Read TSI Defacto, Volume 1, Issue 11 text version

DEFACTO

Volume 1, Issue 11 April, 2004

ANOTHER TSI ASSISTED FSCO AB ARBITRATION WIN

RECONSTRUCTED LOSSES ACCEPTED OVER APPLICANTS' ACCOUNTS OF LOSSES

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TSI'S EARLY WARNING SYSTEM ("EWS") APPLIED TO CRC REPORTS/PHOTOS - 27 RED FLAG CRITERIA APPLIED TSI IDENTIFIES THE FIRST QUESTIONABLE LOSS WITH 11 FLAGS FOUND SECOND QUESTIONABLE LOSS CONNECTED TO FIRST QUESTIONABLE LOSS TSI'S INVESTIGATORS/RECONSTRUCTIONISTS INVESTIGATE THE QUESTIONABLE LOSSES TSI'S RECONSTRUCTION EXPERTS RECONSTRUCT THE QUESTIONABLE LOSSES TSI TEAMS WITH LYNN TOTH, CLAIMS REP, GUARANTEE AND TERRY SHILLINGTON, COUNSEL TO WIN ARB 4 AB CLAIMS DISMISSED NO INJURIES AS A RESULT OF THESE 2 ACCIDENTS! March 11, 2004, Financial Services Commission of Ontario Preliminary Issues Decision, Anang et al and Guarantee Company of North America

Arbitrator Decision

"Ms. Anang, Ms. Ampomah and Ms. Quarshie were not injured in an accident on July 15, 2002". "Ms. Anang was not injured in an accident on July 30, 2002".

EVIDENCE AND ANALYSIS: The July 15, 2002 Incident: Anang testified: She was driving her van, with Quarshie in the front passenger seat and Ampomah in the right rear passenger seat Incident occurred at about 10:00 p.m. on July 15, 2002 She was travelling southbound along Blackstone Avenue at about 15 to 20 km/hr She was stopped at a stop sign at the corner of Blackstone and Lawrence, and made a right turn onto Lawrence The 3rd Party Ford driver was travelling northbound on Blackstone and proceeding to make a left turn onto Lawrence

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Blackstone Ave

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V

Lawrence Ave W

As the 3rd Party was then travelling westbound on Lawrence, it struck the Anang van on the front driver's side The 3rd Party approached on her left, and followed close along side Anang as she was making her right turn onto Lawrence

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DEFACTO

Anang hit her brake to stop her van and the 3rd Party Ford struck her van When Anang's van came to rest, its front was on Lawrence and its rear was on Blackstone The 3rd Party Ford damaged her van by scraping along the left side, along the sliding door over the gas tank, across the front left door handle and side mirror, up to the left front bumper and headlight There was some pre-existing damage to the Anang van on the left side near the hood where rust spots appear She did not know how the 3rd Party Ford caught up with her van in order to hit her front left side and headlight, while she was making a right turn All three Applicants denied that the scraping damage to the left side and front of Anang's van happened elsewhere in another incident Quarshie testified: She only heard a noise, but did not see the alleged accident occur because she was looking to her right She knew the other car, a Ford, hit the left side of Anang's van as Anang was turning right Ampomah testified: She was sitting in the rear right seat with her eyes closed listening to her "Walkman" so she only heard a noise and felt a "shake up" at the moment of impact All three Applicants denied knowing the driver of the Ford. Evidence of Damage to the Ford: CRC Report Contrary to Anang's accounts, the CRC self-report by the 3rd Party driver indicates that the Anang van, which was travelling southbound on Blackstone, hit the passenger side of his vehicle at a 90 degree angle on the front door of his vehicle while he was proceeding westbound on Lawrence across the intersection of Blackstone and Lawrence The photographs attached to the TSI report, dated September 9, 2002, depict damage in the form of dents to the right side of the 3rd Party Ford most pronounced on the back door and extending to the bottom rear of the front door. The Bpillar between the front and rear doors is bent at the level of the rocker panel Accident Reconstruction Evidence: Richard Hawkyard, TSI Solutions Inc A former police officer and investigator for an insurance company Conducted over 4,000 collision investigations, about 150 since he has been employed by TSI Co-authored the TSI report dated September 9, 2002 Accepted as an accident reconstruction expert Attended at the scene of the accident at a later date Took photographs of the damage to the vehicles and the area surrounding the alleged accident scene. Mr. Hawkyard reviewed the police report and the CRC self-reports given by Anang and the driver of the Ford. Anang and the 3rd Party driver of the Ford gave contradictory descriptions of the alleged accident

