Claims
Confident. Precise. Protection.
The Claims Process
Being the subject of an insurance claim can be an overwhelming experience. We understand how you may feel. After all, we have been facilitating the claims process for the accounting profession for over 30 years. With decades of experience, we are uniquely skilled at guiding you through the process, so that you can get back to your practise and continue to serve your clients.
What is a claim?
Your policy contains a formal definition. However, in simple terms, a claim is an allegation of wrongdoing that results in damages to another party and there is a request, or sometimes a demand, for restitution.
It is very important that you report any claim or potential claim to us without delay. It is important to remember not to admit liability and to notify CPA PLI of any developments immediately.
Identify a claim or potential claim
A potential claim could come in the form of a complaint from a client, or it could be more formal, like a lawsuit, or subpoena. Both scenarios must be reported.
When to report a claim
Avoid trying to fix it yourself. Promptly report any allegation of an error, or an omission in the performance of professional services. The timing of reporting may impact your coverage, so prompt attention is extremely important.
Submitting your claim
We have created a form to assist you in reporting a claim. It may be found here. Please complete the document as fully as possible, gathering information as required. The requested information assists us in handling the matter on your behalf. If immediate assistance is required, please call 1-800-267-4734.
Assignment of a Claims Examiner
After submitting the claim form, a Claims Examiner will be assigned to assist you through the entire process. Facilitating the claims process for accountants is what they do.
Assessment of coverage and liability
Your Claims Examiner will assess the claim presented and the coverage available. They will evaluate liability based on the circumstances described, and consider any applicable laws or regulations that may apply.
Engaging third-party experts
In some cases, we may seek insights and assistance from external experts such as legal counsel, independent adjusters or other professionals. For example, their assistance may be required to assess complex issues related to coverage, damages and/or liability.
Assessing damages
We will estimate the damages associated with your claim. This involves an in-depth analysis of the impact of the allegations raised and the damages being claimed by other parties.
Negotiation and Claim Resolution
Once all the assessments are complete, the negotiation process begins. This involves discussions with you and, if necessary, any third parties involved to reach a mutual agreement on handling and resolving the claim. The final step in the claims process is resolution.
FAQs
A claim has been filed against you. What should you do next?
Report the claim immediately, before taking any further action. You can do this by completing a claims form. Additionally, per the terms of your policy, refrain from making any payments or commitments to anyone involved, and do not admit liability, before speaking to CPA PLI.
When will someone contact me about the claim I reported?
Once you have submitted the claim form, a Claims Examiner will reach out to you within 24 business hours to collect more details and evaluate your claim.
How long will it take to settle and pay my insurance claim?
We aim to settle your claim as quickly as possible. The time required to handle each claim depends on the complexity of the situation. Your Claims Examiner will explain the claims process and will keep you up to date on the process.
Will my premiums increase if I report a claim?
Reporting a claim does not necessarily lead to higher premiums. We encourage you to contact your program representative to assess whether your claim or potential claim will affect your premium in any way 1-800-267-4734.
How does my deductible work?
As per the terms of your policy, it is your responsibility to pay the deductible once the claim is settled, but before it is paid to the third party. Your Claims Examiner will explain the process.
How is the value of a claim determined?
Claim value is estimated based on a combination of factors including damages claimed, coverage available, liability assessed, and the expenses involved to support the process.
What should I do if law enforcement authorities are in my office with a warrant to search and seize my working papers?
Here is a checklist of actions you should consider taking if you ever find yourself in this situation:
- Request law enforcement officers for proper identification and detailed information about the search.
- Politely ask the officers to pause the search until your lawyer arrives.
- Immediately contact your lawyer for guidance and support.
- Ask to review your files before they are searched and identify and set aside any documents that may be protected by solicitor-client privilege.
- Ask the police to provide you with photocopies of all the seized documents.
- Refrain from making any statements or answering questions from the police until you have been advised to do so by your lawyer.
- Contact CPA PLI and report the situation.
My client has complained about a mistake or raised a concern regarding the professional services offered by our firm. How should I proceed to address this feedback effectively?
Start by identifying and understanding the specific issue or problem raised. Avoid explaining or defending yourself to the firm. Document the information obtained and promptly report the claim. Assure your client that you will investigate the matter. Do not accept responsibility at this stage.
I received a subpoena. What do I do?
Immediately contact CPA PLI for guidance and support at 1-800-267-4734.
My client is angry and insisting that I immediately pay them money now and seek reimbursement from my insurer later.
It is important that you do not make any commitments (including payments), even if you think you are at fault, as it could impact your coverage. Instead, contact CPA PLI immediately. Your Claims Examiner will manage communication with your client, including the next steps.
What is the difference between a claims-made policy and an occurrence-based policy?
A claims-made policy in insurance is a type of policy that covers claims that are made /reported during the policy period, regardless of when the incident causing the claim occurred. An occurrence-based policy covers claims arising from incidents that occurred during the policy period, regardless of when the claim is made/reported.
Professional liability is usually always a claims-made policy, as damages may only become known well after the services have been provided.
Please note that this web page contains general information and details regarding your coverage and claims process can be found in your policy documentation.
Meet our Claims Experts
Muriel Moscovich
Claims Examiner
Basil Andrews
In-House Counsel
What our clients
have to say
“Your team’s professionalism and dedication to protecting our interests have been impressive. We highly recommend Tracey Gabbidon for her exceptional guidance and support throughout our claims handling.”
Multi-practitioner firm
“I am extremely grateful for the professional conduct displayed by Basil Andrews. He promptly addressed my concerns and provided clear guidance on the status of my claim. Highly recommended!”
Sole practitioner
File a claim or report an incident.
To initiate the process of filing a claim or reporting an incident, please complete and submit this form.
THIS REPORT IS MADE IN CONTEMPLATION OF LITIGATION.
Do not admit responsibility, assume any obligation, or make any commitment to money or services without the insurer’s consent, even if you believe there may have been an error, omission, or negligent act on your part. Any such admission, obligation or commitment will vitiate this Policy as far as that particular claim is concerned.
Fields marked with * are required to submit a claim.
Once you submit this form, a copy will be sent to your email. Please keep a copy of your entire file along with documents such as a lawsuit, correspondence from a claimant/lawyer and subpoena. The assigned Claims Examiner will ask you for copies.