May 24, 2022

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Tribunal sides with Intact in home insurance co-payment spat Canadian Underwriter

A B.C. homeowner who is listed along with a second person on his home insurance policy has lost his bid to have Intact issue him a payment directly for his own personal items damaged in a flood, instead of issuing a co-payment to both people listed on the policy.

Gary Buchanan jointly held a personal property insurance policy with a person identified only as “HL” in a recent decision by the B.C. Civil Rules Tribunal. HL was not a party to the dispute.

At some point in 2020, Buchanan and HL made an insurance claim with Intact after a flood damaged their home. Part of the insurance claim was for damage to Buchanan’s personal property. He claimed $3,065 for the replacement cost of a damaged phone, video camera, and three memory cards for the video camera.

In January 2021, Intact mailed a co-payable cheque to Buchanan and HL at their shared home address, and HL cashed it. The tribunal assumed the cheque was for a settlement amount of $1,763.77, as indicated in a November 2020 email from Intact to Buchanon.

Buchanan insisted that the payment be made in his name only, for the value of $3,065.

For its part, Intact said it was a clear term of Buchanan’s policy that when paying out a claim it will issue a co-payable cheque to both policyholders. The insurer added that under no circumstances is an Intact insurance adjuster allowed to issue a cheque to only one of two policyholders. The insurer denied that it owed Buchanon any more for the claim than the settlement amount of $1,763, which it paid.

Buchanon said Intact never proved that it had such a policy regarding [co-payment]. Even if it did have such a policy, he argued, Intact did not follow it. In support of his position, he claimed that Intact issued a cheque solely to HL for out-of-pocket flooring installation expenses related to the insurance claim.

However, the emails Buchanon submitted as evidence showed only that a restoration contractor agreed to directly reimburse HL, the tribunal found. “There is no evidence the contractor actually reimbursed HL, or that Intact agreed to the arrangement,” CRT Member Sarah Orr wrote in a decision released Wednesday.

Orr found that it ultimately didn’t matter whether or not Intact furnished its co-payment policy.

“I agree that Intact provided no documentary evidence of its co-payment policy, and I find the emails from [an Intact representative] in evidence indicate that they were willing to pay Mr. Buchanan directly for the value of his personal property claim,” Orr wrote in her decision.

“However, I find nothing turns on this [co-payment] policy because Mr. Buchanan has not established that he is entitled to payment from Intact. He says [the Intact representative] failed to follow through on their promise that Intact would pay him directly for his claim by e-transfer. However, I find [the Intact representative’s] statement about direct payment to Mr. Buchanan was conditional on receiving HL’s agreement, and there is no evidence before me that HL agreed to the proposed arrangement.”

 

Feature image courtesy of iStock.com/monkeybusinessimages