Would you be ready to deal with a fire insurance claim?

Global News

The devastating house fires in a northwest Calgary community Tuesday have prompted many homeowners to consider how prepared they are for a disaster.

Beyond the obvious emotional impact, the insurance process can add an entirely new layer of stress.

In December 2015, Michael and Bonnie Peck’s Airdrie home was damaged when their neighbours’ house burned down.

Insurance covered the physical repairs but they were not prepared for the claim process to replace personal belongings and contents.

“There are certain things the insurance company is looking for in terms of what you lost and how to go about proving it.” said Michael. “You’re so overwhelmed with everything else that’s going on, that it’s hard to think about all that stuff at the time.”

Insurance experts say before it’s too late, homeowners should document household and personal belongings on paper and with video or pictures.

That is especially important for anything that’s extremely valuable or sentimental.

“Any contents that are limited or excluded under the policy, that may be an invitation to top those up to schedule them, especially contents that may hard to prove their existence or value”, Ross Bucsis of Westland Insurance said.

Bucsis recommends talking with your broker and making sure you are covered in case of an emergency.

For starters, he suggests reviewing the value of your house every five years to make sure you have guaranteed replacement costs for the building.

Here are some insurance links with tips about what to do to prevent fire and how to navigate a claim.

Canada: Court Of Appeal Provides A Further Look At The Additional Insured

Article by W. Colin Empke

Disputes over additional insured status are legendary and frequent.  Every insurer faces demands for a defence from additional insureds.  Brokers are requested to issue certificates of insurance on a daily basis, identifying people or companies as additional insureds.  Assigning insurance obligations is an essential feature of most contractual relationships.  There is no avoiding the issue of the duty to defend an additional insured.  Yet the outcomes of legal disputes about the issue have been unpredictable in the past and only recently has a trend towards more predictability emerged.  On December 22, 2015, the Ontario Court of Appeal released its latest decision on the topic.  While still not yet solving all of the problems in the area, it continues the trend towards a framework for insurers to resolve these disputes without unnecessary litigation.

In Carneiro v. Durham (Regional Municipality), 2015 ONCA 909, the liability issue related to a fatal car accident, allegedly caused by icy road conditions.  The deceased’s family members sued the Regional Municipality of Durham for its liability as the owner of the roads. The co-defendant was Miller Maintenance Limited hired by Durham as its road maintenance contractor.

The Court of Appeal characterized the allegations against Durham and Miller as “a laundry list of identical particulars of negligence”.  The allegations included the failure to keep the road free from ice and snow, inadequate design of the road, and failure to close the road during a snowstorm.  The plaintiffs did not distinguish between the defendants.    Durham and Miller appointed separate defence counsel and maintained crossclaims against the other, alleging the other was solely responsible.

As expected, the road maintenance contract required Miller to obtain general liability insurance and to ensure that Durham was named as an additional insured on Miller’s insurance from Zurich.  When Durham requested Zurich to defend it in the action, Zurich refused.  Zurich argued the allegations against Durham were unrelated to Miller’s work and therefore fell outside its coverage as an additional insured.  Durham commenced a third party claim against Zurich seeking a declaration that Zurich must defend and indemnify Durham.  Durham brought a motion seeking a determination of the issue.

The motions judge refused to order Zurich to defend Durham.  He found that the duty to defend existed only with respect to “claims insured for Miller”.  The judge accepted the argument that Durham was required to defend itself against allegations unrelated to the contractor’s negligence.  The judge further reasoned that Durham’s liability exposure arising from the contractor’s negligence was adequately protected by the contractor’s own defence.

Durham appealed and won.  The Court of Appeal commenced its analysis by reminding the parties that the duty to defend an additional insured is governed by the allegations in the pleadings and the terms of the insurance contract.  The Court observed that the Zurich policy “contained an unqualified promise to defend the [additional] insured for actions covered by the policy.”   The pleadings rule dictates that the mere possibility some allegations in an action will fall within coverage engages the obligation to defend the action.  The true nature of the pleading was that the deceased’s car slid on an icy roadway.  The common allegation that Durham and Miller failed to keep the roadway clear related directly to the obligations under the maintenance contract.   Accordingly, because the statement of claim alleged facts that, if true, were within the coverage, Zurich’s obligation to defend Durham was triggered.

The Court’s use of the word “unqualified” should not be interpreted as suggesting the duty to defend is unlimited, but only that the insurance policy did not provide for a mechanism to deal with situations where an action contains both covered and non-covered allegations.  The Court observed that there is no obligation to pay costs related solely to the defence of uncovered claims.  Further, it acknowledged that the obligation is to pay only the reasonable costs associated with the defence of the covered claims.   In accordance with the Court’s decision in Hanis v. University of Western Ontario, 2008 ONCA 678, where there are allegations both inside and outside of coverage (so-called “mixed” claims), any reasonable costs associated with the defence of the covered claims are payable, even if they happen to benefit the uncovered allegations.  In this way, the defence obligation is “unqualified”.

