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How to get help if your insurance isn't covering everything or if you don't have insurance

Last Updated Sep 28, 2016 at 2:53 pm MDT

PHOTO. Sign welcoming residents upon re-entry after a 6 week evacuation due to wildfire. NICOLE BAGGIO. Staff.

Many people are taking to social media to express frustrations with a lack of insurance, insufficient supports or coverage that is different from that of their neighbours.

For the insured

In the telephone town hall on Monday evening, Heather Mack, director of government relations for Alberta & the North for the Insurance Bureau of Canada, explained that people who hold insurance should stop comparing what their policy covered with that of their friends and neighbours.

“There is a lot of difference,” she said. “I know you get into comparisons with neighbours but the policies, not only the content of the policy’s different but the price and sub-limits (differ as well.)”

She said there may be some elements, depending on your policy, that will be covered but only up to a certain amount. For example you may have coverage for a flooded basement but only up to $20,000 regardless of whether the repairs and replacing everything in the basement would cost you $60,000. It’s important, Mack said, to discuss with your insurance provider what your coverage looks like and how your policy works.

IBC has put together a fact sheet with information about the Fort McMurray wildfires on their website that includes resources and explanations of things like what insurance covers and how to go through the claims process.

“There are very clear rights and responsibilities that you have,” Mack said, that apply to all people who have insurance at any level. “One of which is that you have the right to timely response from your insurer, you have the right to a clear claims process and to be involved throughout those steps.”

Mack said there are situations when you and your adjuster or your insurance company will disagree.

“There are also very clear dispute resolution processes,” she said. “The first thing is, if you’re having a dispute with your adjuster, if you can’t work things out, you can escalate it then to a claims manager.”

You can also, in many situations, request a different adjuster.

“If you can’t resolve it still you can then go to the ombudsperson of the insurance company. You can always come to IBC at any step in the process as well and we will talk to companies on your behalf,” said Mack.

IBC’s Consumer Information Centre can be reached at 1-844-2ask-IBC (1-844-227-5422) Consumers can also direct emails to FortMacFire@ibc.ca.

“Failing the ombudsperson inside the company there is also a general insurance ombuds service, which is a third party that would get involved. And something else that’s probably not as well known is the dispute resolution through the Government of Alberta, through Treasury Board and Finance,” said Mack.

“Usually it comes into things like, say for example your adjuster says ‘we’ve remediated your home for smoke,’ but you disagree and say, ‘I can still smell it. I think you need to do more.’ If you can’t come to a resolution you can go in to the Government of Alberta’s arbitration process,” said Mack.

All of the above options are free for the consumer and while some are more time-consuming than others she said IBC will be happy to walk people through the process and provide any supports they need.

If you have insurance but are not covered for all of the damages you suffered or all of the related costs, the below information about working with the Red Cross for assistance will also apply to you.

For the uninsured and underinsured

If you do not have insurance, or do not have sufficient insurance, your first step should be to visit the Red Cross in person for a one-on-one, confidential meeting during which your specific needs can be assessed and a plan can be put together to help you.

“We are here to assist community members who either find themselves highly vulnerable now because of this event, were vulnerable prior to the manadatory evacuation and the wildfire scenario in Wood Buffalo and for individuals who are now assessing where they’re at in recovery,” said Jenn McManus, vice president of Alberta operations for the Canadian Red Cross.

“The one thing that we know from our work both internationally and nationally is that households and communities are at a different level of strength before a disaster and the Red Cross works with the community and works with the household to find out how they’re doing after an event,” she said.

McManus echoed the sentiment of IBC cautioning against comparing supports received with other people in our community.

“Community members need to be aware that if they are discussing the support that they’ve received from the Canadian Red Cross with other people there are going to be differences in the support that they get from the Red Cross because it’s based on their personal and household experience,” she said.

“What happens often, in our experience across Canada is that when government provides assistance for emergency situations it’s an allotment of funds per individual or per household. The Canadian Red Cross works individually, with households, to find out what is really happening at that household level and that’s so important for Wood Buffalo residents to know. It is not a blanket, black-and-white scenario for assistance by the Red Cross. It is unmet needs, it is evolving, it’s based on the initial assessment and then ongoing casework with the Red Cross personnel.”

