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APA Claims Committee
APA Claims Committee
Mandate
Responsibilities
Composition
Terms of Membership
Quorum
Process
Technical Advisors
Mandate
The APA Claims Committee shall:
- Oversee the claims adjustment process from the advisor’s perspective
- Ensure that the intent of the policy wording is reflected in each claims adjustment decision;
- Act as a professional resource, as needed;
- Based upon claims adjustment experiences, recommend to the Underwriting Committee that it be aware of potential gaps and/or excesses in the policy wording;
- Ensure that the scope of the policy wording includes the types of risks that the average advisor faces in his/her practice;
- Advise the Underwriting Committee of any unforeseen trends in claims settlements emanating from a class of risks and/or an individual risk;
- Advocate on behalf of a certificate holder when necessary.
Responsibilities
- To carry out it’s mandate in the interests of the Board of Directors;
- To provide expertise and attention to detail on behalf of the Board of Directors in relation to all matters related to the claims adjustment process;
- To attend all Committee meetings as called. Meetings can either be in person or via teleconference;
- To review, annually, the Terms of Reference and forward recommendations, as required, to the Board of Directors.
Composition
- The Committee will be composed of a minimum of three certificate holders in good standing, the majority of whom shall be Advocis members.
- Staff Liaison shall be the COO or his/her representative.
- Appointment shall be by the Board;
- Chair to be a member of the Board of Directors and will be appointed by the Board.
Terms of Membership
- One year term
- Absence of three (3) meetings, member’s commitment is to be reviewed.
Quorum
- Majority – Fifty (50) per cent plus one of the total Claims Committee members, present in person or by phone.
Process
- By consensus where possible;
- Any question shall be referred to Robert’s Rules of Order;
- Chair to receive information, agenda and minutes first for approval;
- Agenda and meeting material to be distributed at least 3 working days in advance.
- Chair shall NOT have a vote.
- Any tie will give the Chair a casting vote.
Technical Advisors
- Where necessary in the opinion of the Claims Committee;
- Technical advisors may sit through one or more meetings.