Study 9 - Automobile Physical Damage Claims 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?
New Brunswick, Nova Scotia, Ontario, PEI & Quebec
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 clains?
Data collection, compilation & reporting
Receives info from insurance companies
Maintains database of stolen automobiles
What are the four types of Appraisal programs?
Appraisers
Appraisal Centres
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?
- Position of autos when police arrived
- Tire tracks
- Was it asphalt surface
- Nature and location of debris
- Snow, ice, other surface elements
- Layout of the scene
- Existing weather conditions
What three things are typically in automobile claim statements?
- Discrepancies between application/policy
- Representations by insured when policy was issued
- Material changes during the policy period
What physical aspects of the accident may be included in the statement?
- State of the weather
- Conditions affecting visibility
- Surface, markings, grade and bend of the road
- Road signs and speed limit postings
- Obstruction of lines of sight by trees, bushes, or other landscape features
What are the typical items in the sequence of events reviewed?
- Direction of travel
- Speeds
- Where impact occurred
- Final resting location of autos
How may you use experts in automobile claims?
- Accident reconstruction can be used to determine how an accident happened / determine fault
- Cause and origin engineer can investigate fire, accelerants, equipment failure (could lead to subro)
- Mechanic may be asked to report on state of auto, to establish value
- Antique car specialist can be asked to evaluate a total loss when conflict of value is anticipated
- Surveyor may be required to check topography of roadway, if defect in road caused against recovery could be possible
What is typically included in the investigation reported?
- Signed statements
- Police reports
- Photographs
- Experts reports
- Documents to support recommendations
Why do most insurers prefer to pay for auto repairs directly?
- Safety of auto could be impaired if insured fails to have damage repaired immediately
- Insured has another accident, overlapping damages could be paid twice, increasing claim costs
- Psychologically, tendency may exist for people to exercise less care with a damage auto
- Repair is considered to be a return to pre loss condition, thus discouraging fraud
How are total losses treated in Quebec?
They may still proceed with repairs
What are the typical steps in an automobile fire investigation?
- Obtain statements from owner and person last possession of auto
- Interview firefighters, police, tow truck driver and any other witnesses
- Hire an expert to determine the cause if required
- Check maintenance records of auto
- Review insured’s finances, including any liens on the auto
- Determine whether insured had other insurance losses
- Check for any reent changes in policy, such as reduced deductible or increase in coverage