: [email protected]

NOVA SCOTIA Michael Connolly, BA, CFEI, CIP ClaimsPro238 Brownlow Avenue, Suite 300Dartmouth, NS B3B 1Y2Phone: (877) 514-6269Fax: (902) 425-9918E-mail: [email protected] NEW BRUNSWICK & PRINCE EDWARD ISLANDGreg Potten, BPE, CIP, CFEIAMG Claims Inc. 212 Queen Street, Unit 308Fredericton, NB E3B 1A8Phone: (506) 458-9000Fax: (506) 458-9595E-mail: [email protected]

QUEBEC/AESIQ Michel Lacelle, PAA/CIPClaimsPro255 Crémazie Est, 2e étageMontréal, QC H2M 1M2Phone: (514) 340-8959 Fax: (514) 342-5474E-mail: [email protected]

ONTARIONiki McConnell, BA (Hons.), CIP, CRM TC Insurance Adjusters Ltd.6-2400 Dundas Street West, Suite 388Mississauga, ON L5K 2R8Phone: (877) 663-0701Fax: (905) 916-0242E-mail: [email protected]

MANITOBACraig Shanks, BA, CIPWheat City Claims Services Ltd.64 Regent Cres.Brandon, MB R7B 2W9Phone: (204) 725-7436Fax: (204) 725-7437E-mail: [email protected]

SASKATCHEWAN Lee Dixon, B. Comm., CIP Midwest Claims Services#7 – 1622 Ontario Ave.Saskatoon, SK S7K 1S8Phone: (306) 668-0870Fax: (306) 249-4114E-mail: [email protected]

WESTERNJody Schmidt, B. Comm., CIP Crawford & Company (Canada) Inc.600, 10709 Jasper Ave.Edmonton, AB T5J 3N3Phone: (780) 486-8024Fax: (780) 486-9001E-mail: [email protected]

PACIFICStacy Phillips, B.Comm., CRM, FCIPClaimsPro600, 1111 Melville StreetVancouver, BC V6E 3V6Phone: (888) 681-6331 Fax: (604) 681-6388E-mail: [email protected]

CIAA REGIONAL PRESIDENTS2016 – 2017

ADVISORYMonica Kuzyk, FCIP, CRMCuro Claims Services125 Northfield Dr. W., P.O. Box 218Waterloo, ON N2J 3Z9Phone: (866) 952-2876Fax: (519) 888-9704E-mail: [email protected]

Lee PowellVericlaim Canada5915 Airport Road, Suite 201Mississauga, ON L4V 1T1Phone: (905) 671-7834Fax: (905) 671-7819E-mail: [email protected]

Fred R. Plant, AIICClaimsPro85 Englehart StreetDieppe, NB E1A 8K2Phone: (506) 853-8507Fax: (506) 853-8501E-mail: [email protected]

Paul Féron, FCIP, CRMClaimsPro210 – 746 Baseline Rd. EastLondon, ON N6C 5Z2Phone: (519) 645-6500Fax: (519) 645-2250E-mail: [email protected]

Lorri FrederickClaimsPro120 Adelaide St. W., Suite 2401Toronto, ON M5H 1T1Phone: (905) 308-6292Fax: (416) 360-7335E-mail: [email protected]

James B. Eso, CIP, CIOP Crawford & Company (Canada) Inc.539 Riverbend DriveKitchener, ON N2K 3S3Phone: (519) 578-5540 Fax: (519) 578-2868E-mail: [email protected]

E. Grant King, BA, B.Ed., CIPCrawford & Company (Canada) Inc.120 – 237 Brownlow AvenueDartmouth, NS B3B 2C7Phone: (902) 468-7787Fax: (902) 468-5822E-mail: [email protected]

Albert Poon, CIPCunningham Lindsey CanadaClaims Services Ltd.1102 – 50 Burnhamthorpe Rd. W.Mississauga, ON L5B 3C2Phone: (905) 896-8181Fax: (905) 896-3485E-mail: [email protected]

Marie C. Gallagher, FCIP, CRMKernaghan Adjusters Limited602 – 1 St. Paul StreetSt. Catharines, ON L2R 7L3Phone: (289) 786-1074Fax: (289) 723-1979E-mail: [email protected]

Craig J. Walker, CIP, FCIAA, FIFAAMaltman Group International2001 Sheppard Ave. East, Suite 810Toronto, ON M2J 4Z8Phone: (416) 492-4411Fax: (416) 492-5657E-mail: [email protected]

CIAA NATIONAL INSURANCE INDUSTRY ADVISORY BOARD Patti M. Kernaghan, FCIP, CRMKernaghan Adjusters Limited300 - 1445 West Georgia StreetVancouver, BC V6G 2T3Phone: 1-800-387-5677Fax: 1-800-387-5644E-mail: [email protected]

Heather Matthews, CIP, CRM, CIOPCrawford & Company (Canada) Inc.539 Riverbend Dr.Kitchener, ON N2K 3S3Phone: (519) 578-5540Fax: (519) 578-2868E-mail: [email protected]

Monica Kuzyk, FCIP, CRMCuro Claims Services125 Northfield Dr. W., P.O. Box 218Waterloo, ON N2J 3Z9Phone: (866) 952-2876Fax: (519) 888-9704E-mail: [email protected]

Fred R. Plant, AIICClaimsPro85 Englehart StreetDieppe, NB E1A 8K2


Patricia M. BattleCanadian Independent Adjusters’ Association/L’Association Canadienne des Experts IndépendantsCentennial Centre,5401 Eglinton Ave. West, Suite 100Etobicoke, ON M9C 5K6Phone: (416) 621-6222Toll Free: 1-877-255-5589Fax: (416) 621-7776 E-mail: [email protected]

Albert Poon, CIPCunningham Lindsey CanadaClaims Services Ltd.1102 – 50 Burnhamthorpe Rd. W.Mississauga, ON L5B 3C2Phone: (905) 896-8181Fax: (905) 896-3485E-mail: [email protected]

Marie C. Gallagher, FCIP, CRMKernaghan Adjusters Limited602 – 1 St. Paul StreetSt. Catharines, ON L2R 7L3Phone: (289) 786-1074Fax: (289) 723-1979E-mail: [email protected]


Ian Frost, FCIPWawanesa Mutual Insurance Company191 BroadwayWinnipeg, MB R3C 3P1Phone: (204) 985-3886Fax: (204) 942-7724E-mail: [email protected]

Tim GuernseyRSA Canada18 York Street, Suite 800Toronto, ON M5J 2T8Phone: (416) 366-7511Fax: (416) 367-9869E-mail: [email protected]

Peter HohmanInsurance Institute of Canada18 King Street East, 6th FloorToronto, ON M5C 1C4Phone: (416) 362-8586Fax: (416) 362-1126E-mail: [email protected]

Glen HopkinsonXL Insurance Company SE100 Yonge Street, Suite 1200Toronto, ON M5C 2W1Phone: (647) 277-8650E-mail: [email protected]

Dan LangerCICMA Ontario Chapter Presidentc/o CIAA5401 Eglinton Ave. W., Suite 100Etobicoke, ON M9C 5K6Phone : (416) 621-6222Fax : (416) 621-7776E-mail: [email protected]

Justin MacGregorGovernor, IBAC151 Rose Glen Rd.Port Hope, ON L1A 3V6Phone: (905) 885-1551E-mail: [email protected]

Penny McCuneSGI Canada2260 11th AvenueRegina, SK S4P 0J9Phone : 844 855-2744E-mail : [email protected]

Alex Walker, CIPAviva Canada2206 Eglinton Ave. E.Toronto, ON M1L 4S8Phone: (866) 692-8482E-mail: [email protected]

Tina Gardiner, B.Sc.,CRM, CIPThe Regional Municipality of York17250 Yonge StreetNewmarket, ON L3Y 6Z1 Phone: 1-877-464-9675E-mail: [email protected]

CAREER RECRUITMENT PLANNINGRichard Swierczynski, BA, CIPAZ Claims Services Inc.1500 Upper Middle Rd., Unit #3,

P.O. Box 76041Oakville, ON L6M 3G3Phone: (905) 825-0027Fax: (905) 825-5543E-mail: [email protected]

COMMUNICATIONSRichard Swierczynski, BA, CIPAZ Claims Services Inc.1500 Upper Middle Rd., Unit #3,P.O. Box 76041Oakville, ON L6M 3G3Phone: (905) 825-0027Fax: (905) 825-5543E-mail: [email protected]

John D. Seyler, CIPIntegrated Insurance Resources5080 Timberlea Blvd., Suite 214Mississauga, ON L4W 4M2Phone: (905) 238-4985Fax: (905) 238-2735E-mail: [email protected]


CONSTITUTION & RULESPaul Féron, FCIP, CRMClaimsPro210 – 746 Baseline Rd. EastLondon, ON N6C 5Z2Phone: (519) 645-6500Fax: (519) 645-2250E-mail: [email protected]

CONVENTIONPaul Hancock, B.Sc., CIP Crawford & Company (Canada) Inc.300 – 123 Front Street WestToronto, ON M5J 2M2Phone: (416) 867-1188Fax: (416) 867-1925E-mail: [email protected]

DESIGNATION/EDUCATIONGary Ellis, BBA, FCIP, RF, FCLA, FCIAA, FIFAAAMG Claims Inc.P.O. Box 20102 SherwoodCharlottetown, PE C1A 9E3Phone: (902) 628-9091Fax: (902) 628-9093E-mail: [email protected]

Robert V. Pearson, CLA, FCIAACIAA Honorary Life Memberc/o CIAA National Office5401 Eglinton Ave. W., Suite 100Etobicoke, ON M9C 5K6Phone: (416) 621-6222Fax: (416) 621-7776E-mail: [email protected]

Lorne Montgomery, CIP, FCIAA, FCLACrawford & Company (Canada) Inc.300-123 Front St. W.Toronto, ON M5J 2M2Telephone: 416-867-1188Fax: 416-867-1925E-Mail: [email protected]

EDITORIALMMary Charman, CIPCrawford & Company (Canada) Inc.1 – 120 Mulock Dr.Newmarket, ON L3Y 7C5Phone: (905) 898-0008Fax: (905) 898-1705E-mail: [email protected]

John M. Sharoun, FCIP, FCIAA, CRMCrawford & Company (Canada) Inc.300 – 123 Front Street WestToronto, ON M5J 2M2Phone: (416) 867-1188Fax: (416) 867-1925E-mail: [email protected]

EMERGENCY MEASURES Richard Van HorneAction Investigations Inc.2 Catelina CourtDartmouth, NS B2X 3G9Phone: (902) 462-1222Fax: (902) 462-3688E-mail:[email protected]

