CIP C112 PRACTICAL ISSUES IN
CLAIMS MANAGEMENT
when a company executes an audit to uncover the root cause of an
issue, unknown, immediately is an example of an - ANSWERS-
emergency audit
Subrogation (definition) - ANSWERS-is the right of an insurance
company that has paid a claim to step into the shoes of the
policyholder, in order to take
legal action against an at-fault third party to recover what was paid.
In regards to subrogation, loss adjusters need to - ANSWERS-1.
Promptly identify subrogation potential
2. Plan an intense investigation
3. Produce the type of evidence needed to establish legal liability
against a wrongdoer
subrogation, when is an insurer not bound by a release signed by the
insured - ANSWERS-if notice is given to the tortfeasor of the
insurer's interest. (case law the insurer is not bound by the release)
Accident Benefits Ontario (even though DCA applies) - ANSWERS-
Insurer can subrogate AB for
,Vehicles that are more likely to be involved in claims resulting n
bodily injury (heavy commercial hits passenger vehicle,via loss
transfer payment).
Loss Transfer form (ON) - ANSWERS-Request for indemnification
form is completed when payment is actually requested.
Somersall v Freeman (2002) - insured was paid to the limits of the
policy by Third Party ($200k) at trial in exchange for a release.
Insured then sued own Insurer for the remainder of the costs. -
ANSWERS-Courts agreed no prejudice as the insured was limited to
the TP policy and their damages where greater than the agreed payout.
Garnishee (definition) - ANSWERS-legal process to seize the
property, money, earnings or receivables of a debtor that are being
held by a Third Party.
Laches - ANSWERS-undue delay in asserting the claim or right of
claim (suffered some prejudice from delay)
Marshalling - ANSWERS-enabling creditors to realize the greatest
possible recovery from a debtor
Law of equity over the common law - law of equity vs common law -
ANSWERS-rule of equity wins
, Indemnity agreement - ANSWERS-protect the insurer's right to
recoup any losses or expenses paid on the bond
Quia Timet Order (Because he fears) - ANSWERS-is an injunction
sought when the plaintiff wants to prevent harm before it occurs
(needs strong evidence harm will occur)
Mareva injunction - ANSWERS-used in order to force a third party to
preserve their assets in anticipation of a recovery action.
Anton Piller Order - ANSWERS-granting civil authority for search
and seizure of relevant property (possessed unlawfully or
being used illegally)
what is the only province in which subrogation is sought in the
insurers name - ANSWERS-Quebec (unless goes to federal court)
Litigation (definition) - ANSWERS-carry on a legal contest or legal
challenge by judicial process.
Litigation Plan - ANSWERS-Maps out how a case will proceed, with
a timetable that includes judicial deadlines and estimates when the
claim will be resolved. Includes time limit to respond to pleadings.
interrogatories - ANSWERS-written questions prepared by a party to
a civil action to serve on another person, who is required to reply in
writing under oath.
CLAIMS MANAGEMENT
when a company executes an audit to uncover the root cause of an
issue, unknown, immediately is an example of an - ANSWERS-
emergency audit
Subrogation (definition) - ANSWERS-is the right of an insurance
company that has paid a claim to step into the shoes of the
policyholder, in order to take
legal action against an at-fault third party to recover what was paid.
In regards to subrogation, loss adjusters need to - ANSWERS-1.
Promptly identify subrogation potential
2. Plan an intense investigation
3. Produce the type of evidence needed to establish legal liability
against a wrongdoer
subrogation, when is an insurer not bound by a release signed by the
insured - ANSWERS-if notice is given to the tortfeasor of the
insurer's interest. (case law the insurer is not bound by the release)
Accident Benefits Ontario (even though DCA applies) - ANSWERS-
Insurer can subrogate AB for
,Vehicles that are more likely to be involved in claims resulting n
bodily injury (heavy commercial hits passenger vehicle,via loss
transfer payment).
Loss Transfer form (ON) - ANSWERS-Request for indemnification
form is completed when payment is actually requested.
Somersall v Freeman (2002) - insured was paid to the limits of the
policy by Third Party ($200k) at trial in exchange for a release.
Insured then sued own Insurer for the remainder of the costs. -
ANSWERS-Courts agreed no prejudice as the insured was limited to
the TP policy and their damages where greater than the agreed payout.
Garnishee (definition) - ANSWERS-legal process to seize the
property, money, earnings or receivables of a debtor that are being
held by a Third Party.
Laches - ANSWERS-undue delay in asserting the claim or right of
claim (suffered some prejudice from delay)
Marshalling - ANSWERS-enabling creditors to realize the greatest
possible recovery from a debtor
Law of equity over the common law - law of equity vs common law -
ANSWERS-rule of equity wins
, Indemnity agreement - ANSWERS-protect the insurer's right to
recoup any losses or expenses paid on the bond
Quia Timet Order (Because he fears) - ANSWERS-is an injunction
sought when the plaintiff wants to prevent harm before it occurs
(needs strong evidence harm will occur)
Mareva injunction - ANSWERS-used in order to force a third party to
preserve their assets in anticipation of a recovery action.
Anton Piller Order - ANSWERS-granting civil authority for search
and seizure of relevant property (possessed unlawfully or
being used illegally)
what is the only province in which subrogation is sought in the
insurers name - ANSWERS-Quebec (unless goes to federal court)
Litigation (definition) - ANSWERS-carry on a legal contest or legal
challenge by judicial process.
Litigation Plan - ANSWERS-Maps out how a case will proceed, with
a timetable that includes judicial deadlines and estimates when the
claim will be resolved. Includes time limit to respond to pleadings.
interrogatories - ANSWERS-written questions prepared by a party to
a civil action to serve on another person, who is required to reply in
writing under oath.
