When in Doubt, Send It Out

Canadian Underwriter - Vol. 76 Nbr. 1, January 2009

Bailey, Gregory P
Permanent Link: http://ca.vlex.com/vid/when-in-doubt-send-it-out-65772952
Id. vLex: VLEX-65772952

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Summary:

Accident benefits adjusters are faced with more regulated timelines than ever before. However, there is no oversight greater than failing to put a priority insurer on notice within 90 days as stipulated in Ontario Regulation 283/95, the "Dispute Between Insurers Regulation" (hereafter abbreviated as "the Regulation"). The 90-day notice provision is set out in subsection 3(1) of the regulation. Here are steps on how to handle priority investigations: 1. Commence priority investigations immediately upon receiving knowledge of a potential claim. 2. Carefully document every step in the priority investigation. 3. Do not simply rely upon information provided by the claimant. 4. Send the Notice by fax and mail. 5. Investigate prior policies. 6. Never rely upon the ability to extend the 90-day notice period. 7. Understand the 90-day notice period and implement a "tickler system." 8. If in doubt, send it out.

Headnotes:

Extract:

When in Doubt, Send It Out

Accident benefits (AB) adjusters are faced with more regulated timelines man ever before. A failure to meet these timelines can result in paying for an assessment or treatment plan that may not have otherwise been payable. However, there is no oversight greater than failing to put a priority insurer on notice within 90 days as stipulated in Ontario Regulation 283/95, the "Dispute Between Insurers Regulation" (hereafter abbreviated as "the Regulation").

The 90 -day notice provision is set out in s...



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