What are the purposes of an investigation in an insurance claim?
British Columbia, Canada
The following excerpt is from Krieg v Shallon Marine Service, 2021 BCSC 670 (CanLII):
As Mr. Justice Romilly explained in Stevanovic v. Petrovic, 2007 BCSC 1392, at paras. 24 to 28, there are several purposes of investigations in an insurance claim. First, an insurer must determine whether there is coverage for the loss in question. This may require the insurer to determine whether there was any breach of the policy. Second, the insurer must determine whether the loss was an insurable risk. This may require the insurer to investigate the cause of the loss and whether any exclusion applies. Third, an insurer must decide whether to fund interim payments to the insurer. This may require the insurer to investigate repairs undertaken by or on behalf of the insurer. Fourth, the insurer may consider whether to offer compensation to the insured to resolve the first party insurance claim. And, fifth – although not listed by Mr. Justice Romilly – an insurer may consider whether to commence a subrogated claim against a party it considers responsible for the loss.
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