Explanations

Pierre is the agent who sold the policy and he is aware who Andrzejek named as his beneficiaries. However, he has also been made aware that there is another relative with the same name and relationship to the deceased.

A beneficiary must complete a claim form. Agents can obtain the claim forms from the insurer and in this situation Pierre should obtain the forms for the Canadian niece and nephew.

Where there is a named beneficiary, the insurer will seek satisfactory proof of identity; for example, individuals with common names might face additional hurdles to establish their entitlement. Beneficiaries are sometimes described in terms of a relationship, such as “children.” These claimants will have to establish their qualification by means of additional documentary evidence, e.g. verification by third party (possibly the agent).

Pierre, as agent for the company, should inform it that there is a potential problem because there is a second nephew in Europe also named Jacob. The company faced with conflicting or difficult to reconcile claims of beneficiary entitlement can turn to the Courts. A statutory provision found in the provincial and territorial insurance acts permits payment into Court. This discharges the insurer from liability, and allows for the resolution of the conflicting claims by a system designed to review evidence and adjudicate claims.

References

Preparation manual: Ethics and professional practice, 3^rd Edition, 2016, sections 3.1.4.4 and 3.3

Evaluated competency sub-component in Curriculum: 1.6. Contextualize the rules relating to claims and the payment of benefits

Competency: Develop an ethical professional practice, in compliance with the rules governing the life insurance sector

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