FINANCEJohn D. Seyler, CIPIntegrated Insurance Resources5080 Timberlea Blvd., Suite 214Mississauga, ON L4W 4M2Phone: (905) 238-4985Fax: (905) 238-2735

E-mail: [email protected]



IBC: LIAISON, LEGISLATIVE & FORMSPaul Hancock, B.Sc., CIP Crawford & Company (Canada) Inc.300 – 123 Front Street WestToronto, ON M5J 2M2Phone: (416) 867-1188Fax: (416) 867-1925E-mail: [email protected]

LICENSINGJ. Miles O. Barber, B.Comm. (Hons.), FCIP, CRM, RFNetwork Adjusters Ltd.67 Folkestone Blvd.Winnipeg, MB R3P 0B4Phone: (204) 897-5793Fax: (204) 897-5797E-mail: [email protected]

MEMBERSHIP & QUALIFICATIONSMarie C. Gallagher, FCIP, CRMKernaghan Adjusters Limited602 – 1 St. Paul StreetSt. Catharines, ON L2R 7L3Phone: (289) 786-1074Fax: (289) 723-1979E-mail: [email protected]

NOMINATINGFred R. Plant, AIICClaimsPro85 Englehart StreetDieppe, NB E1A 8K2Phone: (506) 853-8507Fax: (506) 853-8501E-mail: [email protected]


Lorri FrederickClaimsPro120 Adelaide St. W., Suite 2401Toronto, ON M5H 1T1Phone: (905) 308-6292Fax: (416) 360-7335E-mail: [email protected]

James B. Eso, CIP, CIOPCrawford & Company (Canada) Inc.539 Riverbend DriveKitchener, ON N2K 3S3Phone: (519) 578-5540 Fax: (519) 578-2868E-mail: [email protected]


PRIVACYJames B. Eso, CIP, CIOPCrawford & Company (Canada) Inc.539 Riverbend DriveKitchener, ON N2K 3S3Ph: (519) 578-5540 Fax: (519) 578-2868E-mail: [email protected]

Keith P. Edwards, FCILA, CLA, FUEDI-ELAE — ClaimsPro 120 Adelaide St. W., Suite 2401Toronto, ON M5H 1T1Ph: (416) 777-4479 Fax: (416) 360-7335E-mail: [email protected]

PROFESSIONAL PRACTICESFred R. Plant, AIIC — ClaimsPro85 Englehart StreetDieppe, NB E1A 8K2Phone: (506) 853-8507Fax: (506) 853-8501E-mail: [email protected]


Good afternoon,In reading the article, “Property Loss Update: A review of

recent cases, Part 2 - Carter et al V. Intact Insurance Com-pany” (April-may 2017), I am surprised that there wasn’t mention of the broker’s involvement in duty of care. This case can be summoned up as typical of how things can go wrong when protocol is not followed. To illustrate:

Why was the property not professionally appraised for re-placement cost at the inception of the insurance or at a point when the value reached an exceptional limit? The validity of this is proven by the cost per sq. ft. of construction as shown to be $207 for the limit insured and $156 for the tribunal’s – a difference of 33%.

If not as suggested by the preceding point, by what means or by whom was the insured limit of $7,614,750 established? Surely not by the broker, unless a qualified appraiser (and as reported to RIBO). Where is this information to be found?

Did the broker explain the terms of the RCE regarding re-placement to be of “like, kind and quality”? Augmenting, per-haps, with the words, equal in most or all ways to that existing.

Did the broker explain that when loss or damage reaches more than 50% of the property most Building Departments will require total demolition (this would lead to a conversa-tion regarding the immediately preceding point).

Re Justice Phillips’ number two point: any number of conversations could have taken place regarding the ultimate

disposition of the subject of insurance. For example, was wreckage value insurance discussed if the owners had earlier proclaimed they would not rebuild should loss or damage be extensive, following such questioning by the broker? Again, this would open the door to other relevant points, as above.

Reference to moral hazard is in my opinion beyond the bounds of rational thinking when the contractual concept of the insurance is based on established principles of good faith between the two parties. Unless the client deliberate-ly sets out to tell the broker or insurer that he is falsifying his intentions of the insurance, one will never know until after the fact, and half a lie is always harder to prove than a whole lie.

Number four of the Summary is directly aimed at the broker. What it is saying is that the broker had the last clear chance to make certain that all relevant points were made clear to the client or obtained when any doubt exists.

Four years of loss value determination and settlement. If you need a special lesson as a broker on how to conduct your-self in dealing with a client, this would be it. Better to pass the business on to an outside associate or, perhaps more pref-erable for the sake of the house, to sit down and discuss with others in the brokerage the ways and means of handling such situations. It would be a slam-dunk idea to have the client with you, listening in, and asking all the questions he wants.

The author replies: “These are very interesting observations from reviewing my

article. The writer is a professional broker and his questions demonstrate many good points about what ground should be covered by a broker in selling their product.

When writing this article the point of reference is first the Ontario Court decision. That judgement outlines one judge’s opinion. This decision was not accepted by the named insured, which led them to appeal the decision. Subsequently, the On-tario Court of Appeal heard the case in front of three appeal court judges. Their one-day hearing led to them taking seven months to write a unanimous decision that supported the de-cision of the original trial judge. The appeal court is our top court in Ontario so this decision is very significant.

Any legal decision you review contains an overview of the facts. In this particular case, they reference a decision made in “Appraisal” where the building “replacement cost” is decided at about $5.7 million. The policy limit was about $7.6 million. What we don’t know from the decision is whether or not the “replacement cost” price agreed upon involved estimates to use

part of the existing building to rebuild. For example, perhaps the building foundations were unaffected by the fire and could be re-used. So, looking at pure numbers can sometimes involve a bit of guesswork for the reader.

However, I would say that the letter writer makes an ex-cellent point about how a broker and/or insurer go about determining the policy limit on a building loss. They might be relying upon a building estimating tool or perhaps a sim-ple formula of multiplying the square footage by a cost per square foot. As information technology increases there is not much doubt that this whole area will be tightened up as under-insuring a risk leaves premium on the table that an insurer wishes to collect.

This particular judgement involves a key issue that has little to do with the replacement cost or policy limits. It’s all about what’s considered “material of like kind and quality". Like the letter writer, I have some different views on parts of this judgement but my views won’t count as much as the three esteemed judges who sat on this decision.

Have something to say about an article you've read in Claims Canada? Please send your thoughts to the editor, Emily Atkins, [email protected].

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By Emily Atkins

Watch and waitWill the sharing economy be warm and fuzzy

or an existential threat to the insurance industry?


TThe sharing economy is all around us. Many of us take part either deliberately or simply through expedience — think Uber or Airbnb — but it re-mains a nebulous concept, full of promise and more than a little confusion.

That’s part of the reason the Insurance Insti-tute of Canada decided to commission one of its annual emerging issues reports on the subject. Released this spring, Sharing Economy, Implica-tions for the Insurance Industry, was authored by Paul Kovacs, founder and executive director of the Institute for Catastrophic Loss Reduction (ICLR), president and CEO of the Property and Casualty Insurance Compensation Corporation (PACICC), and Adjunct Research Professor, Economics, at the University of Western Ontario.

A second impetus for the study is the sharing economy’s evolving nature. “We thought the shar-ing economy is really an important issue. It’s some-thing that is not well understood in the industry and it’s changing in a fairly rapid way,” Kovacs said in an interview. “So we’re trying to figure out where we are right now in terms of what the issue is, and in particular what it means for insurance.”

When he says they are trying to figure out what the issue is, Kovacs is being quite literal. When people talk about the sharing economy, they can mean wildly different things, with huge variations in the resulting implications for business. Get any two experts on the sharing economy together, he says, and the only sure thing is that they will dis-agree on what it is.

This is because it is both a new phenomenon and one that is changing extremely fast. Its tenta-cles can be seen to reach into many different areas of economic and social interaction, with appar-ently as many perspectives on how to define it as there are startups that can carry the label.

For the purposes of the paper, Kovacs decided on the Oxford English Dictionary definition: “An economic system in which assets or services are shared between private individuals, either free or for a fee, typically by means of the Internet.”

The report elaborates, noting: “The current widespread use of the Internet supports the emer-gence of online platforms where consumers and providers can meet and agree to exchange goods and services — the sharing economy. This may be a commercial exchange where a fee is paid. Per-haps the exchange involves no payment, but a

credit is banked to secure a service in the future. Several platforms bring together people who pro-vide goods and services free of charge.”

Benefits As the report notes, the concept of ‘sharing’

connotes warm, fuzzy feelings, and many people feel good about participating in transactions that are individualized as opposed to institutional. As well, sharing enterprises promote optimization of assets. By having many people drive a vehicle a car-share program ensures that asset is used, not sitting and depreciating in someone’s driveway most of the time. Likewise, home sharing allows people with extra space to use it productively. This optimization confers personal benefits to the property owners — in the form of cash — and also contributes to lower impacts on the planet’s re-sources, thus making them sustainable activities.

Another benefit is lower prices. Decentraliza-tion reduces the overheads associated with large corporations, and prices are able to fluctuate very directly with demand. As well, sharing enterprise allows people to engage in flexible employment, and it also encourages self-regulation through so-cial media customer reviews, the report notes.

What’s at stakeTo understand its implications for the insur-

ance industry, the report argues you must first understand the philosophical underpinnings of the sharing economy. At its heart is a notion of trust. People feel they can place more trust in an individual from whom they contract a service on relatively casual basis than they can in traditional institutions.

Big corporations have lost the credibility they once had to tell us what we should worry about, Kovacs said. “There was a period 40, 50 years ago where insurance companies, banks, governments, the church, would all say, ‘Trust us’. The rapid ex-pansion and growth and institutionalization of insurance came in a period where the car was just coming in and you were worried about home own-ership, and the insurance companies said, ‘Trust us. Give us a relatively small amount of money, and if something bad happens we’re going be there for you’,” he said. “And the foundation of the shar-ing economy is ‘I’m not sure I want to trust one of these big, faceless groups out there.’”

14 Claims Canada June/July 2017 www.claimscanada.

Kovacs finds it fascinating that this shift in attitude is arising in the face of governments and corporations warning us about what we need to fear. The shar-ing economy reflects an opposing feeling. It’s people putting their trust in other in-dividuals to follow through on a promise made to deliver a good or service.

This trend, he asserts, may have seri-

ous implications for the way insurance is delivered. It is a trust-based business that relies on the consumer’s belief that the insurer will pay out when there is a legitimate loss. But this new economy is based simply on a perceived fellow-feel-ing between strangers.

“Insurance needs trust and has been providing it for a long period of time.

