Study 9 Flashcards
What must an adjuster have knowledge of to handle first party and third party claims?
> Civil Code of Quebec or the applicable provincial or territorial common law system
Provincial or territorial automobile insurance legislation
Highway safety legislation
Specialty agreements derived from legislation (for example, direction compensation agreements)
Policy wordings and endorsements
Reciprocal claims agreements among provinces and territories
What do private insurers offer in BC?
Section A: excess third party liability
Section C: coverage for loss or damage
Section D: excess underinsured motorist protection
What acts as proof of insurance in Saskatchewan?
Registration and drivers license
What do private insurers offer in Saskatchewan?
Optional and excess
What do private insurers offer in Manitoba?
Optional and excess
How does insurance in Quebec work?
Injury is through SAAQ
Damage is through private; can also offer excess AB
What five provinces have direct compensation?
NB, NS, ON, PEI & QC
What are the government insured provinces?
Manitoba, Saskatchewan, BC
Quebec for bodily injury
What provinces does apply the auto deductibles for fire and lightning?
Saskatchewan
What is considered illegal use of the auto?
Convicted cause death or bodily injury due to criminal negligence
Failing to stop at an accident
Driving while impaired
Refusing to comply with breath sample
Operating auto when disqualified from doing so
Under the influence, unable to maintain proper control, using the car in a race or illegal activity, and driving when not authorized by law
Provinces w/ DCPD do not carry the exclusions
What are some common endorsements that may related to auto damage?
Loss of use
Limitation of amount
Waiver of depreciation
Liability for damage to non-owned
Blanket-basis fleet
Ridesharing
What does IBC do in relation to claims?
Data collection, compilation & reporting
Receives info from insurance companies
Maintains database of stolen automobiles
What are the 4 types of Appraisal programs?
Appraisers
Appraisal Centers
Direct Repair Programs
Garage Estimates
What are the minimum standards for a repair facility to qualify for direct repair programs?
Having well-trained staff
Adequate office space
Capacity to do the number of jobs
What should a diagram of an auto accident include?
> Identify accident locus to show type of intersection (T, Angular, Fourway, Fiveway, Sixway, None, lane markings)
Location of accident, label each street
Stop, slow or any other traffic signs
Directions, including compass directions
If a parking lot, show how configured
Do not use terms such as ‘insured’ or ‘third party’ for impartiality, use a legend
What can be included on written statements from police?
the position of the automobiles when police arrived at the location;
what tire tracks were on the road;
whether the surface was asphalt;
the nature and location of any debris on the road that could indicate where the impact occurred;
whether there was snow, ice, or
any other surface element affecting road conditions;
the layout of the scene; and
existing weather conditions
What 3 things are typically in automobile claim statements?
Information about discrepancies between the application and the policy,
representations made by the insured when the policy was issued, and
material changes during the policy period
What physical aspects of the accident may be included in the statement?
the state of the weather at the time;
whether any condition affected visibility;
the surface, markings, grade, and bend of the road;
road signs and speed limit postings; and
obstruction of lines of sight by trees, bushes, or other landscape features.
What are the typical items in the sequence of events reviewed?
the direction of travel of the automobiles, speeds, where impact occurred, and
the final resting locations of the automobiles.
Why do most insurers prefer to pay for auto repairs directly?
> The safety of the automobile could be impaired if the insured fails to have the damage repaired immediately.
If the insured has another accident, overlapping damages could be paid twice, increasing claim costs.
Psychologically, there may be a tendency for people to exercise less care with a damaged automobile.
The repair is considered to be a return to the pre-loss condition, thus discouraging fraud.
How are total losses treated in Quebec?
an insured may proceed with repairs even though
technically an automobile is a total loss.
When does DCA apply to collisions in Quebec?
only to collisions on public highways in the province of Quebec involving two or more automobiles when the drivers have been identified.
What issues does the DCA driver fault chart ignore?
Actions of pedestrians
Speed
Weather conditions
Visibility
Road conditions
Light, sound, or hand signals
Marked or unmarked road lines
What are the three steps to making a claim in Quebec?
> Indemnification under the automobile insurance policy (QPF No. 1) under the optional first- party coverages purchased by the insured
Application of the DCA to determine fault and pay the insured under Section A—Civil Liability according to the percentage of fault assessed against the third party
Pursuit of any opportunity to recover from a third party
What is the basic deductible in Saskatchewan?
$700
When the insured is suspected of having a breached policy condition and might be denied coverage,
what action should the loss adjuster take in order to avoid estoppel?
Issuing a non-waiver agreement or
a reservation of rights letter
4 typical insurance on the automobile
Collision or upset insurance
Specified perils insurance
Comprehensive perils insurance
All-perils insurance coverage (n/a in BC)
