Mathieu Sirois, claim ajuster

Mathieu joined Crawford in 2009. He has 18 years of experience in the insurance field. First hired as a property and casualty insurance agent, he then became a claims adjuster, an expertise he refined within independent claims adjuster firms. He handles files related to divided co-ownership properties as well as general liability, mainly for files concerning syndicates of co-owners and their administrators. His first experience with a divided co-ownership property was a significant loss (over $750,000), when a dishwasher caught fire in an apartment on the 16th floor of a high-end residential tower. Since then, he has taken interest in the issues divided co-ownership losses entail.  In fact, he received training in this area from Emeritus Lawyer Yves Joli-Coeur.

The Independent Claims Adjuster: an ally for any syndicate of co-owners

Your co-ownership is exposed to various risks, as an example, fires, water damages, theft and acts of vandalism, which are required to be insured against. When a loss occurs, the insurance of a co-ownership covers the building as well as the general liability of the syndicate of co-owners.

For the syndicate, subscribing to this type of insurance is mandatory. The law and most Acts of co‑ownership require it. The insurance contract specifies the coverages offered, as well coverage limits and exclusions, in addition to the deductible amounts.

Whether you are a homeowner, a non-occupant owner or a tenant, there is a high probability that one day you will be the author or the victim of a water damage. This is the number one cause for reported claims. In addition, each co-owner is required to be insured against civil liability risks, to which they must respond to as an occupying or non-occupying co‑owners (rented unit).  The Law (article 1064.1 of the Civil code of Quebec) requires each co-owner to be insured.

Sometimes, the water damage is invisible. You find out when your neighbor, who is the victim, tells you that water is coming in from your unit. In co-ownership, it is very difficult to know the origin at first sight. Is this loss originating from a common portion of the building having an impact on the privately owned areas or just a claim concerning privately owned units? Is the leak upstream or downstream from the shut-off valve? All these questions deserve a clear answer. But before drawing any conclusions, you should not waste any time before reporting the loss to your insurer.

If you are the director of the syndicate concerned and you have been informed that a loss has occurred, you must take the necessary precautionary measures and inform the insurer of the syndicate, regardless of the nature of the damage or its alleged origin. If it is a water damage, remove the water and dry the affected area. Once again, you must communicate your intentions to the insurer so that he can be aware of them and determine whether they are appropriate for the loss at hand.

After having been the victims of a loss, the members of the board of directors and the affected co‑owners are often taken by surprise. They often wonder how things will unfold. There is no use in panicking or worrying because usually, once the notice of loss has been reported, various stakeholders enter the scene: the insurer of the syndicate, but also the insurers of the co-owners and tenants who will respectively appoint their own claims adjuster. It is normal for the co-owners involved in a claim, as well as the syndicate, to think that a claim is always the right thing to do. This is true in many cases, but sometimes it may be in the interest of the syndicate to refrain from doing so. Furthermore, the damage may not be covered to a lack of insurance of coverage. If that is the case, the syndicate must take responsibility for the repairs.

From that point own, the intervention of an independent claims adjuster may prove useful especially if the amount of damages is below the deductible amount. The latter may:

  • Take measurements and photographs;
  • Have a consent form signed in order to collect information;
  • Obtain a statement from the insured co-owner, if the latter is liable for the loss;
  • Obtain statements from third parties, including the ones of specialists or service providers;
  • Investigate the exact cause of loss;
  • Assign suppliers and specialist and monitor their work;
  • Appraise property damage;
  • Determine each party’s share of liability;
  • Determine the amount of indemnity;
  • Determine which percentage of depreciation must be applied to the loss summary;
  • Make a detailed report of his observations.

The independent claims adjuster may also assist the syndicate’s legal representation in preparing a formal notice or proceed with legal action against the co-owner liable for the claim, or against the manufacturers of the household appliances that caused the loss. All in all, he is a first line advisor for a syndicate faced with a high deductible imposed by the insurers of syndicates.

Mathieu Sirois, claim ajuster, PAA/ CIP 

Crawford & Compagnie
5100, rue Sherbrooke Est, Bureau 702
Montréal, Québec  H1V 3R9
Tél. (514) 748-7300 poste : 7649
[email protected]