Insurance claims services

Balanced advice for effective claim resolution

As an insurance industry leader, we offer strategic assistance to many of Canada’s top insurance companies as well as to policyholders to help them effectively resolve claims. Our insurance claims services team delivers cost-effective solutions to clients faced with claims ranging in size from simple, local files to complex, multi-million-dollar claims.

Our forensic accountants are dedicated to delivering exceptional service to clients by:

  • producing timely, accurate and defensible calculations, driving reduction in overall claim cycle time
  • adding value through streamlined reporting, enhanced technology adoption and sharing best practices
  • providing expertise, geographical reach and flexibility to serve you how and where you need us

Our team specializes in accident benefits, bodily injury and commercial claims. We tailor our services to meet your unique needs and offer a range of products to accomplish this.

Zainab Walji

Zainab Walji


How we can help

Accident benefit claims

We’ve been quantifying accident benefit claims since the introduction of no-fault insurance legislation in 1990, providing clients with cost-effective solutions and helping them navigate the Insurance Act and ever-changing provincial no-fault insurance legislation.

Our balanced analysis and reports help claimants and insurers settle a majority of their claims. But if a claim is referred to the Financial Services Commission of Ontario, our team includes specialists who can provide evidence there, as well as at private mediations and arbitrations.

We’ve been involved in many of the following types of accident benefit claims:

  • income replacement benefits
  • assessments for priority disputes
  • economic loss for attendant care benefits
  • housekeeping benefits
  • non-earner and caregiver benefits
  • present value of housekeeping benefits
  • net present value of future accident benefits
  • calculation of interest on overdue amounts

With our in-depth knowledge, forensic skill set and experience, we can identify key issues that may impact the claim, such as entitlement issues and income splitting in family-owned businesses. We make sure each claim is supported by a defensible approach, resulting in fair and timely resolutions.

Bodily injury/casualty claims

Whether you’re the plaintiff or defendant in a claim, a fair and objective loss assessment is critical to a quick settlement. Our team has experience preparing, reviewing and critiquing loss assessments for bodily injury and casualty claims. This includes the assessment of losses for settlement, mediation, arbitration and trial, as well as examination and trial preparation and acting as an expert if the matter isn’t resolved out of court.

Our team has deep industry knowledge and access to data analytics tools, economists, forensic accountants and actuaries. This means you’ll get a customized and balanced assessment of the claim so you can achieve a quick and fair resolution.

Commercial insurance claims

In the often confusing aftermath of a crisis or disaster, businesses and their insurers need to assess the damage quickly and organize recovery efforts to reduce business disruption. As an insurance industry leader, we offer strategic assistance to insurance companies, business owners and legal counsel in preparing, investigating and resolving claims.

Our insurance claims services group uses technology to capture data, analyze information, share knowledge and manage the presentation of a claim. We deliver cost-effective solutions to clients faced with litigation, arbitration, mediation or negotiations involving complex insurance issues.

Our team has significant experience quantifying losses on all aspects of commercial insurance claims, including:

  • business interruption losses under gross profit, gross earnings, business income and actual loss sustained forms

  • stock and inventory losses for policyholders with both periodic and perpetual inventory systems

  • the calculation of extra and saved expenses due to an insured loss

  • property losses, including real property, personal property and intangibles

  • professional liability coverage, including errors and omissions, directors and officers

  • fidelity claims

  • product recall and product liability

With our support, the adjuster can focus on other important aspects of the claim and the insured can get back to focusing on their business.

Educational services

Are you looking to enhance the knowledge or trial prep experience of your team when it comes to insurance claims?

We offer a range of educational seminars to law firms, insurance companies and industry associations. Some of our seminar topics include:

  • recent FSCO arbitration decisions impacting the quantum of accident benefits
  • what to look for when reviewing an accounting expert report
  • income replacement benefit calculations
  • income replacement benefit software training (for clients who use our software)
  • bodily injury/casualty claims for economic loss
  • commercial insurance claims

We also offer mock trials for law firms to help their counsel build technical expertise. Our mock trials cover issues related to bodily injury and casualty claims and deal with examination and trial preparation, financial quantification and expert opinions.

Provide your staff with additional training or exposure to a trial setting to give them the confidence and skills they need to succeed.

Contact us

Zainab Walji

Zainab Walji

Partner, PwC Canada

Tel: +1 416 815 5099

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