The Value of having your own Advisor.

The Value of your personal Advisor in a disaster.

An important element of your insurance claim is how your policy can be interpreted to provide cover. Nothing is ever simple, especially when policies are written generically for sale by brokers or online, without underwriting consideration being given to the householder or business that bought the policy.

 

For claims handlers in an office-based environment, everything seems black and white, but where there is any ambiguity, which seems to be in most cases these days, a loss adjuster is appointed to look at the detail.

 

The loss adjuster acts on behalf of the insurers as their eyes and ears.

 

But, who acts on behalf of the policyholder, not the insurer?

Who is there to interpret the policy to the policyholders' benefit?

 

Not for more than they are entitled, but to ensure that correct cover was not missed and they received the maximum that insurers are LIABLE to pay.

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Insurers can sometimes view the policy through narrow eyes. Often, this is more due to a failure by the agents they instruct to view the claim.

Video surveys by inexperienced validation firms, maybe pointing an iPad but not having the technical expertise, which often means that the settlement offered is well below what is necessary to fully repair the damage.

Critical issues are often missed that will have repercussions for the policyholder in years to come. Recurring Damp and Mould, Staining coming through the decorations, plaster work lifting, and electrical failures.

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A Case History

We were reminded of a client in Sussex who had a water-damaged oak floor in their kitchen from a washing machine. The insurer had offered to pay for the floor, which was visibly damaged, but little more and wanted the policyholder to sign an acceptance form.

The policyholder was not happy as they felt that this was not the full extent of the damage and appointed a Loss Assessor to take this up for them.

It was obvious to the assessor that the floor ran under all parts of the kitchen units, so the kitchen would need to be removed. It was also evident that the kitchen units were glued to each other and to the granite worktop. This meant that the kitchen units and worktops would likely need to be replaced.

When works proceeded, the subfloor was rotten (concealed by the oak) and the floor joists also needed replacing. As expected, the kitchen was replaced along with the floor and rotten floor joists.

The claim had suddenly gone from the £3,000 offered to around £35,000.

This may seem excessive, but had the policyholder accepted the original settlement, the insurer would have settled the claim at a significantly reduced liability, and the deeper problems left to come back again

It is not that insurers are necessarily attempting to pay less, but by appointing poor or inexperienced agents, maybe they are not giving the insured true full indemnity.

Whilst this is not typical of all insurers, increasingly, if you pay a low premium, you tend to get a low level of claims experience!