And now a new model has shown up which is a whole different thing,” he says. “If that’s where the future’s really getting to then that could shake things up. Any-way, I don’t think it will get resolved any day quickly.”

Two prongsThe report points out that the sharing


EMERGING ISSUES RESEARCH SERIES 10

INTRODUCTION

Timeline footnotes 1

a https://en.wikipedia.org/wiki/Napsterb https://en.wikipedia.org/wiki/Zipcarc https://en.wikipedia.org/wiki/BlackBerryd https://www.lifewire.com/how-many-iphones-have-been-sold-1999500e https://www.airbnb.ca/about/about-usf http://uberestimator.com/citiesg https://www.statista.com/statistics/269915/global-apple-ipad-sales-since-q3-2010/h Walsh, Bryan. "Today's Smart Choice: Don't Own. Share," as part of Time magazine's "10 Ideas That Will Change the World."

WHAT IS THE SHARING ECONOMY?

Timeline of technological advancements and examples marking the advent of sharing platforms

Image used with permission of IIC


economy has implications for both the insurance product and the mechanisms of the insurance industry. On the first hand, the new sharing economy busi-nesses are operating in a space that has not really been defined. They are typi-cally quasi-personal, quasi-business op-erations that can leave the operator im-properly or insufficiently covered against the risks of doing business.

Until very recently policies have not been available for ride-sharing or room-and home-sharing providers. That is changing, with the province of Ontario, for example, introducing fleet insurance

options for those in ride-sharing enter-prises. Home sharing policies have also been recently made available, beyond the mandatory coverage required by some of the sharing sites.

An opportunity for adjustersBut given the number of individuals

taking part in sharing economy activi-ties, Kovacs says it’s inevitable that there will be messy situations when these peo-ple try to make claims against policies that don’t exactly match their activities.

“It’s not hard to come up with liter-ally hundreds of different companies in Canada who are offering sharing-type services, and I think most of them do not know that they don’t have proper insur-ance right now,” he says. “

“I think the industry will awaken and see this amazing opportunity of lots of customers who want insurance, who want the right insurance, and I hope they involve the experienced claims people in the design and the follow-through in terms of those products.”

He points out that it is the claims managers who know a great deal about what people actually need, because they are the ones who “actually go and sit with policy holders and help them.” Although this isn’t a new issue, that claims manag-ers should be involved in the product de-sign process, “it’s just pushed to a higher level” now.”

Kovacs says there is a ripe opportuni-

ty for adjusters to offer their expertise in helping the underwriters figure out what products will meet the needs of sharing enterprise. “I would love to see them get involved in that,” he says.

An existential questionThe second prong is much more dif-

ficult to get a handle on. The report notes that new insurtech and peer-to-peer in-surance companies are making forays

into the insurance business around the world.

There is an upsurge in enterprises of-fering insurance-like products that aim to compete with the established indus-try, as well as some offering services that dovetail with it. Insurtech, in particular, is opening up new avenues of data analy-sis that promise to enhance the tradi-tional insurers’ ability to analyze risk and underwrite new lines. Many in the

The full 66-page text of Sharing Economy, Implications for the Insurance Industry is available to download at: http://tinyurl.com/iic-sharing


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insurtech space and sharing enterprises are choosing established insurance in-dustry partners (for example, WeGo-Look, which we profiled in the last issue of Claims Canada).

Kovacs said that in his recent conver-sations with senior insurance executives, they are “ uniformly positive” about the opportunities for innovation that the in-surtech industry is offering. “Their big challenge was that there was so much coming in the insurtech area that in-cluded claims and investing and under-

writing…how did they filter through the many different things coming at them and find the ones that would make the biggest impact and they really could work with.”

But many in the peer-to-peer realm are critical of established insurance pro-viders. And they are setting up as com-petitors to both brokers and insurers, of-fering risk pooling or custom coverages.

These organizations — so far there are none in Canada yet — fly under the regulatory radar. In the jurisdictions

where they operate, they are “not subject to solvency and market conduct regula-tions applied to traditional insurers. The company does not put its own capital at risk when it deals with policyholders,” the report notes.

So if they are not insurance, yet com-pete with the established insurance in-dustry, there is great potential for disrup-tion. “Time will tell if there is a clear and consistent distinction between insurance and non-insurance services when viewed by consumers, regulators, and the Cana-dian insurance industry,” the report says.

Where do adjusters fit?Kovacs says although the report did

not focus on claims handling and adjust-ment, he sees several ways the sharing economy might have an impact.

Professional claims adjusting has a cost, and if these sharing services are try-ing to be cheaper, they may eliminate the adjuster and opt instead for peer review. Some have even gone so far as to suggest that a claim’s validity be decided by a jury of fellow pool participants.

However, Kovacs also sees an upside where it may end up falling to experi-enced adjusters to step in, as freelancers, to sort things out when these peer re-views turn out to be questioned by some-one who feels they were treated unfairly.

On the other hand, he says, “I did not see sharing-type products with a different claims management approach transforming insurance in other parts of the world. It isn’t the way it’s gone yet. Personally I think the public like what is in place and they know there’s a cost involved, but you get something of value for that.”

Ripe and ready?The report notes that author Rachel

Botsman “has identified four characteris-tics of industries ripe for disruption: com-plex experiences, broken trusts, redundant intermediaries, and limited access.”

Although the exact fit of the Cana-dian industry to these hallmarks is a matter of debate, signs indicate it may be ready. The industry itself is working hard to streamline its interactions with consumers, particularly in the area of client interaction, indicating that it rec-ognizes the importance of simpler, easier processes. By contrast, peer-to-peer op-erations and sharing enterprises cer-tainly offer attractive simplicity in their person-to-person dealings.

The report notes that while most


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“claimants express high satisfaction with the insurance indus-try” there are always some who have bad experiences. Coupled with the general trend towards a lack of trust in institutions, it is easy to see how the sharing offerings could pose a challenge to the established industry.

The role of the broker is increasingly challenged by the ad-vent and availability of sophisticated new technologies that ask the questions and provide answers to consumers any time, any-where, fulfilling demand for immediacy and simplicity.

Out of sync with Botsman’s criteria is the breadth of options available to Canadian consumers. “Insurance is the most com-petitive financial services industry in Canada, and consumers have many choices in terms of how they purchase protection,” the report states.

It’s clear the Canadian industry is not immune to sharing economy competition and cooperation. The report asks the in-surance industry to take notice of developments in the sharing economy because they threaten to disrupt the traditional way the insurance business gets done.

The report makes recommendations designed to address both prongs of the sharing economy challenge to insurance. On the provision of insurance to sharing economy players, it sug-gests the industry should:

• Work with regulators to ensure innovation is supported to create flexibility for insurers to meet sharing economy consumers, while also protecting the public.

• Assess readiness for the sharing economy; identify how the insurance industry will develop that suit the evolving needs of sharing providers.

• Partner with other stakeholders, including sharing organiza-tions and governments, to better document the current and expected future state of the sharing economy in Canada.

• Establish communications so participants from the sharing economy can express and successfully address their insur-ance needs and expectations.

• Track and report on developments in the sharing economy around the world, including the availability of insurance and the evolution of regulations.

Regarding the potentially disruptive business models being in-troduced, the report suggest the insurance industry should:

• Track how non-traditional competitors affect insurance in coun-tries with similar markets, like the United States and Britain.

• Monitor traditional companies and intermediaries that partner with new entrants or introduce unconventional products and services based on sharing.

• Support insurance regulators in protecting consumers from organizations offering insurance products that are not licensed, fail to comply with established solvency and market conduct regulations, and avoid taxation.

• Prepare to respond to the direct challenges new competi-tors will aim at traditional industry practices; this includes planning to directly challenge false statements.

• Anticipate that the advent of peer-to-peer insurance com-petition in Canada could be used by the industry to press for a review of the current regulations and tax burden fac-ing the industry and its customers.

It’s a wait-and-see game, the report concludes, change is coming, but in what form and how fast remains to be seen.

“I think that sharing will be important, and even if we’re not clear all of what it means yet or what we should include in the discussion, I think it will be a process that will take time,” Kovacs concluded. •

Governments are paying attention…but not doing muchOntario:

In October 2015, the province established the Sharing Economy Advisory Committee with represen-tation from key ministries. Its mandate is to oversee the province’s approach and to “harness opportuni-ties presented by the sector”.

The committee aims to offer insight on policy, regulatory and legislative challenges typically associat-ed with sharing economy business models. It will also be taking into account the views of traditional sectors to ensure initiatives do not unduly affect their com-petitiveness. It expected that new regulations might be required in some circumstances, while in others the regulatory burden might need to be reduced.

By the 2016 budget, the province began to take more of a position, stating: “The sharing economy has significant potential [emphasis added] to create jobs and drive economic growth, productivity and innova-tion. The benefits of the sharing economy also include cost savings and greater choice for consumers, flexible employment opportunities and increased access to capital for small startups.”

Since the 2016 Budget, the Committee has been meeting with municipalities and industry, and has sought public opinion through polling and focus groups.

The province introduced automobile insurance for ride-sharing enterprises by approving a regulatory change under the Insurance Act that allows commer-cial fleet insurance to be offered for vehicles available for hire through an online application.

The province cautions that “more changes will be necessary and the government remains committed to working with FSCO and insurance stakeholders to develop a long-term solution that will fully integrate sharing economy business models into Ontario’s auto insurance system.”

Alberta:The insurance regulator in Alberta established

new coverages for ride-sharing providers in the past couple years, after working with the industry and the providers to examine the scope of the problem.

Quebec: In 2016 the Quebec regulator, the Autorité des

marchés financiers (AMF), reminded people that insurance is regulated and providers of insurance through peer-to-peer risk-sharing platforms, like traditional providers, require registration and regula-tory approval. Consumers were warned that AMF had yet to determine the compliance of peer-to-peer products and the companies offering them.

In northern Ontario, the towns of Elliot Lake and Espanola, along with Manitoulin Island in the

northern part of Lake Huron, form a triangle right in the middle of the 300 kilometres that separate Sudbury and Sault Ste Marie.

If you need a claim adjusted in this zone, Blair Boilard and his team at Algom Adjusters are the ones to call.

Algom Adjusters was formed in 1977 by Roger Lauzon, who purchased a part of the former Algoma Adjusters and set up shop in Elliot Lake. Blair joined the com-pany in 1990 as a “greenhorn” adjuster. He had started work as an insurance bro-ker in 1987, and when Roger had an em-ployee retire, Blair jumped at the chance to make the switch to claims.

“I thought claims would be a very in-teresting side to the business, so I took him up on the offer,” he says.