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damage to the vehicles, as depicted in photographs appended to the TSI report, were inconsistent with the accounts of Anang and the 3rd Party The scratch on the left side of the Anang vehicle goes along the left side of the van from the front to the rear. There is more damage at the leading edge of the scratch at the front of the van than at the end of the scratch at the rear of the van Looking at an exhibit of a life-size photograph of the damaged left door handle on the Anang van, that whatever made contact with the Anang van was plowing forward because the paint rolls up at the right edge of the contact mark Either the contact object was stationary and Anang's van was moving, or the contact object was moving and Anang's van was stationary If an accident as described by Anang happened, where her van was alleged to be executing a right turn as the 3rd Party Ford was overtaking her on the driver's side, the scratches would be from the rear to the front of the van instead of the front to the rear Further, if the 3rd Party Ford struck the Anang van on the passenger's side door, there would be heavy crushing of the passenger door instead of scratching And further, the damage to the 3rd Party Ford would be on its front rather than on its right side There was no damage that is consistent with the Anang van and the 3rd Party Ford coming into contact The damage to the Anang van is not the result of a collision because the horizontal scratches on the left side of her van are indicative of two objects coming into contact in a sliding motion producing abrasions. The surface into which the Anang van came into contact was rough There is nothing with a rough texture on the right side of the Ford at the level of the scratches on the van that could create the horizontal marks Sam Kodsi, Origin and Cause A mechanical engineer Involved in accident reconstruction field for about eight years Accepted as an accident reconstruction expert Relied on the police reports of the accident, the CRC self-reports, the TSI reports, witness statements, damage appraisals, photographs of the collision scenes and of the damage sustained Did not inspect the actual vehicles There are sharp scratches, scuff marks and gouges on the left front of the Anang van, but no paint transfer or scuff marks on the right side of the Ford Corroborated Mr. Hawkyard's evidence: the damage sustained to the Anang van and the 3rd Party Ford could not have occurred as described in the CRC self-reports the damage to Anang van was consistent with it being driven into a rough masonry surface and was not carto-car damage

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DEFACTO

While there was vehicle contact with the 3rd Party Ford, the damage to the Ford was consistent with another vehicle driving into its right side at a 90 degree angle while it was stationary, contrary to the Anang and the 3rd Party accounts The July 30, 2002 Incident: Anang testified: At about 3:15 p.m. on July 30, 2002, she was involved in a second accident with a Toyota she had rented She was in the front passenger seat and a friend, Nantwi, was driving The Toyota had been travelling eastbound on Highway 401 in the far right collector lane and had entered the Highway 400 ramp

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guardrail

Jersey-barrier

e/b 401 collector lanes exit to n/b 400

guardrail

Both occupants confirmed that as the Toyota was entering the northbound Highway 400 ramp the Toyota suddenly spun out and hit the cement guard rail at the left of the car Both occupants estimated the speed of the Toyota to be about 30 to 45 km/hr Both confirmed no other vehicles were involved in the alleged accident Both testified they could not explain how the incident occurred Nantwi testified: It was not raining and the weather was clear The September 9, 2002 TSI report indicates that Nantwi said she did not brake before the car spun out, but her report to the police indicates that she did brake before she lost control of the car Nantwi stated to TSI that she had just rounded a curve on the ramp and was entering a straight area of the road when the car spun out to the left and struck its front on the guard rail Two ambulances arrived and took Anang and Nantwi to Humber River Memorial Hospital Accident Reconstruction Evidence: Robert Seaton, TSI Solutions Inc An accident reconstructionist with TSI Co-authored a TSI report dated November 4, 2002 Reviewed the CRC self-report of Nantwi, the police report and statements by Nantwi and Anang Conducts collision reconstruction for civil and criminal litigation

