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Overpayment situations can be stressful and complex. Especially where Income Replacement Benefits (IRB) had at one time been terminated and then reinstated, or one or more sources of other income replacement assistance may have been retroactively paid, and possibly at different times.  And of course, the overpayment could just be due to calculation error. We […]

What happens when income is paid in goods and services (payment in kind)?   When it comes to calculating income for SABS purposes, it is not always as straightforward as the wages on a pay statement. Occasionally, income comes in the form of goods and/or services. How do we translate those goods and services, such […]

Learn what to look for when using an OCF-2 form, to ensure an accurate Income Replacement Benefit (IRB) calculation.

The Role Employment Insurance Benefits Play in Calculating an Income Replacement Benefits (IRB) Employment Insurance (EI) benefits appear in many ways within IRB calculations. They can be the entire basis of eligibility for an IRB, a component of an individual’s pre-accident income, or received post-accident as a form of payment for loss of income. This […]

It may sound like a simple concept at first, but classifying expenses as fixed and variable in the context of a business interruption claim can be tricky.  The issue that often trips people up is thinking in absolutes, such as, how would the expense behave in the event the business is shut-down?  But, this is […]

Summary 12-months starts from the day the first payment in error is made, regardless of whether additional payments with the same error were subsequently made. However, subsequent decisions appear to indicate otherwise, and support an overpayment can be recovered for the 12-months prior to notification. For an updated discussion on related overpayment topics, be sure […]

In our experience, the concept of co-insurance in relation to business interruption is one of the least understood and most feared topics by all parties involved.  It could be the setting of appropriate policy limits for business interruption, determining co-insurance compliance, or insured’s feeling unfairly penalized when co-insurance requirements are applied following a claim.

One of the most contentious issues in any business interruption matter is often the treatment of payroll. 

(Gross Profit vs. Gross Earnings vs. Hybrid Policies) Traditionally, business interruption insurance policies have fallen under one of two styles, Gross Earnings or Gross Profits.  In recent years the consistency in policy styles has been eroding and new hybrid style forms are starting to become more prevalent. 

Not all businesses have to file Harmonized Sales Tax (“HST”) remittances.  For those which do, they can be a valuable source of information in the claims process…