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1992 Report of the Auditor General of Canada
Exhibit 2.4—Review of claims that took more than six months to process during 1990-91 and 1991-92
CASE 1
- Claim for damages due to lightning.
- Headquarters rejected the claim because "the Plan does not insure against lightning".
- Regional staff identified examples of similar claims approved in the past.
- Legal advice was sought and suggested claim could be paid.
- Legal advice also suggested that policy wording could be changed to prevent future confusion.
- Headquarters maintained decision to reject the claim.
- Fisherman initiated legal action.
- Regional staff again showed examples of similar claims approved in the past.
- Headquarters approved the claim.
- Turnaround time: 18 months.
- Management still not clear as to whether existing policy covers damage caused by lightning.
- Claim for motors that were installed on a new uninsured vessel damaged by fire.
- Motors were originally on an older, insured vessel.
- Considering mitigating circumstances, the regional manager recommended approval of the claim for motors on a "common sense basis".
- Headquarters rejected the claim on the basis that equipment is insured only insofar as it is used on the insured hull.
- Damaged hull was not insured and not claimed.
- Using a broad interpretation of FVIP Regulations, headquarters suggested that the new vessel and motors be retroactively insured so that a claim for both the hull and motors could be paid.
- Regional staff expressed serious reservations about insuring a boat after the fact and requested that the initial claim for motors only be approved.
- Headquarters approved the initial claim for motors.
- Turnaround time: 5 months.
- Claim for latent defect.
- Suggestion that wear and tear may be the cause.
- Special investigation concluded that the cause was latent defect and not wear and tear.
- Regional manager recommended approval of the claim.
- Headquarters argued wear and tear was the cause.
- Headquarters requested the damaged components for examination by metallurgical laboratories.
- Regional manager provided the requested component mentioning that past experience with such examination "has been less than satisfactory".
- No result of metallurgical analysis in the file.
- Headquarters approved the claim.
- Turnaround time: 9 months.