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Received motor vehicle accident training while an officer with the Ontario Provincial Police (" OPP"), completing the highest level courses Coordinated OPP training in the mathematics and physics of motor vehicle reconstruction analysis Served nine years with the Toronto Metropolitan Police Service and 13 years with the OPP Directly involved in over 1,000 reconstruction investigations Accepted as an accident reconstruction expert The alleged accident could not have occurred as described by Nantwi The damage to the front bumper of the Toyota was not consistent with it striking or being struck by a narrow object or edge, but rather the result of a rectangular object impacting the bumper left of centre. This is evidenced by the vertical crease to the left of the rectangular imprint on the bumper as depicted in photographs attached to his report There are no rectangular projections or objects exposed to traffic on the left side of the exit ramp from the 401 collector lanes where the collision is alleged to have occurred The Jersey barriers are smooth-surfaced and the barrier sections are installed edge-to-edge. Mr. Seaton referred to the barriers on the left side of the highway, which the Toyota is alleged to have struck, as Jersey barriers, the same structures Anang and Nantwi called guard rails The Toyota was alleged to have been travelling at between 30 and 45 km/hr., which is below the advisory speed of 70 km/hr The Toyota was alleged to have just completed the left curved portion of the ramp and had reached the straight area of the ramp when the Toyota was alleged to have turned and hit the Jersey barrier. Mr. Seaton testified that at the speed the Toyota was travelling on a left curve it would not have driven off the road because the lateral sideway forces would be greater than the forward forces and would have prevented this from happening There is no evidence of any human or mechanical factor that might have caused the Toyota to go out of control There were no skid marks on the road or other evidence of breaking No evidence of uneven wear on the tires which would suggest balance joint problems or a steering deficiency The air bags did not deploy, which can occur at speeds of 12 to 19 km/hr. with frontal or near frontal impact. Mr. Seaton concluded that the damage to the Toyota is inconsistent with Nantwi's and Anang's descriptions of how the damage occurred Sam Kodsi, Origin and Cause Corroborated Mr. Seaton's evidence Reviewed the TSI and police reports and the statements of Nantwi and Anang Noted that, were the alleged accident to have occurred as described by Nantwi and Anang, one would expect a shallow angle contact of from 15 to 45 degrees between the Toyota and the Jersey barrier with impact, making front end damage to the car unlikely The damage to the Toyota would have to have occurred at a 90 degree angle Corroborated Mr. Seaton's view that the localized damage to the front bumper and the top of the hood is inconsistent with the Toyota hitting a Jersey barrier and more consistent with it hitting a pole

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DEFACTO

Explained that if Nantwi had lost control of the Toyota as she described, the car would have side swiped the barrier, and it would have been impossible for the Toyota to hit the barrier at a right angle under the circumstances

Arbitrator's Reasons for Decision On Both Incidents :

Evidence presented by the Applicants in respect of both incidents unreliable and generally implausible Evidence of the applicants lacked the ring of truth that characterizes credible evidence Re The July 15, 2002 Incident: Evidence was scant and what Anang did offer did not seem reasonable On cross-examination Anang conceded that she could not explain how the accident happened Anang could not explain to her satisfaction how the Ford, which was travelling northbound on Blackstone and turning left (westbound) onto Lawrence, could hit her van along the driver's side after she had travelled southbound on Blackstone and was in the process of executing a right turn (westbound) onto Lawrence Mr. Hawkyard's and Mr. Kodsi's evidence echo the arbitrator's concerns about the plausibility of Anang's and the other Applicants' accounts of the alleged accident Re The July 30, 2002 Incident: Anang and Nantwi could not explain to the arbitrator's satisfaction how the Toyota, which was travelling 30 to 45 km/hr. on the highway ramp, spun out and collided with the left roadside barrier under circumstances where the weather was clear and there is no evidence of human or mechanical failure Anang and Nantwi could not explain what happened to cause the Toyota to leave the road Rob Seaton and Sam Kodsi concur that: The damage to the Toyota is inconsistent with Nantwi's and Anang's accounts of the Toyota hitting the barrier The damage to the front bumper and top of the hood is localized and appears to be the result of a collision with an object like a pole at a 90 degree angle and is therefore inconsistent with the Toyota hitting a highway barrier It is not likely that the Toyota, travelling at 30 to 45 km/hr. on the ramp, would go out of control and collide with the barrier at right angles, a side swipe more likely

Arbitrator Said: " Mr. Seaton also testified, and I find persuasive, that at the speed the Toyota was traveling, the strength of the lateral sideway forces would have likely prevented the car from leaving the road at all".

EARLY IDENTIFICATION AND INVESTIGATION ENHANCE YOUR OPPORTUNITY FOR SUCCESS! CONTACT TSI FOR AN E-EWS PROGRAM FOR YOUR COMPANY AND ON YOUR LOW IMPACT/ INJURY INVESTIGATIONS AND RECONSTRUCTIONS ­ WE WILL ASSIST

