Legal Expense Insurance. CLAIMS All you need to know

Transcription

1 Legal Expense Insurance CLAIMS All you need to know

2 Claims: All you need to know Agenda Claims process A day in the life of a Legal Expense Insurance Claims Handler LEI Claims in numbers The civil litigation process The element of confidentiality / privacy Reasonable prospect of success Our panel law firms Customer stories

3 Claims Process It starts with a phone call Legal advice is given Claims determination Panel lawyer is assigned

4 A day in the life of a Claims Handler CLAIMS Review the advice lawyer s notes Contact the insured to get the full picture In most cases, request and review documents relevant to the case If the claim is covered and legal representation is required, a lawyer is appointed If the claim is not covered, contact the insured and explain why ON-GOING CLAIMS Review files to ensure a smooth and timely progression Ensure the file meets the likelihood of success requirements Manage cost and invoices Discuss the evolution of files with the panel lawyers Be the advocate for the clients

5 LEI Claims in Numbers 5 million dollars Paid in claims since DAS Canada opened its doors in 2010

6 LEI Claims in Numbers 10,006 calls to the Legal Advice Helpline

7 LEI Claims in Numbers 2,808 claims submitted 1,741 claims covered 1,067 claims not covered 829 claims closed 912 active claims 107 exclusions 960 pre-inception

8 LEI Claims in Numbers The Legal Advice Helpline TOP 3 TYPES OF CLAIMS: Traffic tickets: 505 Contract disputes: 400 Employment disputes: 317

9 Civil Court Active Cases Elapsed time from case initiation to first disposition 350, ,000 52% 250, , , ,000 18% 15% On average, in one year, there are 920,000 active civil court cases 50,000 8% 8% - CANSIM Table

10 The Civil Litigation Process Negotiations Demand letter Courtmandated negotiations / settlement discussions START HERE Legal issue Legal representation Issue proceedings Trial

11 The element of confidentiality / privacy Solicitor-client privilege and client privacy/confidentiality apply. Detailed information regarding the nature of your client's claim cannot be disclosed to you. If your client encounters any issue during the claims process, we ask you direct them to contact DAS Claims Department Representative directly. Feel free to raise your client's concern with your DAS Broker Consultant, who can monitor the issue on your behalf and keep you informed while staying within solicitor-client privilege rules.

12 Reasonable Prospect? 51%

13 Reasonable Prospect? Reasonable prospect of success: For civil cases, reasonable prospect of success means we agree it is always more likely than not that an insured person will recover losses or damages (or obtain other legal remedy which we have agreed to) or make a successful defence. Is it possible to appeal the decision?

14 Our Panel Lawyers National coverage Strict service standards

15 Customer Stories Meet Jenn Jenn purchased a vacation to a 5 star resort in the Caribbean through a travel agent, and was looking forward to a week in paradise. Upon arrival, she found that the resort was not at all as advertised. To her surprise, not only was the hotel a 2 star facility, it was also infested with insects.

16 Customer Stories Meet Jenn As the bugs had invaded the entire hotel, Jenn called the travel agent for help. She was told that cancelling the holiday was not an option and had to stay for the full 7 days. By the end of the week, she was covered in bites and sleep deprived, having only managed to sleep a few hours each day. The holiday created a great deal of anxiety for Jenn, and cost her a lot of money. The bug infestation was so severe she had to leave her luggage and belongings behind. When all attempts to recover any expense through the travel agency failed, Jenn turned to her DAS policy for help. As it was the first time she was using her DAS policy, Jenn wasn t sure what to expect. She braced herself, anticipating never ending meetings and huge amounts of paperwork. To her delight, none of her concerns materialized. The DAS team handled everything, only asking Jenn to provide receipts, dates and contact information. Three weeks later, the assigned lawyer was able to recover 67% of Jenn s expenses. She also saved $1,500 in legal fees.

17 Customer Stories Meet Fred Fred owns a small trucking company and often works with a broker to arrange shipments. While on his way to deliver a shipment to a client, one of Fred s drivers got stopped at a weighbridge. The truck was found to be overloaded. In order to be allowed to continue, the driver was forced to go back to the warehouse to unload parts of the shipment. As a result, the driver failed to arrive on time for the delivery, and the client refused the shipment as it was time sensitive. Not only did the broker refuse to pay Fred for the job, he also refused to pay for 12 previous jobs.

18 Customer Stories Meet Fred Fred called DAS for help. We appointed a lawyer who successfully negotiated a settlement whereby Fred agreed to return the goods to the customer at his own cost, and in return the broker released the funds for all the jobs that had been done. Fred saved $4000 in legal fees.

19 Customer Stories Meet Peter Peter is a taxi driver. One Saturday night, he picked up an intoxicated customer who began to verbally and physically abuse him. Peter had no choice but to defend himself from the unruly passenger. As a result, the passenger called the police and Peter got charged with battery.

20 Customer Stories Meet Peter Peter called DAS immediately. We assigned a lawyer who had the charges dismissed. Without a DAS insurance policy, Peter would have had to pay $7,500.

21 Customer Stories Meet Brenda Brenda had been an employee of a financial services company for over 10 years. When the company was bought out by another company, a lot of staff were dismissed, including Brenda. Her contract contained a clause making it impossible for her to work in the same industry and province for the next 3 years. On top of this, Brenda was only offered the statutory minimum.

22 Customer Stories Meet Brenda Brenda called DAS. It only took a couple of months for the appointed lawyer to get Brenda double the severance, as well as a cancellation of the post termination restrictions. This allowed her to start applying for other jobs in the province she lived in right away. Brenda saved $3500.

23 Questions?