We’ve been hearing a lot about this topic in the news over the last couple of weeks, and is of great interest for those of us in Ontario who drive south in the winter, especially for March Break!
Florida has passed a law requiring all out-of-country drivers to have an International Driver’s Permit (IDP). Failure to do so could result in fines and/or other charges. It’s not clear what the intention of this legislation was, and if it was to ensure that tourists from overseas were confirmed to be properly licenced. Those of us who have handled auto claims know that it can be quite arduous to confirm licence details from drivers from overseas, further hindered by communication and language barriers. In all likelihood, this law stemmed from such issues, and not because of us, their cousins north of the border.
In Ontario, anyone staying in the province for less than 3 months does not need an IDP. These drivers only need a valid licence from their home province or country, and need to be at least 16 years old. After 3 months, an IDP is needed. More information can be found here on the government’s website.
What are the implications of failing to get your IDP for your Florida vacation? One is that your insurance company might not cover you if you are in an accident. This can have dire consequences for large repair and medical bills. As per CAA (the only place in Canada where you can get an IDP) this new law is not being enforced for Canadian drivers, pending further review of the law. However, strictly speaking, if you do not have a valid licence, your insurer can deny coverage. So, what now?
You’ll likely want to err on the side of caution, and join the lineups at CAA to get your International Driver’s Permit. It’s a quick process, the cost is $25, and you must be at least 18. Don’t worry! It’s just a translation of your information. You don’t have to write a test.
What are some common situations for subrogation in winter? There are a few!
1. Potholes
With the temperature fluctuating, our streets become riddled with potholes. Driving over these can often cause significant damage to vehicles. Who is responsible for maintaining roads? It’s likely the city or municipality. It is important to send notice to the city or municipality immediately after the damage occurs. This is important for two reasons. One is that the city will attempt to repair the pot hole, preventing further damage. The other reason is that the notification for most cities is needed within 7-15 days if there’s any chance of subrogation recovery. It is important to follow up on these notices, and to thoroughly document loss details.
2. Snow Plows
Most often, when vehicles are parked on the side of a road, and a plow goes by after a heavy snow, there is a chance for damage to the parked vehicle. Snow plows long gone though, right? Maybe not. Ensure that photos and a cause of the damage to the vehicle are documented as soon as possible. If the damage is consistent with being hit by a plow, there is a chance of recovery. Find out what time the damage occurred, if there were any other vehicles damaged, and who was responsible for the snow removal. Not always easy, but worth a shot!
3. Snow Birds
Lucky folks will get out of the snow for winter, and head south to the U.S. Almost all states are tort for recovery. This means that you go to the at-fault party for recovery of damage. If one vehicle does not have collision coverage, that driver has to go directly to the other insurance company for their damage. It’s important to ensure adequate reserving for these losses, as the at-fault company has an exposure to third party property damage, as well as injury claims.
The important keys for pursuing subrogation successfully is to recognize the opportunities early, and to get complete details of the loss, and documentation to support damage and payments. Attempting recovery too late often leads to failure.
We are pleased to introduce Kevin M. Quinley, our guest blogger. He has a great blog on his own site, www.claimscoach.com, and has graciously allowed us to feature him as a guest blogger. Kevin Quinley CPCU, ARM, AIC is the principal of Quinley Risk Associates LLC, a boutique claims consulting firm based in the Richmond, Virginia area. He provides his nationwide clientele with services related to claims training, productivity, litigation support and expert witness services. He is the author of 10 books and over 600 articles on various aspects of insurance, risk management, claims handling and litigation management. You can reach him at or at his website, www.claimscoach.com.
Police Reports: Investigative Linchpin or Adjuster Crutch?
To what extent should an adjuster rely upon a police investigation? Should it substitute for the adjuster’s investigation or part of it? Or, should it simply augment the investigation but not be viewed as a substitute for it?
This issue arose recently in the context of a bad faith claim where I was engaged as an expert witness. The plaintiff/policyholder alleged, among other things, that the insurance carrier failed to conduct an adequate investigation. Part of the argument was that the insurance adjuster relied too much on the police investigation and did not do more in the way of taking a formal statement from the policyholder and interviewing witnesses.
The Police Report reflected the account of the incident (an alleged assault and battery) from the standpoint of the insured and of witnesses. There was no dispute about what happened in the incident itself. The coverage dispute pertained more to the policyholder’s intent and whether his actions triggered the “expected or intended” or the “willful and malicious” policy exclusions.
This raised the issue as to whether adjusters are obliged in every case to go beyond the Police Report or whether, in certain cases, the report can be the cornerstone of an adjuster’s investigation.
As new adjusters, we are often taught — rightly — to NOT view police reports as sacrosanct. Police Reports can contain errors, just as medical reports or even attorney reports can contain errors. Typically, police are not eyewitnesses to an accident or incident. Their reports will capture facts relevant to the breaking of laws and ordinances.
However, in some instances a Police Report might serve as the cornerstone of a claims investigation. This is not to say that the Police Report always constitutes the end-all and be-all of a claim investigation. It is not to say that the Police Report is necessarily the entirety of an adjuster’s investigation. However, there may be situations where there is no need for the adjuster to plow the same investigative ground that the police have tilled if the basic facts of a claim are not in dispute.
Consider a straightforward accident where Car A rear-ends Car B. No one disputes that, and it is reflected in the police report. Is the adjuster still obliged to track down, identify and take statements from all witnesses? At some point, this appears to be overkill.
Unless the adjuster is on notice that the Police Report is in some way erroneous or disputed, and if nobody disputes the basic facts of a straightforward accident, there may be instances where the adjuster can rightly rely on a police investigation for the bulk of the fact-finding without being accused of laziness.
The overarching principle is that adjusters and insurance companies are obliged to conduct reasonable investigations. This is required in many state unfair claim practice statutes. It is also found in the NAIC Model Unfair Claim Practices Act. Of course, “reasonable” is not defined. There is no paint-by-numbers description of what goes into reasonable. The statutes do not delineate the components of a “reasonable” investigation. What is reasonable in terms of investigation must be determined by the particulars of each individual claim.
At one extreme, you have straightforward scenarios where it is undisputed that Car A rear-ended Car B. If the police report reflects that, both drivers agree and there is no evidence to the contrary, then perhaps the police report can serve as the cornerstone of the adjuster’s investigation.
At the other extreme are complex and disputed facts situations. These could include the Deepwater Horizon oil spill in the Gulf of Mexico or the Fukushima nuclear meltdown in Japan. Here, official reports might be taken with a grain of salt and should be the starting point, not the endpoint of an insurer’s investigation.
So, where do you stand on the issue? Are there situations where the Police Report can substitute for a big chunk of the adjuster’s investigation, OR is the adjuster obligated to always go back over the features captured in the report?
With the new Accident Benefits regulation in effect for 2 years, have these changes had an effect on fraud? Is the amount of fraud reduced or have the culprits gotten better at hiding it? It seems like we’re always two steps behind!
Time will tell, if the amount of fraud is being reduced, especially with the drastic increase in the amount of mediations being scheduled through FSCO. Hopefully, less fraud will equal lower claim payouts AND lower premiums.
We’ve attached 2 videos from the Insurance Bureau of Canada that demonstrate the implications and financial cost of fraud.
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