Blair then worked his way up through the ranks, earning his license and work-ing towards his CIP designation (then the AIIC). He and Roger became partners in Algom Adjusters in 2010, and Roger has subsequently retired from the business.

Blair is now the owner, and has two colleagues, adjuster Cheryl Sharratt, and Sherrie Boilard, Blair’s wife, who is the support person. Their youngest, Autumn, is working part time this summer, helping in the office.

Big or smallAlgom Adjusters not only covers a

relatively large geographical area, it is also diversified in the kinds of files it handles.

“Big or small, we do them all,“ Blair says. “Honestly, I’ve always joked with various insurers about that over the years, but we do all lines.”

The focus is on property, both private and commercial. He does a bit of casualty and a/b work and the company has a couple of municipal accounts. There are also busi-ness interruption claims, so “we are lucky — we are well rounded and see claims from all sides of business,” Blair notes.

It’s a good space to work in, he adds. “We’re not counting on any one area for work.”

Who you knowWhile the geography and scope may

be large, it’s the small, tight-knit commu-nity that helps to define Algom’s success.

“Being as small as we are, when we get a claim from whoever it is, they know who is handling their claim,“ Blair says. “We’re not passing it on to others, so I think we’re fortunate that way. We get work because of the good work that we do.”

Reputation is absolutely essential, he adds. Living in a smaller community means he knows all the players.

“We know the people, whether it’s the contractor, the lawyer, the doctor — whoever. And it helps to have some back-ground information sometimes.”

This knowledge comes in handy, Blair says. For example, if there is a need to do surveillance, he will engage in pre-sur-veillance.

“So we’ll get all the goods on the in-dividual because of the contacts that we have,” he says.

That way he knows ahead of time if someone they are watching is planning an activity like climbing a tree to cut it down, or putting up a scaffolding to work on their house. Then he can arrange to have an in-vestigator in place to record the action.

Not only does this allow his investi-gator to get the information he needs to

make a case, it also saves his clients costs because he can target resources efficiently.

“We’re really successful with that be-cause we are the eyes and ears here. It’s the old school way of doing things and it still works,” he adds.

The local advantageBlair says that although being a small IA

has its challenges sometimes when consid-ering competition from the larger, national firms, he also notes that being smaller — and local — confers big advantages.

He has built strong relationships with smaller insurers and mutuals. “They seem to be quite receptive to working with smaller companies like ours,“ he says.

As well, geography is on his side, as any other adjuster would have to travel between 320 and 400 kilometers to get to Elliot Lake and back for an investiga-tion. In Espanola, they are the closest IA to Manitoulin Island.

Blair notes, “we still have lots of com-petition and that’s the nature of the busi-ness. Our industry is changing because we see contractors covering a large area and they are doing work directly for vari-ous insurers with no adjuster on site. But that’s just a sign of the times.”

He notes that by being on site Algom has helped clients save costs. In one recent claim a contractor removed wet material from a garage bay and then introduced drying equipment, which was not re-quired as the wet material had been re-moved. This simple application of “com-mon sense,” Blair says, saved Algom’s principal $3,000.

Strength in numbersBlair has long been a believer in the

power of the CIIA. Over the years he has


S• spotlight

In the knowLocal knowledge is key to success for Algom AdjustersBY EMILY ATKINS

attended many conventions and semi-nars, noting that he has met lots of fellow adjusters this way, many of whom he con-siders great friends.

“There’s some great people in our in-dustry and in our association,” he notes. “And they’ve done some great things over the years. I was impressed with the plan for insurance for the members.”

One initiative he is particularly inter-ested in now is finding a way for the as-sociation to offer a health benefit plan for members. “As a small IA we have a benefit plan for myself and my staff. But it would be pretty nice if we could, as an associa-tion, be a group and look to have the same coverages with much more feasible fees or rates,” he says.

Blair also believes the association can help small IAs work on succession plan-ning, which he knows is a serious issue for small companies, requiring a lot of fore-thought and consideration.

He says that being in the north might be a hindrance or a help in his eventual search for someone to step in at Algom

Adjusters. However, he’s not quite there yet. “Cheryl and I are almost the same age

actually, and we both enjoy doing what we’re doing. I’m here for probably another five to ten years for sure. When I am ready to slow down a little bit, then I would look at bringing in another junior person if they are interested.”

Endlessly interestingFor the time being, thoughts of suc-

cession really aren’t top of mind, as Blair says. He loves his work, and the variety is brings. “You never know what tomor-row’s going to hold.”

Sometimes its rough, he says, citing the collapse of the Algo Mall in Elliot Lake in 2012, which killed two, injured 19 and de-stroyed many businesses and the public library. “It was a pretty big hit for a small community,” he says. “But it’s turned a cor-ner and a lot of it is due to insurance.”

Satisfaction comes in knowing that he is doing a job that people appreciate and remember. He recounts being called to a remote property on Manitoulin Island

where the owner said he specifically asked for Blair because of a claim he had worked years before.

Keep it personalWhen asked about the keys to success

in claims, Blair says keep on learning. “Take advantage of every educational

opportunity that you have, and there are lots out there. And now with webinars there are even more opportunities and it takes less time, and it’s a lot less costly.”

Perhaps it’s a product of his success in a small community where personal rela-tionships play a large part in business, or maybe it’s the reason for it, but Blair also says that he would far rather attend a sem-inar or conference in person. “It’s when you have an opportunity to sit down with someone and have a coffee or a beer af-terwards; you can learn just as much by interacting with people on a social level. If you take the time to just get to know people, have a conversation, I learn more sometimes outside of the seminar than I do inside.” •


L-R: Cheryl Sharratt, Blair Boilard, Sherrie Boilard and Autumn Boilard of Algom Adjusters


Across industries, and around the globe, artificial intelligence (AI) is trans-forming customer service.

It’s a major player in insurtech, which is taking on a new importance in the in-surance industry – and it’s about time, too, according to Insurance Canada.

“With a few exceptions, the vast majority of P&C insur-ers have lagged other industries in the application of tech-nology,” said contributor Patrick Vice.

So, what can artificial intelligence do for property claims in Canada? Let’s find out.

Artificial intelligence on the rise“According to a study by Oracle, nearly eight out of 10

businesses have already implemented or are planning to adopt AI as a customer service solution by 2020,” said Ade-lyn Zhou at Forbes. The study surveyed 800 business execu-tives across France, the Netherlands, South Africa and the UK who do business in manufacturing, high-tech engineer-ing, online retail and telecommunications.

While Oracle didn’t focus specifically on the insurance industry, its findings are salient nevertheless. In the risk management realm, AI has the potential to improve efficien-cies in risk analysis, customer interaction, decision-making and claims assessment.

“AI’s initial impact primarily relates to improving effi-ciencies and automating existing customer-facing, under-writing and claims processes,” said PwC in a study published last spring. “Over time, its impact will be more profound.”

Bringing AI to customer service – with chatbots

For insurers who want to improve customer service with AI, there are two primary strategies.

In the first, human reps can use artificial intelligence to help them become more efficient and effective in their exist-ing job descriptions. In short, it’s a new tool with which reps can improve on their current tasks.

In the second strategy, chatbots become the customer-facing agent, taking care of customers’ needs with no hu-man involvement. For example, NextInsurance — a Silicon Valley insurtech company based in Palo Alto, California — just launched “the world’s first full insurance signup via Facebook Messenger,” it said, enabling American photogra-phers and physical trainers to get business insurance from a chatbot.

The benefits of using chatbots in this way are straightfor-ward: They improve the customer experience while cutting costs for insurers.

And, when it comes to property claims, improving the

experience isn’t just icing on a cake. It’s crucial. According to Canadian Underwriter, research shows that a positive customer experience is a key determinant in customer re-tention. Chatbots lower handling time by at least 10 percent, resolve more issues without needing to escalate (saving on the cost of more expensive support), increase first-contact resolution rates, and save insurers from having to train agents on basic tasks that chatbots can do for them, Zhou said.

How chatbots improve property claims

Customer acquisition and support aren’t the only ways to put chatbots to work in insurance. Chatbots can revolution-ize the claims process, as well. According to PwC, the “robo-claims adjuster” can leverage a variety of AI technologies to reduce processing time and costs.1. Soft robotics. Bots use mining techniques to identify bot-

tlenecks, optimize efficiencies, and improve conformance to standard claims processes.

2. Graph analysis. Bots use social networks to find fraud patterns in claims.

3. Machine learning. Bots use deep learning techniques to automatically categorize severity and build predictive models.

BY DARA BANGA, FCIP, CFEI

How AI is transforming property insurance claims


4. Sensors (IoT). Bots use home and industrial data from connected devices to build operational intelligence on the frequency and severity of property claims.

5. Simulation modeling. Bots build deep causal claims models and link them with products and distribution.It’s one thing to talk about how chatbots do things. It’s

quite another to talk about how they make people feel. So, how do the points on this list translate to a better customer experience?

An opportunity for disruptionFiling a claim in the conventional way is nothing to get

excited about. It can take weeks for claimants to navigate the back-and-forth following a loss, get a decision, and receive their reimbursements.

This is one place where artificial intelligence may well disrupt the conventional scene: In Toronto, for example, the P&C startup Turque plans to leverage advanced technology to deliver a “streamlined claims experience”.

What specifically does that mean? In Turque’s case, cus-tomers will be able to access a “virtual vault” of data on their house coverage and deductibles. There, they’ll be able to file claims, upload media (photo, video and voice record-ings), schedule repairs and take care of property emergen-cies. More importantly, it will give them a transparent view

of how their claim is moving through the process, helping them maintain realistic expectations and feel more involved in the meantime.

Turque isn’t just planning to do better at what’s already be-ing done. They aim to expand on the conventional model at the same time, combining typical insurance products with legal and tax services as well. To repeat what PwC said earlier, the impacts of advanced technology in insurance are already sig-nificant, and will only grow “more profound” over time.

Get ready for an insurtech breakthroughWith all this activity brewing in the AI chatbot insurtech

scene, one can expect good things. According to Mukul Ahuja, a business strategist at Monitor Deloitte, 2017 is go-ing to be a breakthrough year for insurance in Canada.

“To start with, global venture capital activity related to insurance startups hit its highest annual total in 2016 with $1.69 billion invested in 173 deals,” he said. “Meanwhile, Canada has emerged as a premiere test bed for fintech solutions broadly speaking, having evolved some key assets and raised more than $1 billion in start-up funding since 2010. Indeed, Canada has the highest concentration of tech firms outside of Silicon Valley (in Ontario), a well-established research and ad-vanced education infrastructure, the largest financial sector in North America outside of New York, as well as important en-trepreneurship and incubator spaces, such as Toronto’s MaRS Discovery District, the Ryerson DMZ, and Communitech in Kitchener.”