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DEFACTO

TSI'S EXPERTS

Level IV Collision Reconstructionists Rob Seaton: Lead reconstructionist. 23 years as a police officer specializing in collision investigation and reconstruction. Sergeant in charge of the OPP's reconstruction program. Taught collision reconstruction at the Ontario Provincial Police Academy. Consultant to the Provincial SIU on collisions involving Police vehicles. Accepted as an expert in court. Gary Carty: 21 years experience as a police collision investigator and reconstructionist. Investigated more than 1500 collisions. Responsible for the investigation and reconstruction of more than 100 fatal and life threatening collisions. Accepted as an expert in court. Ian Woodworth: 16 years experience as a collision investigator and reconstructionist. Investigated and reconstructed hundreds of collisions, including over a hundred collisions involving fatalities. Accepted as an expert in court. Engineering Dan Mills: Investigated more than 200 collisions and conducted more than 60 crash tests as Lead Collision Investigator for Transport Canada's Vehicle Safety Research Centre (Determines the effectiveness of Canadian Motor Vehi-

cle Safety Standards). A graduate of Ryerson University, Dan teaches Collision Reconstruction to VSRC and police investigators. Level III Collision Analysts Ian Harrison: 28 years with Toronto Police Service. Investigated over 2,500 collisions. Investigated hundreds of traffic collisions involving serious injury or fatality. Level II Collision Investigators & Equivalent Al Jenkins: 17 years with Metropolitan Toronto Police. Investigated thousands of collisions , both as a police officer and on his own, many of those involving serious injury, pedestrians and fatality. Accepted as an expert in arbitration. Accepted as an expert in court. Rick Hawkyard: 14 years with Metropolitan Toronto Police, worked in the Criminal Investigation Bureau; was a forensic photographer; and a Special Accident Investigator. Investigated in excess of 4000 collisions, hundreds of those involving fatalities. Special Investigator and Senior Claims Specialist with Canadian General Insurance and is a Certified Fraud Examiner and Certified Fire and Explosion Investigator.

Other Investigators Lee Thistle: Former Peel Regional Police officer, having reached the rank of Detective. Recognized as a pioneer in fraud prevention in the insurance industry. While with the ICPB, awarded the Doug Hiron Memorial Award, in recognition for excellence in insurance fraud investigation. Established and managed two successful SIU's. Specializes in large loss fires and is a Certified Fraud Examiner and Certified Fire and Explosion Investigator. Accepted as an expert in court. Stan Swann: 23 years with the Royal Canadian Mounted Police, focusing on commercial crime. Managed Zurich Canada's Investigative Services Unit. Specializes in fidelity, property and municipal liability claims. Holds CIP designation, Certified Fraud Examiner and a Canadian Certified Fire Investigator, Level C. Doug Lamb: A licensed appraiser and Class A Mechanic with 35 years in the automotive industry. An expert in brake system examinations, he is accepted as an expert witness by the Ontario Motor Vehicle Industry Counsel. Scott Griffin: 20 years of experience as an Insurance Fraud Investigator. He is also a surveillance expert.

WHO IS TSI?

In 1999, Jim Jasper, Mark Edwards and Lee Thistle, leaders in Canada in the Property & Casualty and Life & Health insurance industries in the creation of best claims practices, fraud control and legal management programs, came together to form TSI Solutions Inc. TSI helps private and public insurers implement solutions to improve overall performance and efficiency and in particular, reduce unnecessary claims loss and expense leakage. One of our primary objectives is to strengthen fraud recognition and investigation programs of insurers. Our investigative team includes CFEs, Certified Fire and Explosion Investigators and Level III and Level IV Collision Analysts and Reconstructionists. We serve our customers not only through providing claims investigation support, but also through our various training programs and our claims best practices tool, "TSI Claims Scorecard 1000". This tool objectively and systemically identifies and prioritizes improvement opportunities and benchmarks claims and management practices against outside standards.. Lee Thistle, C.O.O. Recognized as a pioneer and leader in fraud prevention and investigation in Canada, with more than 30 years' experience. Established two effective SIU's at 2 major P&C carriers. Leads TSI's Claims Investigation Support ("CIS") unit. Mark Edwards, President. 30 years experience in the Life & Health and P&C industry as VP, General Counsel & Corporate Secretary, VP Claims, a Director of various companies and as a Consultant. A change and performance management leader in best practices claims and legal management. Jim Jasper, Chairman & Treasurer. 35 years in the P&C industry in the US and Canada. A change management specialist with more than 125 General Management Consulting projects to the P&C industry.

"The Solution Implementer"

10 Kingsbridge Garden Circle, Ste 704 Mississauga, Ontario Canada L5R 3K6

Phone: 905-502-3480 Fax: 905-502-3468 Email: [email protected]

WWW.TSISOLUTIONSINC.COM

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TSI Defacto, Volume 1, Issue 11