INSURANCE CONTRACT OR INSURANCE POLICY
The insurance contract between you and the insurer explains
all your rights and obligations, in particular regarding coverage,
exclusions and limitations. It is the final word on how much
coverage you actually have.
CONSENT WITH RESPECT TO PERSONAL INFORMATION
The claims adjuster will ask you to sign a consent form for
the collection and communication of personal information.
This consent form must comply with the Act respecting the
protection of personal information in the private sector. By
signing it, you authorize the insurer or your claims adjuster to,
if necessary, collect personal information from third parties,
as well as to communicate this information to other persons for
the purposes of investigating and processing your claim. The
ChAD recommends adjusters use the model form available
NOTICE OF CLAIM
The claims adjuster will take your statement (and possibly the
statement of any other person insured under your contract)
regarding the circumstances surrounding the loss. It can be
taken over the phone or on paper, in which case the adjuster
may ask you to sign it. The claims adjuster will provide you with
a copy upon request.
RESERVATION OF RIGHTS LETTER
If the claims adjuster’s investigation raises certain doubts
regarding the admissibility of the claim and the insurer wishes
to carry out a more in-depth investigation, the claims adjuster
will give you a reservation of rights letter. This document
explains the insurer’s right to refuse the claim or to cite
exclusions in the insurance contract.
Unlike the reservation of rights letter, the non-waiver
agreement requires the insured’s signature. By signing this
document, the insured declares that he has been informed of
the insurer’s position. He thus acknowledges the possibility
that the insurer may cite exclusions or refuse compensation,
even if it continues to proceed with the investigation. The
insured is not required to sign a non-waiver agreement. In this
case, he will be sent a reservation of rights letter.
CONTRACT FOR CLAIMS ADJUSTERS MANDATED BY THE INSURED
The claims adjuster mandated by a claimant must provide
you with a written contract stipulating that he will represent
you in discussions and negotiations with the insurer and the
claims adjuster mandated by the insurer who has been
assigned to your file. Although the content and format of
the contract of the claims adjuster mandated by the insured
is at the adjuster’s discretion, he is obliged to offer two
payment options: a percentage or an hourly rate. The ChAD
recommends adjusters use its model contract (available in french only), which is
available at chad.ca.
ASSIGNMENT OF CLAIM
This document allows the insurer to pay the service provider
directly. Please see the dictionary of terms and the
text box "Should I sign the assignment of claim or not?" on the page "Step bu step: what to do when a loss occurs?".
PERSONAL PROPERTY INVENTORY
In order for the claims adjuster to do his work (investigate,
estimate and negotiate), he must have an inventory of your
personal property that was either damaged, destroyed or
stolen. The faster he gets it, the faster your claim will be
processed. It is up to you to prepare it and ensure that it is
complete, though the claims adjuster can certainly help you
to do so. Read the section entitled "The claims settlement
process – Estimating the damages”.
QUOTE/ESTIMATE FOR RENOVATIONS
Carefully read the quote for renovations that the contractor or
appraiser has prepared before you approve the work he plans
to do and the materials chosen (which must be of the same
nature and quality as before the loss). You can ask that the
quote include an estimate of costs.
CLAIM (OR PROOF OF LOSS)
Once the claims settlement has been negotiated, the claims
adjuster may, in certain cases, have you sign a claim, which
indicates the amount paid by the insurer in accordance with
the coverage provided for in your contract. This document
is usually given to you at the end of the claim process and
summarizes the agreement as a whole.
STATEMENT OF SATISFACTION
Once the work is completed, the contractor or insurer may
ask you to sign a document confirming that you are satisfied
with the work done. If you are not satisfied, do not sign
Before signing a document, do not hesitate to ask
questions. The person who is asking for your signature
must be able to justify the request and clearly explain
it to you. Certain explanations are not acceptable, for
instance: “You must sign the document, otherwise we
won’t do the work,” or “You must sign the document,
otherwise your claim will not go through.” You also
have the right to receive a copy of all the documents
you have signed that are related to your claim.
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