Canadian Claims Adjusters’ Code of Ethics

Canadian claims adjusters uphold an ethical code that ensures the utmost fairness and integrity in their professional lives. While different provinces and associations may have their own variations, the code of ethics of the Canadian Independent Adjusters’ Association proposes an ethics for the industry across Canada. Here is an exploration of its three key themes.

Respect

At the heart of claims adjusters’ code of ethics lies the principle of treating policyholders with unwavering respect. This commitment sets the stage for a positive, empowering claims experience. When individuals file insurance claims, they are often in vulnerable situations, facing losses, damages or unexpected events. In such moments, it’s crucial for adjusters to approach each interaction with the empathy and compassion that undergird the courteous treatment of claimants. This involves going beyond the technicalities of the claims process and recognizing the human element involved. Adjusters must ensure that policyholders feel heard.

Prompt service is a vital part of this respect. It alleviates policyholders’ concerns during challenging times. Adjusters prioritize responding promptly to inquiries, acknowledging the receipt of claims, and initiating the investigation and evaluation process without unnecessary delays. By being proactive, they aim to minimize the disruption and stress in claimants’ lives that unforeseen events cause.

Heeding specific policyholder rights is another critical aspect of this commitment to respect. Adjusters must acknowledge that policyholders have the right to seek legal counsel and should never discourage them from doing so. They understand that legal advice is beyond their scope and refrain from providing it. Policyholders also have the right to privacy and consent regarding medical information. Adjusters ensure that individuals have control over their own personal medical information, which is never obtained without their explicit consent.

Knowledge

Claims adjusters must possess a deep understanding of insurance policies, coverage details and claim assessment procedures. This expertise allows them to provide accurate, comprehensive explanations to policyholders about their coverage as it relates to the specific loss or claim. This clear communication is essential: it ensures policyholders have a full understanding of the process, potential outcomes, and any necessary actions on their part.

By providing of knowledgeable service, claims adjusters give policyholders the information and support they need to successfully file a claim. Through their commitment to effective, top-notch service, they contribute to a smoother, more satisfactory claims experience.

Impartiality

Adjusters’ impartiality is another key element that builds trust among all stakeholders in the industry. They must not engage in actions that could skew settlements. By embracing fairness and objectivity, adjusters refrain from personal biases and impartially resolve claims.

For this reason, adjusters represent only one interest and disclose all facts relevant to the loss or claim to the insurers or self-insurers. They avoid any potential conflicts of interest arising from dual assignments, personal relationships or financial interests that could influence their decision-making. Furthermore, adjusters abstain from accepting inducements or considerations from any party involved in the claim, other than their principals. This ensures their objectivity and prevents any undue influence that could compromise fairness.

Impartial conduct maintains the integrity and trustworthiness of claims adjustment. This means that claimants receive fair compensation. It also protects insurers’ financial interest and reputations. This principle contributes to the overall transparency and reliability of the insurance industry, fostering a sense of security and confidence for all parties.

Claims adjusters’ code of ethics serves as a crucial framework for ensuring ethical practices in the insurance industry. It establishes a standard of conduct that benefits claimants and insurance companies and protects the profession’s overall reputation. By adhering to these ethical guidelines, claims adjusters build trust, maintain integrity, and navigate the complexities of the claims process with the highest level of professionalism. Ultimately, their commitment to ethical conduct not only safeguards the policyholders’ and insurers’ interests but also contributes to the long-term sustainability and credibility of the insurance industry.