In Québec, claims adjustment expertise is reserved for holders of a claims adjuster certificate issued by the Autorité des marchés financiers (the “Authority”), with a few exceptions. One of these exceptions applies to major weather events, or “special circumstances,” which are occurring more frequently. For example, during torrential rain, ice storms or extreme winds, claims multiply, causing significant damage and stress for insured individuals. During these peak periods, claim requests increase sharply, creating heavy workloads for claims adjusters.

Under the Act Respecting the Distribution of Financial Products and Services (“the Act”), as amended by Bill 16 on various measures mainly relating to the financial sector, the Autorité has the power to expand the workforce authorized to act as claims adjusters during special circumstances, under conditions it determines (“authorized persons”). These activation conditions were recently published on its website.

What role can members of the Chambre de l’assurance play in this context, and what are their obligations? This article focuses on the obligations of damage insurance agents and brokers, as well as claims adjusters, once a permission is activated. This information complements the Autorité’s web page, which also outlines the activation conditions and firms’ responsibilities.

1. Obligations Relating to Authorized Persons (including agents and brokers)

Under the conditions set by the Authority, the firm must associate each claims file with a claims adjuster as soon as it is assigned to an authorized person. The claims adjuster must be able to take over the file at any time, including when the permission expires, if the file is not completed.

If multiple files are assigned to the same authorized person, they may be associated with different claims adjusters.

Good practice : When a claims adjuster takes over a file previously handled by an authorized person, they should review the entire file, including all tasks completed and steps taken since it was opened.

2. Obligations Relating to Telephone Employees (non‑certified)

During the permission period, telephone employees are authorized to handle claims valued up to $30,000, instead of the usual $7,500 limit provided under section 10 of the Act.

At all times, the claims adjuster’s supervision obligations toward non‑certified employees remain applicable, including requirements related to supervisor qualification, full responsibility for files, file review and communications with clients..

The Chambre reminds claims adjusters supervising non‑certified employees that these workers play a key role in the industry and in protecting the public. Rigorous supervision ensures the application of good practices, thereby supporting the protection of claimants.

The translation of this article was done using AI but was reviewed by humans.