Among other factors, such as the sharing economy, au-tonomous cars, the IoT and big data, AI is slated to play an important role here.

While it’s hard to believe that AI will ever replace the need for thoughtful, thorough independent claims adjusters in the field, it’s easy to see how it could automate the reso-lution of simple claims and provide data to better inform complex claims decisions.

At the end of the day, according to the German scientist Sebastian Thrun, AI isn’t actually about robots. “Nobody phrases it this way, but I think that artificial intelligence is almost a humanities discipline,” Thrun said. “It’s really an attempt to understand human intelligence and human cognition.”

Perhaps no other AI application makes this clearer than customer service in insurance claims. First and last, the pur-pose of the tool is to deliver a positive experience for those who use it — and in so doing, to improve business outcomes for those who deploy it.

Dara Banga, FCIP, CFEI, is the President of DSB Claims Solutions, headquartered in Brampton, Ontario. To learn more, visit www.dsbclaims.com.

How AI is transforming property insurance claims

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In Whirlpool Canada Co. v Chavila Hold-ings Ltd., 2017 ONCA 81, a three-member panel of the Ontario Court of Appeal, with Chief Justice

Strathy dissenting, found there was no conflict of interest in defence coun-sel, appointed under a contractual indemnification agreement, defend-ing the Appellant, Whirlpool Canada Co. (Whirlpool). Defence counsel had been instructed not to raise a limita-tion defence argument on behalf of Whirlpool.

While the case did not involve an insurance policy, it is of interest be-cause the Court used duty-to-defend principles in its analysis, and the rea-soning of both the majority and dis-sent have the potential to affect how the courts may approach the question of conflict of interest in the future.

The majority of the Court of Appeal found the parties did not have adverse interests and that the representation of Whirlpool was not materially or ad-versely affected. For this reason, Whirl-pool’s appeal from the judge’s decision that there was no conflict was dismissed.

Dissenting, Chief Justice Strathy found defence counsel was in a conflict of interest after being instructed not to raise the limitation defence. Addition-

ally, the duty to defend in good faith was breached.

BackgroundIn 1997, Whirlpool sold land to

two of the Respondents, Outrigger Investments Limited (Outrigger) and Chavila Holdings Limited (Chavila). The parties entered into an indemnity agreement at the time of the sale. Out-rigger and Chavila agreed to indemni-fy Whirlpool for liability arising from the contamination of the lands in the vicinity of the property.

863800 Ontario Limited (863800), a company affiliated with Outrigger and Chavila, also purchased neighbouring land from Canadian Pacific Railway Company (CP) and Oxford Properties Group Inc. (Oxford).

In 2004, 863800 brought an action against CP and Oxford for the con-tamination of the land it purchased. In 2012, after the pleadings had closed, CP and Oxford issued separate actions against Whirlpool seeking contribu-tion and indemnity.

After the proceedings were brought against Whirlpool, Outrigger and Chavila confirmed they would defend Whirlpool. Further, 863800 confirmed it would not seek to collect any award it received against CP and Oxford, for which Whirlpool was required to in-demnify CP and Oxford.

After appointing Whirlpool’s de-fence counsel, Outrigger and Chavila instructed counsel not to raise a limi-tation period defence on behalf of Whirlpool. As companies affiliated with 863800, Outrigger and Chavila did not want Whirlpool “assisting” CP and Oxford in a limitation argument.

In response, Whirlpool brought an Application arguing the appointed counsel was in a conflict of interest, and that Whirlpool was entitled to re-tain its own separate counsel paid for by Outrigger and Chavila.

The decisionAt first instance, the Court found

there was no conflict of interest in ap-pointed counsel taking instructions from Outrigger and Chavila. The non-pursuit of the limitation defence was of no consequence to Whirlpool given the indemnity agreement. Whirlpool would suffer no economic setback even if judgment were found against it.

In response to Whirlpool’s argu-ment that it may still suffer reputation-

Ontario Court of Appeal finds no conflict of interest in

BY MICHAEL S. TEITELBAUM

split decision

al damage and/or the indemnity may not be paid, it was found there was no specific evidence provided to support that argument.

The Court found there were no in-structions it could foresee being given by Chavila and Outrigger to appointed counsel that would harm Whirlpool to the benefit of 863800. 863800, Outrigger, Chavila and Whirlpool all had an inter-est in maximizing the liability of CP and Oxford. The application was dismissed.

Whirlpool appealed the decision that the appointed counsel’s representation of Whirlpool did not place him in a prohib-ited conflict of interest. It argued that as companies affiliated with 863800, Out-rigger and Chavila had an adverse inter-est vis-à-vis Whirlpool in the outcome of a limitation defence argument.

The majority decisionJustice Benotto, with Justice La-

Forme concurring, dismissed Whirl-pool’s appeal. They found the appointed

counsel was not in a conflict of inter-est in defending Whirlpool while tak-ing instructions from Outrigger and Chavila.

Justice Benotto reviewed the law on a lawyer’s duty to avoid conflicts of interest. The bright line rule, set out in R v. Neil, 2002 SCC 70, says a law-yer may not represent a client in one matter while representing that client’s adversary in another matter. Impor-tantly, the bright line rule only ap-plies where the immediate interests of clients are directly adverse. If the im-mediate interests of the clients are not directly adverse, the applicable test is whether there is a substantial risk that the lawyer’s representation of the cli-ent would be materially and adversely affected.

Justice Benotto found Whirlpool and 863800 did not have adverse inter-ests because: 1) Given that Whirlpool would be indemnified, Whirlpool had no “direct interest in the outcome” of

either action. For this reason, it was unlikely that appointed counsel’s rep-resentation of Whirlpool would be adversely affected by the instructions from Outrigger and Chavila; and, 2) Whirlpool agreed to the terms of the indemnity agreement at the time of the sale of the land. The agreement contemplated that litigation may occur and that Whirlpool knew that issues of reputational damage and damage to its credit rating could arise. Justice Benot-to found those matters could not now be raised to ground a claim of conflict of interest.

Benotto found that insurance law principles supported the decision that there was no conflict of interest. Outrigger and Chavila, in defending Whirlpool, were in a similar position to liability insurers, and must exercise reasonable care and skill and pursue Whirlpool’s best interests by minimiz-ing its liability. Benotto found it was unlikely Outrigger and Chavila would

infringe the duty of utmost good faith to minimize Whirlpool’s liability. In-deed, Whirlpool’s interests overlap with the interests of 863800, Outrig-ger and Chavila in maximizing the liability of CP and Oxford. Moreover, Whirlpool’s interests would not be af-fected because of the indemnity agree-ment and 863800’s undertaking not to collect any damages for which Whirl-pool is found liable.

The dissent Chief Justice Strathy dissented,

finding Whirlpool was entitled to sep-arate counsel for two reasons.

First, the situation was contrary to the bright line rule. The interests of Whirlpool were directly adverse to the interests of 863800. It was in Whirl-pool’s interests to raise a limitation defence, and it was not in the interests of 863800. The success of the limita-tion defence would mean the defeat of 863800’s action. His Honour reasoned

that Whirlpool should not have to rely on 863800’s undertaking, a party with which it has not contracted, and run the risk of a judgment going against it, and then having to enforce the in-demnity. Chief Justice Strathy also dis-agreed that the indemnity agreement meant Whirlpool had no direct inter-est in the result of the action. A judg-ment against Whirlpool could cause reputational damage or damage to its credit rating. He found that Whirlpool should be entitled to raise every viable defence it wished in order to avoid call-ing on the indemnity agreement.

Secondly, Strathy found that un-der insurance law principles, Chavila and Outrigger breached their duty to defend. The indemnity agreement was akin to a promise by an insurer to defend an insured. By agreeing to pro-vide a diligent defence, Outrigger and Chavila must conduct the defence in good faith and exercise reasonable care and skill in doing so. The companies

have a duty not to “steer” the defence in favour of the indemnifying parties. By abandoning the viable limitation defence for the benefit of 863800, Out-rigger and Chavila breached their duty to defend. As a result, Chief Justice Strathy would have found Whirlpool entitled to retain separate counsel at the expense of the Respondents.

CommentaryThe majority and dissenting de-

cisions differed on three important points: First, whether or not Whirlpool had a direct interest in the outcome of the actions. The majority found that because Whirlpool was to be indem-nified if liability were found against it, it did not have a direct interest in the proceedings. Chief Justice Strathy disagreed, focusing on other detri-mental effects a judgment might have on Whirlpool despite the indemnity agreement, such as a judgment against it potentially impacting its business


reputation or credit rating. Strathy found that there is a benefit to avoiding liability entirely, instead of relying on indemnification.

Secondly, both the majority and dissent relied on insurance law prin-ciples to support their respective con-clusions. Outrigger and Chavila were found to be analogous to liability in-surers, and Whirlpool to an insured. In a similar position to an insurer, the majority found that Outrigger and Chavila were bound by a duty of good faith, which they were unlikely to breach given the similar interests on liability. Conversely, Strathy found the two companies had already breached their duty to Whirlpool by instructing the appointed counsel not to raise a vi-able defence.

Finally, there was an important dis-agreement on the practical importance of not raising the limitation defence. Both decisions recognized that CP and

Oxford had already raised the limita-tion period issue. Since it had already been raised, the majority viewed the issue as more theoretical, with little practical consequence. In contrast, Chief Justice Strathy found that the re-fusal to instruct on, and raise, a viable defence was important, despite the fact that the defence was already raised by the CP and Oxford.

The differing views expressed in the insurance law principles analysis raise the possibility that the courts may be-come further engaged in the conflict of interest issue when addressing the duty to defend, and the right to ap-point and instruct counsel. To date, generally speaking, unless the con-flict is obvious, the courts have been inclined to rely on appointed defence counsel’s ethical obligations to defend a matter in their client’s best interests as long as this is the mandate given to defence counsel by the insurer. Argu-

ably, this comports with the practical approach taken by the majority, so this tack would prevail. If the Chief Jus-tice’s stricter but possibly theoretical concerns about reputation and credit rating were always included in the determination then it appears there would be more potential for a conflict to be suggested. The question might then become whether or not there’s a conflict as long as some interest of the insured may be affected, and the in-sured wants to protect it.

We will have to see whether, go-ing forward, this becomes a matter of debate when the courts deal with the issue of conflict of interest in duty to defend cases.

Many thanks to Andrew W. Cot-

treau, a student-at-law in Hughes Amys LLP’s Toronto office, for his ex-cellent assistance in the preparation of this article.


