Insurance and Negligence Claim FAQs

Some Alberta property policies require the insured to carry coverage equal to a specified percentage of the property’s value. If the insured limit is too low at the time of loss, the insurer may apply a co-insurance penalty and reduce the payment. This issue often depends on valuation and policy wording.

Replacement cost coverage generally pays the cost to replace damaged property with new property of similar kind and quality, subject to the policy terms and limits. Actual cash value, or ACV, accounts for depreciation based on factors such as age, use, and condition. Alberta claims may involve one or both measures depending on the policy.

A reservation of rights letter tells an Alberta policyholder that the insurer is investigating or adjusting the claim without accepting that coverage applies. The letter often identifies potential coverage concerns and preserves the insurer’s ability to later deny all or part of the claim.

Not every Alberta claim requires a proof of loss, but when one is requested or required, deadlines can matter. If you missed or may miss a proof of loss deadline, speak with a lawyer promptly. The proof of loss is an important claim document and timing issues should be addressed carefully.

If an Alberta insurer voids a policy, it is taking the position that the policy should be treated as if it did not exist at the time of the loss. Insurers may allege voiding where there was a material misrepresentation or a material change in risk. Premiums are often returned, but the effect on coverage can be significant.

Exclusions are policy terms that describe situations where coverage does not apply. In Alberta insurance disputes, the insurer generally has to prove that an exclusion applies. Some exclusions apply across the policy, while others apply only to certain types of coverage.

Policy conditions are requirements that a policyholder must follow to maintain or access coverage. In Alberta claims, conditions may include post-loss duties and may come from the policy or applicable legislation. An insurer may allege a breach of condition when it believes those obligations were not met.

Binding coverage means an insurance broker has put coverage in place with an insurer, often before the formal policy documents are issued. In Alberta, coverage may begin once it is bound, depending on the authority granted to the broker and the terms of the binder.

Yes, some Alberta claims involve both an insurer and an insurance broker. This may happen where the insurer is alleged to have wrongly denied or underpaid the claim and the broker is alleged to have failed in arranging or advising on coverage. Depending on the facts, both claims may proceed in one lawsuit.

Disputes about what was requested from an Alberta insurance broker can be fact-specific. Relevant evidence may include emails, applications, handwritten notes, broker memos, call recordings, renewal documents, and prior insurance history. These records can help determine what was discussed and whether the broker met the required standard.

Depreciation is a reduction in value based on factors such as age, use, wear, and condition. Betterment refers to a situation where repairs or replacement leave the policyholder with something considered better than what existed before the loss. In Alberta property claims, insurers may raise these issues when calculating payment.

A material change in risk is a change after the policy is issued that may affect the insurer’s willingness to insure the property or the premium charged. In Alberta, an insurer might raise this issue if, for example, an owner-occupied home became a rental property. If proven, it may affect coverage.

A material misrepresentation occurs when important information is misstated or omitted in an insurance application or other communication. In Alberta, an insurer may allege that it would not have issued the policy, or would have issued it differently, if the correct information had been provided.

A non-waiver agreement is a document an Alberta insurer may ask a policyholder to sign while it investigates a claim. It usually states that the insurer is not giving up its right to rely on policy defences or deny the claim. Legal advice should be obtained before signing.

A subrogated action occurs when an insurer brings a claim, often in the policyholder’s name, against a person or company alleged to have caused the loss. For example, after paying an Alberta fire loss, an insurer may sue an electrical contractor whose work allegedly caused the fire.

Uninsured losses are losses that are not covered by the insurance policy. In Alberta, some uninsured losses may still be relevant in a broker negligence claim if the broker’s alleged failure caused the policyholder to be without coverage that should have been arranged.

No. A complaint to a broker’s regulator deals with professional obligations and discipline. It does not necessarily result in compensation for the person who suffered a loss. A lawsuit is a separate legal process used to seek damages for losses allegedly caused by broker negligence.

Limitation periods depend on the type of claim, the policy, and the facts. Some Alberta property insurance claims may have short contractual or statutory deadlines, and broker negligence claims may have different limitation issues. Because missing a deadline can affect your rights, it is important to speak with a lawyer promptly.

