AMF Claims Adjuster (Quebec) common mistakes
AMF Claims Adjuster (Quebec) · Understand the traps and how to avoid them.
The candidate answers questions about the adjuster's duties by describing what a broker or an insurer's underwriter does, for example explaining that the adjuster places the risk or sets the premium, instead of describing the adjuster's role of investigating the loss, quantifying the damage and recommending settlement.
The candidate has only a general familiarity with the insurance industry and has not separated the distinct functions of the parties, so the roles blur under time pressure.
What to do instead
Before the exam, write a one-page table listing the parties (insured, broker, underwriter, adjuster, independent expert, reinsurer) and one sentence on each party's function, then drill questions by asking 'whose job is this?' before choosing an answer.
When a question asks about the adjuster's duty of impartiality or conflict of interest, the candidate picks the answer that best protects the insurer's financial result, or states that the adjuster must follow the insurer's instructions on the amount payable.
The candidate confuses the commercial mandate (the adjuster is paid by the insurer) with the professional duty, and has not internalized that the adjuster's report must reflect the facts and the contract regardless of who pays the fee.
What to do instead
Memorize the principle that the adjuster's loyalty is to the facts and the contract, not to a desired outcome, and practise scenario questions by asking 'which answer would still be defensible if the file were reviewed by a regulator or a court?'
The candidate treats the Civil Code of Québec as a subordinate or optional source and answers coverage questions by citing only the wording of the policy, without identifying the article that supplies a default rule or the mandatory rule that the parties cannot contract out of.
Anglophone and common-law-trained candidates in particular tend to reason from policy wording and case law alone and underestimate how much of Québec insurance law is codified and mandatory.
What to do instead
Build a short index of the key Civil Code of Québec insurance provisions by topic (insurable interest, disclosure, premium payment, claim notification and proof, limitation period, subrogation) and, for each, note whether it is mandatory or may be varied by agreement; answer every coverage question in two steps, contract wording first, then the Code.
The candidate applies a limitation or prescription period from memory by using the general two-year or three-year rule without checking which period the Code attaches to the specific claim, and without noting when the period starts to run.
Several different periods exist for different obligations and the candidate memorizes only one figure, then applies it indiscriminately.
What to do instead
Create a small chart of the relevant periods with their triggering event, and for each practice question state the start date of the period explicitly before selecting an answer.
On a property claim, the candidate indemnifies the insured on a replacement-cost basis when the policy provides actual cash value, or ignores the deductible, the policy limit, or a coinsurance or underinsurance clause when computing the amount payable.
The candidate jumps to the largest or most generous figure and treats the calculation as arithmetic, forgetting that the valuation clause, limit and deductible are separate contractual constraints.
What to do instead
Adopt a fixed calculation sequence: establish the applicable valuation basis, compute the loss, apply the limit, apply any coinsurance or underinsurance factor, then subtract the deductible; write the sequence out in every practice calculation.
The candidate accepts the insured's inventory or proof of loss at face value, or conversely rejects a claim outright because documentation is incomplete, instead of identifying the missing elements and pursuing them through the adjuster's investigative powers.
Candidates reduce claim handling to a binary of accept or deny and do not know the intermediate steps of investigation, examination, and request for further particulars that the law and the policy allow.
What to do instead
Study the statutory and contractual mechanisms for obtaining information and proof of loss, and answer scenario questions by choosing the option that advances the investigation rather than the one that closes the file prematurely.
The candidate denies a property claim for an exclusion without first confirming that the insured bears the burden on the exclusion while the insurer bears the burden on the initial grant of coverage, and without checking whether an exception to the exclusion restores coverage.
Burden of proof is rarely visible in the fact pattern, so the candidate argues substance only and skips the structural analysis of who must prove what.
What to do instead
For each exclusion question, write two lines before answering: 'insurer must first show the loss falls within the insuring agreement' and 'insured must then show an exception applies if one is relied on'; then check every exception listed in the exclusion.
On a liability claim, the candidate confuses the duty to defend with the duty to indemnify, or states that because the insurer is defending under reservation of rights the insurer has accepted coverage.
The two duties are usually discussed together and the candidate does not separate their triggers, which are the allegations in the claim versus the facts ultimately established.
What to do instead
Learn the distinct trigger for each duty and the meaning of a reservation of rights and of a defence under protest, then classify each practice scenario as 'defence question', 'indemnity question', or 'both' before answering.
The candidate ignores the possibility of concurrent or multiple causes in a liability or property loss and assigns the whole loss to a single excluded or covered cause without addressing how the policy allocates a loss with mixed causes.
Exam fact patterns contain a dominant cause that draws attention, and candidates stop analysing once they find one cause that fits an exclusion.
What to do instead
Train a habit of listing every contributing cause in the fact pattern and stating, for each, whether it is covered, excluded, or neutral, then determine the outcome on the combined analysis rather than on the first cause found.
The candidate answers a subrogation question by saying the insurer simply 'takes over the insured's rights' without addressing the conditions, such as the requirement that the insurer have indemnified the insured, the limits of the transfer, and the effect of a waiver of subrogation or of the insured's own fault.
Subrogation is learned as a slogan rather than as a mechanism with preconditions and limits, so the candidate gives a conclusion without the elements.
What to do instead
Write out the elements of subrogation as a checklist (payment of indemnity, transfer up to the amount paid, preservation of the insured's remaining rights, effect of waivers and family or co-insured situations) and answer subrogation questions element by element.