I have defended pro-fessionals who have found themselves on the wrong side of a defamation action. Often my clients had a genuine need to

voice criticisms of a person or com-pany. Other times, it was just too easy for them to publish their own piece on social media, or to endorse and hyper-link to the defamatory words of others.

It usually becomes quickly appar-ent that the defendant had not appre-ciated, at the time of publishing, the likelihood they would be sued, or what would be involved in proving they fall within the protection of defences such as fair comment, truth, or qualified privilege.

In the insurance context, insureds are frequently and understandably unprepared for what a defamation de-fence involves. This discussion hopes to flesh out common misgivings that insureds have when sued in defama-tion. In some cases, understanding these points can assist the insured in

coming to terms with the fact that the best course of action may be to remove the publication and agree to a carefully drafted, and relatively palatable, apolo-gy and retraction. In other cases, these points simply prepare the insured for the road ahead.

The meaning defended is not the meaning intended by the author

A publisher rarely appreciates that the meanings and innuendoes which will need to be defended are not the meanings and innuendoes the indi-vidual intended to convey or believed were being conveyed. In a defamation suit counsel will fight over the mean-ings of the words published. Plaintiff’s counsel will argue that the most ghast-ly and horrendous meanings were con-veyed, while defence counsel will seek to minimize or deny these meanings.

When considering meaning, the Court will not consider what the defen-dant meant to say, but rather will look at the words conveyed, consider the context, and then arrive at a meaning

which the Court believes a reasonable and ordinary reader or listener would take from the statement. A defendant is often shocked to learn he or she can-not simply take the meaning intended, and justify or otherwise defend that meaning.

The limits of truth The defence of truth (formerly re-

ferred to as “justification”) can provide a full defence to a claim in defamation. To succeed, the truth of every injurious imputation that the trier of fact finds to be conveyed by the publication must be proven on a balance of probabilities to be true. Those meanings will be fought over and not determined until trial. The Court will focus on the sting of the defamatory imputations, and whether the various stings are substantially true.

There are risks in pleading truth where there is no evidence to support it. The failure to successfully prove facts pled to be true in a defamation ac-tion could encourage a finding of mal-ice, which would defeat the fair com-ment and qualified privilege defences.

What an insured needs to know when

defending a defamation actionBY KAREN R. ZIMMER


Furthermore, it could also result in ag-gravated and punitive damages being awarded to the plaintiff. These types of damages are rarely covered in the in-surance context, so insureds are well warned to keep this in mind.

"Fair comment” is not as easy as it sounds

Often, my defendants say that what was said was “fair comment”; however, they do so without appreciating what is involved to successfully rely on this legal defence.

To defend a statement as fair com-ment, an insured must meet the fol-lowing stringent requirements: the comment must be on a matter of public interest; it must be a comment based on provable facts that are either stated with the publication or are otherwise known to the reader (such as being notorious); the comment, though it can include in-ferences of fact, must be recognizable as comment, as opposed to a statement of fact; the comment must satisfy the fol-lowing objective test: could any man honestly express that opinion on the proven facts; and, the defendant must not have acted with malice.i

Hence, the defamatory words must be recognizable to the ordinary reader as comment upon true facts, and not a bare declaration of facts. A comment contains an element of subjectivity and is capable of proof, whereas a statement of fact is capable of being determined to be accurate or not. An inference or deduction from facts may properly be regarded as comment, but an implica-tion is regarded as a statement of facts.ii The difficulty is that the point at which criticism ends and accusation begins is not always easy to distinguish, and the line between them can be, and fre-quently is, very tenuous.iii

In most cases where the defence of fair comment is successful, the facts on which the comment is based are clearly stated in the publication, and the opin-ion is expressed in a way that makes it clear that the opinion is an inference or a deduction based on the stated facts.

Limitations of qualified privilege As noted above, there is often a

real need to share a concern. There are certain occasions in which a person

can publish, in good faith, defama-tory statements which turn out to be potentially untrue. Such an occasion of qualified privilege arises where: (i) persons of ordinary intelligence and moral principle would have felt a duty to communicate the information in the circumstances; and (ii) the informa-tion was conveyed only to the recipi-ents who had an interest in receiving it. This reciprocity of interest is essential.

A beautiful characteristic of this de-fence is that it protects all kinds of per-sonalities. The Court is required to take defendants as it finds them, “accord-ing to their temperament, their train-ing, their intelligence”. If an occasion of qualified privilege arises “he will be pro-tected, even though his language should be violent or excessively strong, if, hav-ing regards to all the circumstances of the case, [h]e might have honestly and on reasonable grounds believed that what [h]e wrote or said was true”.iv This defence does not mix well with the Inter-net. When publishing on a website, the defendant is publishing to the world.v It does not matter if they believe the web-site on which they publish would only at-tract readers who would have an interest in the matter. Unless they are publish-ing to a website which requires the user to log in, and those members able to log in have an interest in the matter, serious challenges will arise in meeting the re-ciprocal interest element of this defence.

A finding of malice defeats the quali-fied privilege defence and the fair com-ment defence. A Plaintiff can rely upon any conduct of the defendant leading up to the conclusion of trial in attempt to prove that the defendant was motivated by malice when publishing.

When it does not matter that the words were not your own

The Internet opens up a whole new area of potential liability, namely the potential for Facebook and other so-cial media users, website operators and Internet service providers to be liable for postings made by third parties on their site. One can be liable for defama-tory statements posted by third parties if one knew or ought to have known of the defamatory publication and failed to remove it.vi

While the simple act of hyperlink-

ing to a website that contains defama-tory material is insufficient for liability to arise for any defamatory publication at the hyperlink, liability will arise if the hyperlinking is done in a way that includes an adoption or endorse-ment of the defamatory content of the hyperlink.vii When defending the defamatory words of others, the same challenges discussed above can arise when seeking the protection of truth, fair comment, and qualified privilege defences.

Conclusion An insured should have his or her

eyes wide open to the above potential challenges in defending a defamation claim. Early on, counsel should take risk management steps, including en-suring there are no other defamatory publications out there to be discov-ered, and that the insured appreciates that his or her future conduct could be used in furtherance of the Plaintiff’s efforts to establish malice.

This article has focused on tech-nical defamation points which can work against the defence. Fortunately, there are various technical defamation points to be discussed another day, which can be used against a Plaintiff to dismiss or deter action.

i Simpson v. Mair, 2008 SCC 40 ii Kemsley v. Foot, [1952] AC 345 (H.L.) iii Boland v. The Globe and Mail Ltd.,

[1961] 21 D.L.R. (2d) 401 (Ont. C.A.) iv Harrocks v. Lowe, [1974] 1 All E.R.

157 (H.L.) v See for example Rubin v. Ross, 2013

SKCA 21 vi Weaver v. Corcoran, 2015 BCSC

165; Pritchard v. Van Nes, 2016 BCSC 686

vii Crookes v. Newton, 2011 SCC 47

Karen Zimmer is partner at Alex-ander Holburn Beaudin + Lang LLP, a Vancouver-based law firm. She is the leader of the firm’s Defamation + Publication Risk Management Practice Group. Her libel and slander practice involves defending media, regulatory bodies, health authorities and profes-sionals, school boards, colleges and universities, municipalities, non-profit associations, and other professionals.


This year marks a decade since the release of the Report on Civil Justice Reform Proj-ect by the Honourable Mr. Justice Osborne. This article reviews the jurisprudence deal-ing with the proliferation of experts and ex-pert bias to examine whether the Osborne Report’s objective of early dispute resolution

and reducing use of judicial resources has been advanced.In 2015, in the case of the White v Burgess,1 the Supreme

Court of Canada affirmed the previously established test for admitting expert evidence, which requires two steps: (1) meet-ing the Mohan factors, and (2) the court’s gatekeeping role.2 The Supreme Court noted the “unmistakable trend of the jurispru-dence…has been to tighten the admissibility requirements and to enhance the judge’s gatekeeping role”. Unfortunately, this trend has not been demonstrated in the subsequent jurispru-dence and instead the issue of bias continues to be dealt with at trial, with some exceptions.

Two recent lower court decisions, Giordano3 and Bruff-Mur-phy4, dealt with the issue of bias in the context of a threshold motion and both addressed the concern through the weight-ing of evidence rather than admissibility of the evidence. In Bruff-Murphy, the court addressed admissibility of a defence expert who had been found biased in several prior cases. The court determined, despite concerns with the expert’s report, that the evidence should be proffered. At the threshold motion, Mr. Justice Kane raised significant concerns about the expert’s impartiality. The expert doctor testified he saw his role as de-termining whether the plaintiff’s description of their condition was accurate by looking for inconsistencies. Justice Kane com-mented that the doctor:• failed to put to the person the inconsistencies;• would not allow any audio recording of the assessment;• in addressing credibility of the party, the doctor went outside

his terms of engagement;• conducted no testing nor requested treating doctors test results;• made comments out of context;• had a good memory for the points he was defending but not

on other points. Justice Kane was clear that in future cases he would not

qualify witnesses as experts whose reports present an approach similar to what was seen in that case. The case highlights the high threshold to have an expert disqualified.

The same expert was the subject of another motion, in Dag-git v Campbell,5 where defence sought an Order to appoint this doctor to do an Independent Medical Examination (“IME”). Madame Justice MacLeod-Beliveau commented in obiter that

an extension of the court’s right to name a doctor for an IME is the discretion not to name a particular health practitioner if he/she is found to be biased, which would be uncommon.

These recent cases show clear judicial direction that this level of bias will not be tolerated and will be excluded at trial reinforcing that the “hired gun” methodology of choosing an expert is likely an unsuccessful strategy. However, leaving the determination of bias until the trial, or even after trial does nothing to address the objective to cut down the time and costs spent getting to trial.

A slow shift in addressing these concerns earlier in the process has been seen through parties imposing terms on court ordered as-sessments. Although, this movement could have its benefits, little is to be gained where the opposing counsel unilaterally imposes restrictive terms not required by the Rules.