She said the exceptions to that are the evacuee assistance and re-entry support that was given out to all residents.

Any longer-term assistance will have to be determined on an individualized basis.

“The one-on-one consultation with the Red Cross personnel is absolutely essential. This allows the Red Cross to understand what’s happening at the local level, what’s happening with families, it allows us to work in partnership with other social service networks for referrals,” said McManus.

“It also helps us work alongside of local government leadership and provincial leadership so that those layers of government are aware of what are the realities happening at the community level,” she said.

It’s important to understand the mandate of the Red Cross, both internationally and within Canada, is that as a humanitarian organization they support community members who have faced an experience, an emergency and a disaster and that applies to all people who have gone through the wildifre and evacuation.

“We have raised the money, given by the generosity of Canadians to us to be able to then get back into the community so that households and individuals can work on longer-term recovery and we work at that individual and household level based on a national standard for recovery,” McManus said.

If you have not yet received your re-entry funding or the initial emergency funding from the Red Cross you should be connecting with them at the Future Forward Building at 9717 Franklin Avenue which is open Monday to Friday 8:30 to 4:30.

For those not yet back to Fort McMurray

If you are not yet back in town you will not receive the re-entry funding. That money is only for covering the costs of re-entry.

If you are staying out of town and need more assistance than what was provided during the evacuation because you lost your home or cannot return to it you can visit any Red Cross location across Canada for assistance. You will receive the same needs assessment and your case will be dealt with depending on your individual needs.

In-town assistance

Here in Fort McMurray there are many people seeking assistance at the Hardin Street Building location of the Red Cross and McManus said they are working right now with people on a first-come-first-served basis but they’re also in the process of putting together a plan to start booking appointments.

“We are working in a fluid situation and right now the Hardin Street location in Fort McMurray is quite busy so we ask that residents have patience with our team,” she said. “We are trying to see as many people daily as we can.”

Another thing to keep in mind, McManus said, was that you can reach out to the Red Cross at any time, even if you’ve received some assistance already, because every single person’s situation is different and will continue to change.

“And one week can vary from another, you know. I sat on Saturday listening to families tell our case workers their personal stories and they are facing realities that they never actually anticipated and never planned for,” she said. “That’s why it’s so important that we meet face-to-face with individuals and that residents come and meet with us more than once if their needs are emerging.”

The Red Cross will be working in the community for the next several years and they will be able to help people as their needs arise.

“We will not duplicate assistance from another entity, be it government or insurance, so one of our mandates is that we will not duplicate financial assistance for an area of recovery that is covered by provincial government, another entity such as insurance, so that’s where the one-on-one consultation is so important,” she said.

The Red Cross is also working to fund community organizations like the Wood Buffalo Food Bank so they have the resources to help the people in the community who have always relied on them and who are reaching out now for the very first time.

“I visited the Wood Buffalo Food Bank on Tuesday and they are experts in food security and so the Red Cross wants to ensure that they have the right resources and capacity to be part of our referral network and that we share that referral network,” she said.

Referrals could be given to other social profit organizations that can help with a variety of needs.

If you are unsure whether you will qualify for assistance you should still visit the Red Cross and find out because every single situation is being looked at in its own right.

What the RMWB is responsible for

As some people seek assistance for things not covered by their insurance many are asking what the Regional Municipality of Wood Buffalo is responsible for.

“The RMWB’s only role in the clean-up program is to permit and regulate the activity. Our jurisdiction extends over the entire project area, but our piece in the puzzle is only to make sure people are operating legally (i.e. having the right permits) and that they’re doing it safely (using development compliance officers to inspect sites),” said Robin Smith with the RMWB in an email.

He said as part of recovery work an approach for uninsured homes is being developed with the RMWB, IBC, Red Cross working together on a solution.

“We don’t have those answers yet,” he said.

The Wood Buffalo Recovery Committee and Recovery Task Force will be responsible for formulating these kinds of plans and programs in the future.

Much of that work will come into place in the coming weeks, once the six members of the public have been chosen to sit on the committee and when funding and approvals are in place for hiring the staff needed to do the work.