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THE insurance CLAIM PROCESS – HOW DOES IT WORK?

There has been a continuing increase in severe weather catastrophes and a surge in litigation claims for personal injury.

If you have never had your property damaged or had someone take legal action against you, the first time it happens, you might not be sure what to do, or even where to start. It can be exceptionally intimidating and sometimes overwhelming.

Here's what you need to know when submitting an insurance claim

Below are some practical tips/guidelines that you can follow should an incident occur, which may give rise to a claim.

PROPERTY DAMAGE: WHAT NOW?

  • If the incident involves theft or loss of property, the police must be advised and a police report obtained.
  • If the incident involves water damage to carpet, immediately telephone a carpet firm to have the carpet dried, stretched and/or lifted. If the carpet has shrunk to the extent that it cannot be re-laid, obtain two quotes for its replacement. 
  • For other damage incidents, obtain at least two quotes for repair or replacement of the damaged items, retain colour photographs evidencing the damage and take any reasonable steps to minimise any further damage. 
  • For any claims exceeding $3,000, a loss adjuster is likely to be appointed by your insurer. 
  • Report claims for damage to your insurance broker as soon as practicable to enable prompt lodgement of the claim with your insurer. 
  • Where a broker is not involved, report the matter to your insurer without delay.

Insurers are sometimes seen as being “difficult” with the volume of documentation and proof of ownership and value that is required to finalise a claim, but this is due to the unfortunate amount of fraud that occurs within our society and they must meet all requirements to ensure that they are making a correct payment.

Your broker can help you through this process – explaining what the Insurer needs to move the claim forward. Whilst this can be a very emotional time for you, working through with your broker one step at a time will help finalise the claim more quickly.

MOTOR ACCIDENTS: WHAT NOW?

  • If an accident occurs, exchange names, addresses, registration numbers and obtain the third party's insurance company details.
  • Note the location of the accident, time, date, road and weather conditions, including names and addresses of any witnesses. 
  • The police should be advised if appropriate and required by law. 
  • Retain details of the police station, reporting officer as well as police event number. 
  • If the incident involves a third party, do not admit liability.  
  • Report to your insurer as soon as practicable.

LIABILITY: WHAT NOW?

  • Complete a detailed incident report containing the third party's name, date and time of loss as well as a full description of any loss, damage or injuries. Include any relevant photographs and supporting documentation detailing the circumstances. Do not give an interview or make any statements to a loss adjuster or other person investigating any incident unless such person is acting on behalf of your insurer.
  • Do not reply to any letters of demand (other than to acknowledge receipt of the correspondence and/or any Court proceedings). Forward same immediately to your insurance broker for provision to your insurer. 
  • Incidents which involve children may result in claims for damages being made many years after the incident so keep incident reports and records of such incidents in a safe place and make doubly sure that your insurer has been notified. 
  • Do not admit liability regarding any incident that may give rise to a claim against you.


PROFESSIONAL INDEMNITY: WHAT NOW?

  • It is imperative that you inform your Insurance Broker as soon as you become aware of a circumstance that may lead to a claim.
  • Make detailed notes of any conversations with parties involved while they are fresh in your mind.
  • DO NOT admit liability or reply to any letters of demand (other than an acknowledgement of receipt of the correspondence). Forward any such documents immediately to your Insurance Broker for provision to your Insurer.
  • You should always seek advice from your Insurer prior to engaging the services of a solicitor (it is likely that if you have a situation that is covered by the policy they may appoint Lawyers on your behalf).

When you have a customer threatening you it is very difficult not to have a knee-jerk reaction – explain to the customer that you will investigate the matter and revert back at the earliest. Then fully review circumstances and contact your broker without delay.

Should any circumstances arise which may result in a claim, you must immediately notify your Insurance Broker or Insurer, as appropriate since any delay in notifying the insurer may result in your insurer refusing to accept your claim.

If you would like further information, please feel free to contact Rebecca Fleming, Account Manager of our Special Programs Division at Gow-Gates Insurance Brokers on (02) 8267 9919 or rfleming@gowgates.com.au to discuss your circumstances or to obtain a quotation.