Important : You have the right to receive a copy of all documents you have signed
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 at chad.ca.
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 by 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 the document.
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.
For further information
The Claimant's Handbook
This guide will help you to keep track of all the steps, documents and information you need to settle your claim.