Insurance Certificates & Commercial Policy Basics

Susan Saksida, CIP, CRM, RMCO *protected email*

This past Tuesday, Susan Saksida, Risk Management & Insurance Consultant with Cameron & Associates, delivered a building blocks session for the Ontario Risk and Insurance Management Society.

This presentation included:

  • Introduction to Commercial Insurance Policies
  • Parts of the policy
  • Exclusions
  • Endorsements
  • Certificates of Insurance
  • Misconceptions & meanings

The presentation was delivered to a group of new to senior risk managers and sparked some great discussions on what to look for in policies and endorsements, and what information is necessary for the insurer’s protection on Certificates of Insurance.

Seminars like this are great to share information and help further everyone’s expertise.  Keep an eye out for ORIMS’ next professional development sessions.

We have included links to pdf versions of our presentations for further reference in the links below.

Need help with Risk Management, Training or  Certificates of Insurance?  We have the expertise and experience to assist!

Let us know how we can help.

Introduction to Commercial Insurance Policies Presentation

Certificates of Insurance Presentation

 

Are You Ready for the AB Mediation Backlog “Fix”?

On May 23, 2012, Tom Golfetto, Executive Director of the FSCO Dispute Resolution Group, issued a letter updating stake holders on the progress of DRS initiatives. The RFP procurement process in nearing completion and he expects that the first set of files will flow to the outsource vendors at the beginning of July. They expect that outsource vendors will be able to handle 2000 mediations per month and 500 arbitrations. This is in addition to the 2,793 mediations being handled per month by FSCO DRG staff. It was conspicuous that Tom’s letter did not give the number of cases currently in backlog but that was estimated at 30,000 (see our previous blog entry)

The problem with the math is that it does not account for the estimated 3,000 new cases coming in per month. If this number stays constant, FSCO staff can only keep up with the new ones and the backlog will be reduced at the rate of 2,000 per month over the next 18 months to 2 years.

The letter is available here.

In any event, the “warning” to be ready for the onslaught echoes my article “When the Dam Bursts”, FSCO warns: “please ensure that you retain additional staff as necessary, so that there are no scheduling delays due to unavailability of your staff”.

Cameron & Associates would be pleased to assist Insurers to resolve this challenge on a long and short term basis. Contact us for more details.

Thank you,

Jim Cameron & Team

Coaching and Mentoring Program (C.A.M.P.)

With the summer fast approaching, we got to thinking of C.A.M.P.!  Even though this C.A.M.P. doesn’t involve mosquitoes and campfires, we’re still very excited.

This program is specifically tailored to your needs.  We offer one-on-one coaching and mentoring both in-person and on the phone.

Who this program suits:

  • Small claims departments
  • Claims handlers who need focussed and specific training
  • New adjusters
  • Adjusters transitioning to handle a new line of claims (e.g. from Auto Physical Damage to Bodily Injury or Accident Benefits or from Personal Lines to Commercial)
  • Brokerages who handle claims in-house

This is a suggested program:

  • One on one mentoring with an experienced claims professional
  • In-person & telephone mentoring
  • Technical assistance on coverage and procedural issues
  • Assistance with file action plans, including investigation
  • Call observations, and feedback
  • Assistance with correspondence response
  • Reserve recommendations
  • Exposure identification
  • Negotiation best practices
  • Statement taking basics, observation & feedback
  • Coaching on the Litigation process

In a nutshell, this program provides you with immediate technical expertise, coaching and training to further hone your claims handling skills.

Program Delivery and Timelines:

Month one: One to two days per week of side-by-side coaching (can be full or half days), followed by as-needed phone consultations, charged hourly

Month two: One to two days every two weeks of side-by-side coaching, followed by as-needed phone consultations, charged hourly

Ongoing: Phone consultations, with one day per month of side-by-side coaching and follow-up after month 2

Contact Us

If you have specific claims training requirements for an individual or small group, we can design this program for you.

We’d love to chat more about our C.A.M.P., let us know how we can help!