In the face of “mixed” claims, the defence obligation is not unrestricted.    This means the insurer may seek an apportionment and reimbursement of defence costs incurred solely with respect to uncovered claims.  What is emerging in the Carneiro decision and the Court’s prior decision in Tedford v. TD Insurance, 2012 ONCA 429 is the preference that any reallocation be by agreement of the parties or by application to the Superior Court “at the end of the proceedings.”  Prior case law seeking to have a Court make an interim allocation of costs for an additional insured appears to be falling out of favour.  The duty to defend the action against an additional insured may now require the insurer to pay 100% of the defence costs on an interim basis.  But the additional insured may be required to reimburse the insurer at a later date.

The focus must now shift to how Carneiro will impact cases involving a legitimate argument that an additional insured has independent negligence for an accident.   Postponing the allocation discussion may have unintended consequences.  No doubt there remains many issues to be resolved with respect to coverage for the additional insured.  The industry may well revisit the manner in which it endorses policies for additional insureds.

The content of this article is intended to provide a general guide to the subject matter. Specialist advice should be sought about your specific circumstances.

$8M awarded to paralyzed Quebec hockey player faces legal challenge

The decision to award a young Quebec hockey player $8 million for taking an illegal hit that left him paralyzed is being challenged.

The defence filed a request for an appeal in the case involving Andrew Zaccardo, who was 16 when he was checked from behind, along the boards, during a Midget AA game in 2010.

Quebec Superior Court Justice Daniel Payette’s ruling, which came down on Feb. 3, is believed to be the highest amount of money ever awarded in Canada in a case concerning hockey violence.

In his 24-page judgment, Payette ruled that the illegal hit on Zaccardo, which was made by defenceman Ludovic Gauvreau-Beaupré, was not accidental.

It found Gauvreau-Beaupré to be at fault. Gauvreau-Beaupré, along with Chartris Insurance Company of Canada, which insures players in leagues associated with Hockey Canada and Hockey Quebec, are responsible for paying the sum.

In the appeal request, obtained by CBC News, the defence says that the judge made several errors in law, such as dismissing the testimony of the referee.

It also states that the judge was wrong to conclude that a player does not assume any risks in the game of hockey. The court document says that once players steps on the ice, they assume the responsibility of taking hits or getting injured, given that physical contact is part of the sport.

“The judge was misguided in concluding that even in the case of a contact sport like hockey, where physical contact is permitted, the participant does not assume the risk of another player’s mistake, whereas many regulations exist to allow for penalties to be given by the referee to punish behaviour that goes against the rules, all of which is part of the game,” the document states.

The defence, Robinson, Sheppard, Shapiro, is representing Gauvreau-Beaupré and Hockey Canada’s insurance company.

ICBC Ordered to Pay $350,000 in Punitive Damages for False Fraud Allegation

Today’s guest post comes from B.C. injury claims lawyer Erik Magraken

Reasons for judgement were released today by the BC Supreme Court, Vancouver Registry, ordering ICBC to pay $350,000 in punitive damages for malicious prosecution following assertions that the Plaintiff acted fraudulently following a pedestrian collision.

In today’s case (Arsenovski v. Bodin) the Plaintiff was walking with her husband when he was struck by a vehicle.  The Plaintiff was not struck by the vehicle but did fall down and suffer some modest injuries during the incident and she reported this to ICBC.  Specifically she told ICBC that “the last thing I remember was stepping off the curb to cross the street.   I don’t know how far we had walked on the street.  The next thing I remember was being on the pavement“.

ICBC, through a Special Investigations Unit officer employed with them,  requested that Crown Counsel prosecute the Plaintiff for fraud as she was not struck by the vehicle.  Charges for making a false statement to ICBC were approved.

The problem is the statement was not false.  The charges were stayed on the day of the start of the criminal trial.

The Plaintiff sued ICBC for malicious prosecution and succeeded with Madam Justice Griffin finding that ICBC’s false fraud allegations and actions were “so high-handed,  reprehensible and malicious that it offends this Court’s sense of decency“.  In finding $350,000 in punitive damages were appropriate the Court provided the following reasons:

Screenshot decision

Labour Minister Christina Gray says concerns to be addressed in review of labour laws

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Leading Reinsurers Line Up for Lemonade, the P2P Insurer

By Andrew G. Simpson

Lemonade, the startup peer-to-peer insurance carrier that has raised $13 million in initial funding, announced a line-up of  global reinsurance partners, including Berkshire Hathaway and leading Lloyd’s of London syndicates.

Lemonade set records with its initial funding by Sequoia and Aleph, followed by its announcement that four senior insurance executives from ACE and American International Group (AIG) had joined its ranks.

Daniel Schreiber, CEO and co-founder of the P2P insurer, said that with Berkshire Hathaway’s National Indemnity and Lloyd’s of London backing Lemonade, the stage is now set for Lemonade’s consumer launch in the coming months.

“For insurance to provide true peace of mind you want to know your insurer is both willing and able to pay your claims,” said Schreiber. “Lemonade is the only insurer that doesn’t make money by denying claims – so no one is more willing than us.  With the backing of the world’s foremost reinsurance names, no one is more able either.”

In addition to Berkshire Hathaway’s National Indemnity, the P2P insurer said its reinsurance line-up includes Everest, Hiscox, Munich, Transatlantic and XL Catlin.

Read more here:: Insurance Journal

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