Claims Management and Handling Flashcards
7 cards from real RIBO practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Claims Management and Handling flashcards as text
Under the Ontario Insurance Act's Statutory Conditions, within how many days must an insured submit a Proof of Loss after a property loss?
Answer: 60 days
The Ontario Insurance Act Statutory Conditions require an insured to deliver a Proof of Loss to the insurer within 60 days of a loss, unless the insurer grants an extension.
What does the designation 'without prejudice' mean in claims correspondence?
Answer: Statements made cannot be used as evidence of liability or admission in legal proceedings
'Without prejudice' protects settlement negotiations by ensuring neither party's statements can be used against them as admissions in court.
What is an 'ex gratia' payment in the context of insurance claims?
Answer: A voluntary goodwill payment by the insurer when there is no contractual obligation to pay
An ex gratia payment is made voluntarily by the insurer as a goodwill gesture even though the policy does not technically obligate them to pay the claim.
What is 'salvage' in the context of property insurance claims?
Answer: The remaining value of damaged property that the insurer takes ownership of after paying a total loss claim
After paying a total loss claim, the insurer acquires salvage rights—ownership of the remaining damaged property—to partially recover their claim payment.
What is the insurer's 'duty to defend' under a commercial liability insurance policy?
Answer: The obligation to provide and fund a legal defense for any claim that potentially falls within policy coverage
The duty to defend is broader than the duty to indemnify—the insurer must defend the insured against any claim that could potentially be covered, even if coverage is ultimately denied.
What is the purpose of a 'reservation of rights' letter issued by an insurer?
Answer: A notice that the insurer will defend or investigate the claim while preserving its right to deny coverage later
A reservation of rights letter allows the insurer to assist with a claim or defense without waiving its right to deny coverage if the claim is ultimately determined to be excluded.
Under the Ontario Insurance Act's Statutory Conditions, what is the limitation period for an insured to commence legal action against a property insurer?
Answer: One year from the date the loss occurred
The Statutory Conditions in the Ontario Insurance Act set a one-year limitation period from the date of loss for commencing legal action against a property insurer.