Nicole Langley, Training & Business Development:  *protected email* or 416-306-2857

Brian Grieve, Vice President: *protected email* or 416-350-7359

Mediation Skills Workshop

We are excited to announce that we have expanded our “Mediation Assistance Program” to include a Mediation Skills Workshop.

In this one-day workshop, you will receive tips & coaching in Mediation Best Practices through examples, demonstrations & role-plays.  We will help you to effectively prepare for & participate in mediations.

Topics discussed:

  • File & strategy preparation
  • Challenges in file management
  • Information on relevant regulations, practice notes & forms
  • Mediation process & goals
  • Mediation behaviour & etiquette
  • Communication skills
  • Settlement practice tips

Stay tuned for our next scheduled session, or let us know how we can tailor this workshop to meet your specific needs.

Contact Us

Nicole Langley, Training & Business Development:  *protected email* or 416-306-2857

Brian Grieve, Vice President: *protected email* or 416-350-7359

AB Mediation Backlog

35,000 cases and counting.  What happens when the dam bursts?

Under the current Ontario Insurance Act, if you have a dispute with an Insurer involving the payment of accident benefits under the SABS (Statutory Accident Benefits Schedule), you must file for mediation with the Dispute Resolution Practice Group (DRPG) at FSCO (Financial Services Commission Of Ontario). This mediation must take place before the claimant can proceed to the courts through a law suit or by arbitration (again to be filed with the Dispute Resolution Practice Group).

The Act provides that such mediation shall take place within 60 days of the filing date with FSCO.  FSCO have found themselves facing some staffing issues and an unusual volume of cases being presented which resulted in a backlog of about 35,000 mediations.

The Auditor General of Ontario commented on this situation and FSCO has posted an RFP for outside services to assist in aggressively attacking the backlog.  One of the problems may be, however, what happens when the case is not settled at mediation.  If only 60% settle, 40% of these or 14,000 new cases will appear before the courts or at arbitration within the next few years.  Are we ready?

A great article in the Law Times talks a bit more on this subject.

We can help Insurers to get ready for mediations, and coach on mediation best practices.

Let us know if we can help! 

Thanks for reading,

Jim Cameron

Understanding Accident Benefits: A Primer for Brokers & other Insurance Professionals

We’re excited to announce that we will be delivering an Intro. to AB workshop on May 2nd at the Insurance Institute in Toronto.

We would love to see you there!  Our last courses on this topic were a big hit.

This one-day course is meant for someone with little-to-no claims experience, and will give a general overview of what benefits are, and some claims handling procedures.

Check out the Institute’s website for more information and registration.

Mediation Assistance Program for Insurers

At Cameron & Associates, we are pleased to announce our new Mediation Assistance Program (M.A.P.) for Insurers.

Are you ready?

FSCO has recently initiated a project to clear the backlog of over 30,000 mediation requests.

Implications for insurers:

  • Your AB team will receive an influx of mediation scheduling requests
  • Your ADR team and claims handlers will experience a dramatic workload increase to prepare for mediations
  • Your senior claims handlers will be preparing for mediations, spending less time on active files

At Cameron & Associates, our M.A.P. team is ready and available now for claims handling while your team readies for mediations.  Our highly skilled Accident Benefits team provides on-site assistance to insurers on long and short-term contracts.

What our M.A.P. Team can do:

  • Full AB file handling from Med./Rehab. to Catastrophic Claims
  • Mediation brief preparation

Help with individual tasks within the AB department:

  • Respond to incoming forms & mail
  • Make initial calls & return calls on AB claims
  • Identify red flags indicating possible fraud
  • Reserve worksheets
  • Processing & requesting payments
  • Correspondence to claimants
  • HCAI notification clearance

Please let us know how our team can support you.

Brian Grieve, Operations Manager via phone: 416-350-7359 or email: *protected email*

Nicole Langley, Training & Business Development via phone: 416-306-2857 or email: *protected email*