The terms often incorporate uncontroversial requirements such as providing the expert’s CV, content in the report, form to be completed, an index of the documents or payment of reasonable expenses. Production of the doctor’s notes and recording the as-sessment are often requested and can, at times, be contested. How-ever, parties often request much more invasive terms. Lavecchia v. McGinn6 dealt with an IME motion where the plaintiff requested that defence agree to the following additional terms:a) plaintiff was not to be asked to complete any documents such

as questionnaires at the examination;b) doctor was not to express any opinions dealing directly or

indirectly with liability;c) doctor was not to express any opinion on the credibility,

character or truthfulness of the plaintiff;d) health records and information of the plaintiff were not to be

To Admit or

Not to AdmitExpert evidence on trial

BY DEBBIE ORTH

30 Claims Canada June/July 2017 www.claimscanada.

disclosed to any other person or entity other than defence counsel.The court opined that term (a) has to be decided case by

case, given that some disciplines utilize standard diagnos-tic tools and tests, which would be appropriate. The plaintiff conceded that terms (b) and (c) were too broad and as such were not ordered. It was recognized that determining issues of credibility are properly the adjudicator’s role. Term (d) is of particular interest; it was an indirect way to prevent a “ghost written” report. The parties agreed that the expert report must be written by the expert herself/himself and not by admin-istrative staff or other individuals. The court commented on the need for greater rigour and predictability concerning the role and use of experts so as to save time at trial and promote settlements; it noted the cases of El-Khodr v. Lackie and El-bakhiet v. Palmer which raised concerns at trial about ghost writing and an expert opining on credibility. Master Macleod, in Lavecchia, supra, stated:

I do not, however, accept that the best approach is to be found in plaintiffs seeking to unilaterally impose restric-tive terms on the conduct of defence medicals. Nor is it reasonable to have actions grind to a halt while the parties attempt to negotiate terms of a consent order as has hap-pened here. A standard form of order may well be a very good idea.

The 2017 case of Kushnir v. Macari7 addressed the issue of terms relating to ghost writing. The plaintiff sought an Order, inter alia, that the expert report be drafted solely and entirely by the assessing doctor, the research and medical record re-view be done by the assessing doctor and the records not be shared with any third parties. Defence argued that this was an attack on the integrity of the assessor and that the asses-sor takes responsibility for the report in signing it. Plaintiff argued that these terms were needed to ensure trial fairness. No specific wrongdoing was alleged against the proposed as-sessor.

Citing the facts of El-Khodr, where the expert testified at trial that part of the report was written by somebody else, the court acknowledged the problem of ghost writing. The court was prepared to address same but found the conditions sought were overreaching and suggestive of inappropriate behaviour by the assessor. The Order encompassed a term that the report shall be written solely by its author and health records should not be disclosed to anyone other than defence counsel. The decision was not appealed.

Unfortunately, in the broader context there is little prog-ress in terms of achieving the long-term goals of early dispute resolution in order to reduce costs and conserve judicial re-sources. In the past two to three years, there is clear judicial com-mentary suggesting a slow shift towards addressing the issue of admissibility and the treatment of bias at an earlier stage of the action in the specific context of court ordered IMEs.

At this juncture, this issue often entails the same amount of judicial and legal resources to address the terms and conditions requested by parties. Further, this also fails to have broader im-plication outside of the medical expert’s field. It is yet to be seen whether courts will provide clear guidance that can result in a standard form terms and conditions for IMEs, which would at least have the effect of leveling the playing field such that experts on both sides of the dispute would be subject to the same terms.

Suffice it to say the courts have clearly indicated they will take a position on admissibility of experts in those extreme cases where it is warranted. Accordingly, it is incumbent upon the parties on both sides of the dispute to do their due diligence in advance of selecting an expert to ensure that expert will uphold their duty to the court.1 2015 SCC 23 (CanLII), <http://canlii.ca/t/ghd4f>.2 In R v Abbey, 2016 ONSC 7 (CanLII), http://canlii.ca/t/gm-

r5x, the Court of Appeal introduced a two step inquiry to admit evidence.

3 2014 ONSC 7516 (CanLII), <http://canlii.ca/t/gg2d0>. 4 2016 ONSC 7 (CanLII), <http://canlii.ca/t/gmr5x>.5 2016 ONSC 2742 (CanLII), <http://canlii.ca/t/gpqm3>.6 2016 ONSC 2193 (CanLII), <http://canlii.ca/t/gp6zq>. 7 2017 ONSC 307 (CanLII), <http://canlii.ca/t/gx9g6>.

Debbie Orth is a partner at Bertschi Orth Solicitors and Barristers LLP and a member of the Board of Canadian De-fence Lawyers. She practices in Insurance Defence and Com-mercial Defence focusing on accident benefits, personal injury coverage, educational malfeasance and property and casualty.


OTS• on the sceneOTS• on the scene

Jwan Thapar

30 Forensic Engineering, has ap-pointed Jiwan Thapar, PEng, MEng, PSP, PMP, as practice lead within the Construction Services Group. Jiwan brings over 10 years of experience in consulting, engineering and con-struction management. He gained extensive experience in preparing and evaluating construction claims (delay, lost productivity and acceleration). He has represented both owners (public

and private) and contractors for commercial matters ranging in value from $10 million to over $250 million. “I am happy to welcome Jiwan to the Construction Services Group as our new practice lead. On top of the great work experience and educa-tion, he is an incredible, dynamic individual that will be a fan-tastic fit for the organization,” said Doris Marshall, principal, construction claims of 30 Forensic Engineering. ●


Calvin Newman (left), chair of the CMH Foundation and presi-dent of Newman, Oliver & McCarten Insurance Brokers Ltd., receives $10,000 donation from Economical Insurance for new portable x-ray machine. Presenting the cheque from Eco-nomical is Jason McDowell, business development specialist.

The 37-year-old portable x-ray machine used for bed-ridden patients in the Campbellford Memorial Hospital (CMH) will be replaced thanks to a $10,000 donation from Economical Insurance. This is the fourth $10,000 donation that Economi-cal has made to the CMH Foundation in recent years for new medical equipment. The new portable x-ray machine for the Diagnostic Imaging Area of CMH will allow for faster treatment decisions for bed-ridden patients. “Diagnostic Imaging is one of the most important areas in the hospital,” said John Rus-sell, executive director of the CMH Foundation. “The current x-ray machine has served the hospital well, but it’s seeing the end of its days here at CMH. With Economical Insurance’s gen-erous support, we are now able to continue offering modern-ized care to our patients.” “We are proud to give back to CMH in association with Newman, Oliver & McCarten,” said Tom Reikman, SVP and chief distribution officer at Economical In-surance. “Newman, Oliver & McCarten has been our trusted broker partner in serving the needs of the community for near-ly 120 years.” ●

Allan Bauer

Mark Mason

Origin and Cause opened its Edmonton branch a year ago, in response to the high frequency of investigations they were conduct-ing in the region. The company has now hired two new forensic experts – Allen Bauer and Mark Mason – to ensure the highest standard of technical excellence and customer service for their cli-ents in the region. “The insurance and legal community in Edmonton have been extremely support-ive and welcoming to Origin and Cause since we opened our doors last year. The feedback we receive daily from our clients is incred-ible, and really makes me proud,” said Mazen Habash, president of Origin and Cause. Allen is a fire and explosion investigator with over 13 years of professional ex-

perience in fire suppression. He is a captain-qualified fire investigator with the City of Edmonton Fire Rescue Ser-vices Investigations Branch and has performed over 150 investigations. He is currently a member of the NAFI, FIAA and IAFF. Mark has worked for the provincial downstream hydrocarbon regulator in Ontario for approximately 14 years. In that time he has led, and assisted in, over 100 explosion and fire investigations. Mark has extensive ex-perience in hydrocarbon appliance operation and failure mechanisms, and expert knowledge of all Canadian codes and regulations with respect to hydrocarbon fuels. Mark has CFEI, G1, LP, PM2 certifications and over 22 years’ experience in the hydrocarbon fuels industry. ●

Gillian Van Kempen

Gillian Van Kempen has tak-en on the role of president of Best Buy Insurance. Gillian is the 4th generation of the Van Kempen family to join the insur-ance broker side of the busi-ness. The family’s roots date back over 70 years to 1946 when Gillian’s great-grandfather founded his insurance broker-age in Toronto. Gillian received

her honours Bachelor of Arts degree from the Univer-sity of Toronto and went on to attain her CAIB, CIP, FCIP and CRM designations. She has served as president of the Insurance Brokers Association of Ontario’s Durham affiliate and continues to sit on numerous insurance industry boards, company broker councils. Gillian has been a licensed broker for 20 years and has worked in virtually every channel of the insurance industry. Best Buy Insurance is very pleased to benefit from her exper-tise in this new role. She succeeds her father, Kip Van Kempen. ●


OTS• on the scene

WINMAR International Inc opened a new location in Este-van, Saskatchewan, located at 238 3rd Street. With 22 years in the construction business, owner Kyle Jacques has been a long-time WINMAR family member, successfully operating WINMAR Moose Jaw for the past seven years and WINMAR Regina for five years. Kyle’s success has come from his commitment to provid-ing outstanding customer service and quality workmanship. He and his team will strengthen the WINMAR organization but also its commitment to its insurance partners, the company said. ●


CIAA New Members — May 2017

CORPORATE MEMBERSHIP Sage Claims Solutions Inc. Hamilton, ON

INDIVIDUAL MEMBERSHIP

Claims ProDeborah Brick Oakville, ON Level 1Nikhil Joshi Oakville, ON Level 1

Cunningham Lindsey Stacie Karpenko Winnipeg, MB Level 1

Kernaghan Adjusters Ltd. Cindy Lambright Surrey, BC Level 1

Sage Claims Solutions Inc. Christine Andrews, CIP, FCIP, CRM Hamilton, ON Level 3

Sedgwick CMS Canada Inc. Fred Duz, CIP Mississauga, ON Level 3Pierre-Marc Laurin Mississauga, ON Level 1Josie McKinnon, CIP Mississauga, ON Level 3

T & L Adjusters Ltd. Marcus Ergezinger Edmonton, AB Level 1

Vericlaim Shauna Dobson, CIP Edmonton, AB Level 3Leslie Telch, CIP Mississauga, ON Level 2

Lee Powell

Sedgwick, and its subsidiary Veri-claim, announced the appointment of Lee Powell to vice president of the complex loss division of Vericlaim Canada. “His appointment is part of our focus on expanding our geographic coverage and commitment to build-ing our business across Canada. The experience and expertise that Lee brings to Vericlaim will be a major as-set,” said Mike Holden, president of

Sedgwick and Vericlaim Canada. Lee brings some 20 years of in-dustry experience to Vericlaim Canada. Specialties include con-struction, petrochemical and oil and gas, equipment breakdown, commercial property, boiler and machinery, and product liability. He is a member of CIIA, and earned the CRM from the Global Risk Management Institute and holds the Chartered Insurance Professional designation. ●