Claims involving insurance disputes and broker negligence are assessed on their specific facts. In some cases, additional damages may be considered where an insurer is alleged to have acted in bad faith or where other compensable losses are supported by the evidence. A lawyer can review whether emotional harm or other damages may properly form part of the claim.

Many Alberta policyholders cannot identify the exact value of every damaged item, especially after a major fire, flood, or other total loss. It is still important to create the most complete contents list possible and assign values to the items. Where available, include both the estimated replacement cost and the depreciated actual cash value, sometimes called ACV.

In Alberta property claims, receipts are not always required for every damaged item. They can, however, be useful for expensive, unusual, or specialized belongings. If you are replacing contents and seeking replacement cost, keep receipts for the replacement purchases because those records may help support the amount claimed.

The amount available in an Alberta property claim depends on the wording of the insurance policy. Some policies provide coverage based on depreciated value, while others provide replacement cost coverage up to a stated limit. Certain policies may also include guaranteed replacement cost wording, but whether that applies depends on the specific terms and facts of the claim.

In Alberta, additional living expense coverage may apply to the increased costs caused by an insured loss while the property is being repaired or replaced. These costs usually have to be actually incurred and supported with records. Coverage can depend on the policy wording, limits, and whether the expense was necessary and reasonable.

Some Alberta property insurance disputes can involve court steps, including applications, motions, or a trial. Many claims are resolved before a full hearing, but the path depends on the coverage issues, the evidence, and how the insurer responds.

Many civil insurance disputes in Alberta are resolved before a full court hearing. Settlement depends on the strength of the evidence, the policy wording, the value of the claim, and the positions of the parties. The timeline can vary from case to case.

Many Alberta broker negligence claims are resolved before a full trial, as is common in civil litigation. Whether a claim settles depends on the evidence, the losses claimed, the broker’s role, and the positions of all parties involved.

For many large Alberta property loss and insurance coverage disputes, clients may choose a contingency fee arrangement. Under that structure, legal fees are paid from a portion of a settlement or court-ordered amount rather than through monthly invoices. The available fee structure depends on the file and is discussed before a retainer is signed.

For Alberta property insurance matters, it is helpful to provide the full insurance policy and any written communication from the insurer, including reservation of rights letters, denial letters, critical path letters, proofs of loss, schedules of loss, repair estimates, and documents that help show the value of the claim. Because property policies can vary significantly, our lawyers review the policy wording and claim history before assessing the next steps.

Some Alberta property losses may also involve personal injuries, such as smoke inhalation, exposure to mould, or other health effects connected to the incident. Whether there is a separate injury claim depends on the cause of the harm, the evidence, and the available legal remedies.

An Alberta insurance claim may be underpaid if the amount offered does not fully address covered building repairs, replacement, emergency work, additional living expenses, or contents. For business claims, underpayment may also involve lost income or extra expenses that were not properly accounted for under the policy.

A proof of loss is a sworn document used in an insurance claim to set out details of the loss and the amount being claimed. In Alberta property claims, more than one proof of loss may be submitted as the claim develops and additional information becomes available.

An insurer may request an examination under oath, often called an EUO, to obtain more information about a claim. In Alberta, this may involve questions about the cause of the loss, the amounts claimed, and supporting documents. The examination is usually conducted by the insurer’s lawyer and recorded by a court reporter.

A lawyer is not always required for a proof of loss or examination under oath, but legal guidance can be valuable. In Alberta property claims, a lawyer can help prepare you, review the documents, and identify questions or requests that may be improper or outside the required scope.

Business interruption coverage can protect an Alberta business from income loss caused by a covered property loss that forces the business to close or reduce operations. Some policies may also cover extra expenses incurred to continue operating or to reduce the overall interruption loss.

In Alberta, an insurer dispute usually involves an allegation that the insurance company breached the policy, which is a contract. A broker negligence claim is different because it focuses on whether the insurance broker failed to meet a duty of care, such as by not obtaining appropriate coverage or not explaining important coverage limits.

When a broker says coverage existed but the insurer denies the claim, an Alberta lawyer can review whether the problem is the insurer’s interpretation of the policy or the broker’s handling of the coverage. In some cases, both the insurer and broker may need to be included in the same claim.