Sharp Mobile Technology Ltd won the inaugural IBAA Hackathon on May 9th. The hackathon gave teams 24 hours to create a new technology that would help advance the bro-ker channel. Sharp Mobile, an independent insurance tech-nology company beat out stiff competition, including Intact Insurance, for their interactive broker chat called BRIE. BRIE (Broker Resource Information Engine), is an intelligent chat ro-bot that can answer a diverse range of insurance questions that draw from various insurer underwriting manuals. Some of the questions used in the live demo at the Hackathon include: How much a client will pay in cancellation fees, information about a specific insurance company’s motorcycle policy, as well as requesting BRIE to text a pink card to a client. “As an insurance broker I was very excited to see what Sharp had submitted at the IBAA Hackathon. A lot of the pain points in document management, information lookup and market re-search seemed to disappear thanks to an AI chat bot named BRIE – the most amazing part being that she was developed in a mere 24 hours,” said Scott Romans from Ing+Mckee Insurance. ●

Mike Alwyn

Sedgwick and Vericlaim also ap-pointed Mike Alwyn as senior vice president of specialty services for Vericlaim Canada. “We have no doubt that Mike’s experience and expertise will be a strong asset to the organi-zation,” said Mike Holden, president of Sedgwick and Vericlaim Canada. Mike brings 30 years of experience in claims adjusting with specialties in mining, commercial property, course

of construction, and jeweler’s block/fine arts. Not only is he one of our industry’s most well-known Executive General Ad-justers (EGA), but he also has an MBA and holds the Fellow Charted Insurance Professional (FCIP) designation. In addi-tion, he is a recipient of the Canadian Insurance Claims Man-agers Association Award. Aside from the insurance industry, Mike was a member of the Canadian Forces Air Reserve, serving over 20 years, attaining the rank of Captain, and was awarded the Canadian Forces Decoration. ●

Kernaghan Adjusters has added a branch in Barrie, Ontario, and hired Eric Gunnell as senior adjuster in the Barrie/Newmarket region. He brings over 35 years of experience in the insurance claims in-dustry. During his career, he has held various positions from assistant claims manager to independent adjuster. He is a well-respected, large-loss commercial adjuster with expertise in transportation, property, liability and catastrophe claims. Eric has worked in the UK, Australia and

Canada. “The experience Eric has gained both internationally and locally has given him a unique perspective and understanding of all facets of the claims business,” said Dennis Schembri, VP Ontario Operations. ●

Eric Gunnell


OTS• on the sceneClaimsPro has appointed Drew Knox

to lead its Transportation, Equipment & Cargo division, a highly-specialized divi-sion of the company that offers claims services specific to the TEC sector as it pertains to collision, cargo, and liability insurance. ClaimsPro provides TEC ser-vices throughout North America. The TEC division is part of ClaimsPro’s Spe-cialty Risk Division (SRD), led by Sean Forgie, Senior Vice President, SRD.

Drew has 30 years’ experience in the insurance industry and ex-tensive background in large commercial property loss as well as cargo losses of all types, both as an insurer and an independent adjuster. His previous experience includes time as a Staff Field Adjuster and Claims Manager with a large insurer. He is a mem-ber of the Insurance Institute of Manitoba and the Canadian As-sociation of Fire Investigators. He is based in Winnipeg. ●

Drew Knox

Sedgwick and Vericlaim have opened an office for Vericlaim in Montreal. Industry experts Denis L’Ecuyer and Pierre-Marc Laurin have joined the team as casualty claims examiners. Denis brings 45 years of ex-perience in all lines of claims business to his new role. He specializes in liability, property damage, commercial, industrial and institutional claims, as well as products liability and some li-ability bodily injury claims. Prior to joining Sedgwick and Veri-claim, Denis held management positions with major insurance organizations in Quebec. Denis speaks French and English. He has taken multiple AIAC courses from the Insurance Institute of Quebec and holds a general ad-

juster’s license in New Brunswick (all categories). Pierre-Marc has nearly a decade of experience in all types of commercial and personal losses, with a specialization in liability cases. He has handled claims across the re-gion of Quebec for major accounts. Pierre-Marc joined Sedgwick in No-vember 2016 as a resident examiner for Quebec. He has completed his col-legial studies with the Vieux-Montreal CEGEP and is pursuing the CIP des-ignation with the Insurance Institute of Canada. Pierre-Marc is bilingual in French and English and is a fully li-censed adjuster for Quebec. ●

Accident Support Services International Ltd (ASSI), facilitators of Collision Reporting to the Insurance Industry, announced that the Oakville, Ontario location of the Halton Collision Reporting Centre (CRC) has moved from Bronte Road to 95 Oak Walk Drive, Oakville. Accident Support Services International Ltd operates three Collision Reporting Centres in partnership with the Halton Regional Police Service. ●

With flooding caused by persistent rains having recently escalated into a state of emergency in areas of Quebec and Ontario, The Guarantee Company of North America (The Guarantee) re-sponded with support to the Canadian Red Cross. The Guarantee has donated $10,000 to the Canadian Red Cross Spring Floods Appeal to assist individu-als, families and communities affect-ed by the flooding. “The Guarantee is pleased to support the Canadian Red Cross in their efforts to assist Cana-dians affected by the current state of emergency,” said Richard Pouliot, na-tional VP, operations and distribution management. “We know that unfore-seen events can be devastating and we hope our $10,000 donation will assist the Red Cross in supporting those in need who have been impacted by the catastrophic flooding.” ●

continued on page 34 ...

Denis L’Ecuyer

Pierre-Marc Laurin


OTS• on the sceneThe Centre for Study of Insurance Operations (CSIO) has

made enhancements to its eDocs Availability Chart. This reference tool, originally launched in October 2016, shows which types of documents insurance companies send as eDocs for personal lines, commercial lines and farm poli-cies. The improvements include a revised design for bet-ter user experience as well as additional information noting which insurers provide the Insured Copy as eDocs. Cur-rently, eight insurers send the Insured Copy: Intact Insur-

ance; L’Unique General Insurance; Norfolk Mutual Insur-ance Company; Optimum General Inc; Peace Hills Insurance; SGI CANADA; Trillium Mutual Insurance Company; and West Wawanosh Mutual Insurance Company. “We are quite pleased to increase the value of the eDocs Availability Chart through these enhancements,” said Catherine Smola, president and CEO, CSIO. “These improvements to the chart were made in di-rect response to enhancement suggestions we received from our members. ●

SCM Insurance Services has made its initial entry into the US by acquiring Nixon & Company, Inc. Nixon & Company, Inc was founded more than 40 years ago and remains headquar-tered in St Louis, Missouri. It provides a new platform from which SCM will continue to build out its service offerings both domestically and into the Lloyd’s of London marketplace. SCM announced its intention to expand into the United States with the hiring of Scott Goodreau in the fall of 2016 as the company’s chief operating officer – USA. Scott, an executive with 20 years’ experience in the industry, has held diverse leadership positions for distribution, carrier, and technology companies. “This is a strong opportunity, not only for us as organizations, but for our clients,” he said. “SCM studied the US market closely before deciding that this was both the right time, and Nixon the right company, to begin our expansion into the United States.” ●

The devastating losses in Kelowna, Slave Lake and Fort McMurray have led to a deeper understanding of the Wildfire Urban Interface Fire Risk in Canada. Fire Underwriters Sur-vey (FUS), a division of Opta Information Intelligence, has developed a new model for insurers to better understand the risk of wildfire-related losses. A new Canadian Wildfire Grad-ing Index will be released in British Columbia and Alberta in mid-2017, with a full rollout nationwide by year’s end. The system provides standardized risk benchmarks for all areas of Canada using GIS, geodatabases, weather databases, his-torical data, digital satellite imagery and advanced analytics tools. “This is another example of the Fire Underwriters Sur-vey and Opta providing crucial fire protection data for Cana-dians,” says Greg McCutcheon, President of Opta. “We take great pride in helping insurers and all Canadians prepare and combat fire risk exposure.” ●



OTS• on the scene

Ribald humour and not-so-gentle ribbing were the order of the day at the 58th Quarter Century Club Luncheon and Roast of Tim Guernsey, RSA Canada’s VP of claims. Held annually to honour a claims industry vet-eran, the May 24th roast at Toronto’s distinguished Albany Club treated more than 170 guests to loads of laugh-out-loud jokes and jibes from master of ceremonies John Cherrie and roasters Dennis Schembri of Kernaghan Adjusters, Walter Aronovitch of AMR Barristers and Solici-tors LLP, Murray Ritch of Ritch Williams Richards Lawyers, and Eric Grossman of Zarek Taylor Grossman Hanrahan LLP. ●


OTS• on the scene

What happens in the courtroom of a liability trial — and how can adjusters prepare? Attendees of the CIAA/CICMA Western Education Conference in Edmonton on April 25 had a chance to find out through a mock trial contested by legal teams from CBM Lawyers and Dean Duckett Carlson LLP. The trial featured the presentation of surveillance and Facebook evidence, and testimony from expert witnesses and an adjuster. A tradeshow, seminar on social media and an IBC presentation of claims-management lessons from the Fort McMurray fire rounded out the day’s events. ●

Transitioning from daytime to evening wear was unnecessary for any horse racing fans who attended the 23rd Annual Star-light Insurance Gala on May 6, because the event’s Run for the Roses theme was inspired by the day’s other big event: the 143rd running of the Kentucky Derby. The evening’s festivities, which included raffles and a silent auction, were in aid of the Starlight Children’s Foundation Canada, a charity “dedicated to bringing laughter, joy and hope back into the lives of chil-dren with serious illnesses.” Local TV newscaster Anwar Knight hosted the fete at Toronto’s Royal York Hotel. ●

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OTS• on the scene

Sub-par weather didn’t stop competitors from bringing their A-game or their winning attitudes to the CIP Society Fellows’ Golf Tournament on June 5. DiamondBack Golf Club in Richmond Hill, Ontario hosted this year’s edition of the annual event. With their team score of seven-under, Ray Arndt of Lyon & Butler In-surance Brokers, Jeff Skelton of Roughley Insurance Brokers, Rick Moore of Adriatic Insurance Brokers and Nazir Haji of AEGIS London took home the tournament’s big prize. ●

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OTS• on the scene

Banff is always a great place to be, but never more so than when the Annual Convention of the Insurance Brokers Association of Alberta is in town. Held May 7-10 at the Banff Springs hotel, the confer-ence brought together more than 500 brokers and other insurance professionals for a golf tournament and tradeshow, the President’s Gala dinner and an educational program featuring such subject-matter experts as BMO Financial Group chief economist Doug Porter, Google Canada marketing chief Fab Dolan, and Blair Feltmate of the Intact Centre on Climate Adaptation. ●

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The ARC Legal Reporter Winter Issue – Article #1

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each intimately connected to their local market.

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National scope.

That is the ARC Group.

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A National Network of Independent Law Firms

The ARC Legal Reporter Winter Issue – Article #1

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

Reported Case: Blyth v. Crowther and Kelly Citation: 2009 NBCA 80 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?

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