A new study has shown that the number of cancer related death for firefighters of the age 75 or under are three times higher compared to the general population in the UK.
If you have had an insurance claim that has been rejected (also known as repudiation) by your Insurance company, it may often feel like all hope is lost. Here we try to address some of the problems which can cause an insurance claim to be rejected and what you can do to avoid this.
Rejected Building Insurance Claims
Having the correct insurance policy
Most rejected insurance claims and policies we see are under insured. The value of reinstating your property is not what the market value is. Remember that about 30% of the rebuild is in the ground. Add to that legal, professional and local authority fees and you can see that the sum you have covered in the policy gradually eroding.
Make sure your home is not undervalued as this is the most an insurer will pay out. In some cases an insurer may even return your premium and cancel the policy as you have grossly misrepresented their risk. Remember it’s your responsibility not the insurance company to obtain accurate values for reinstatement.
Rejected because Lack of Maintenance
Another reason insurers reject property insurance claims is if the loss or damage was the result of “gradual deterioration” or a lack of “maintenance”, you will not be covered. Things such as failed damp proof course and some rot are examples of this.
Poor design and faulty workmanship. In this instance you will not be covered. If you believe the cause to be as a result of negligence by a contractor then you may be wise to seek legal advice regarding a claim against the supplier or installer. Your building insurer is likely to reject (repudiate) any claim in this regard.
Beware of taking long holidays. If you leave a property Unoccupied for 30 consecutive days or more without advising your insurer, they could have grounds to repudiate a claim. This is especially true for fire claim damage and water damage.
Material value changes
Material change in the risk – insurers must be informed of any “material increase” in the value of the risk they are covering. For instance, with home prices and building costs escalating so quickly, the replacement value of homes has increased. Any alterations to your property will likely increase the value and there could be risk of damage during construction. If this happens, seek the advice of an insurance claims management company.
Rejected Contents Insurance Claim
Non-compliance with security requirements – make sure you are familiar with policy conditions and endorsements. Should you fail to comply with your policy conditions on minimum security, your claim could be rejected.
You must have what’s known as an “insurable interest” in the property, in other words a financial interest in insuring the asset. If you only part own it or not at all then you will find insurers will reduce proportionally or even refuse to pay at all.
Disclosing all details
Check that you have provided all details in the policy form as correct and accurately as possible to your best k knowledge. Insurance companies will try to reject claims on the basis inaccurate provided information.
How Oakleafe Claims Can help
Loss Assessors Oakleafe Claims offer a mid term survey to identify material changes and problem areas in a policy that needs the policyholders attention. Key to this are the warranties and conditions that are the spine of any cover.
Rejected Insurance Claims (Repudiation):
The term repudiation in Insurance claims management refers to the rejection by Insurers to pay a claim. They will relate this rejection to a specific reason such as non-adherence to a warranty or condition in your contract of insurance.
It is always advisable to seek the help of a claims management company in this instance. Sometimes it can be easily turned around with the production of information in the right manner which has been misinterpreted by the Loss adjuster.
Many businesses make mistakes when trying to determine their plant and machinery sums insured. Setting the correct sum insured requires careful consideration of a number of factors, and a thorough knowledge of the policy terms. Brokers and Insurance Loss Assessors can play a key part in helping customers correctly value their assets, and avoid underinsurance.
For businesses that rely on key machinery, underinsurance can have severe consequences. Simply using the purchase cost for valuing assets is a mistake made by many, resulting in inaccurate sums insured and inadequate claim settlements. Valuing assets for insurance purposes requires a particular methodology, and assessors can play a key role in helping customers approach the issue.
What happens if I have a claim?
The basis of settlement determines how a policy is worded to calculate a claim. When setting the sum insured, different approaches must be taken, depending on which basis of settlement is specified. Insurance policies can specify different bases of settlement. It is therefore essential that the applicable basis is known before valuing assets.
In the UK, it is usually an indemnity or, more commonly, reinstatement basis for items of machinery. Other basis of settlement do exist, such as an agreed value basis, but are less common for most customers’ purposes.
An indemnity basis reflects the traditional principle of insurance: to return the insured to their position prior to the loss – no more, no less.
An indemnity basis will cover either:
- Cost of repair, less an allowance for wear, tear and depreciation • Cost of a similar machine, giving regard to its age and condition
- A settlement on this basis is therefore unlikely to fund the full cost of a new replacement asset, so customers should be particularly conscious of overstating sums insured.
- The purchase cost should be avoided, as the value of plant and machinery can rapidly depreciate once in operation. A reasonable starting point is the current market value of the asset, taking into account age and condition.
- Difficulty arises where a current market value is not easily determinable, particularly if the asset is no longer being produced or actively bought and sold.
- Valuations for an indemnity basis can therefore be a difficult task for customers to undertake alone, and both under- and over insurance are distinct risks.
Reinstatement is the most common basis of settlement used in the UK insurance market. This departs from traditional principles, as a claim settlement will result in an improvement to the insured’s position.
Reinstatement will cover either:
- Cost of repair, with no deductions made for wear, tear or depreciation • Cost of replacing the asset with a new item of similar type, capacity and utility (new for old)
- The sum insured on a reinstatement basis should include the full cost of completely replacing an item of plant or machinery with a new item of similar type and capacity. In addition to the purchase cost, this sum should include factors such as fabrications, freight and installation costs.
- If the item is readily available for purchase, then determining an appropriate sum insured should be relatively simple. However, difficulty arises if machinery is old or no longer in production. In those circumstances, the cost of an alternative piece of equipment of a similar nature and capacity must be identified.
Getting The Value Right
The approach taken to valuations will produce different results, with reinstatement sums insured being notably higher than those on an indemnity basis. Approaching a valuation from the wrong starting point is likely to result in either over- or underinsurance. Plant and machinery are also particularly susceptible to fluctuations in value, making it difficult for people to establish an accurate sum insured.
It should be stressed that there is no substitute for regular professional valuations to be undertaken for insurance purposes. It may be the difference between sinking or survival. You must seek an Insurance Assessor.
An owner of a jewellery store has had £2,225 worth of goods stolen in February. After contacting the insurers (Legal and General) looking to claim. Their insurance only offered them £1,257 in cash to replace what they had. Or the absurd offer of vouchers in full amount to use in a different jewellery store.
Having a disaster in your home or business, is to say the least, a very traumatic experience and now you have the responsibility with dealing and submitting a complex and difficult Insurance Claim.
Fortunately, you have prepared well. The good news is that you have a strong insurance policy covering you against such circumstance, you have paid your premiums on time, year after year.
Unfortunately, the bad news is that the impending insurance claim you’re about to make will often seem more frightening with great difficulties and stress in comparison to the actual disaster.
Why are Insurance Claims Difficult?
Insurance Claims are Difficult because it the responsibility of the policyholder to prepare and present their claim to the Insurance Company. This could often mean you would have to quantify and justify every single aspect of the loss while trying to keep things afloat.
Insurance companies would send out their own Loss Adjuster whose sole responsibility is to represent the Insurance’s interest and investigate the cause of the incident. Additionally, they can try to interrogate you and find any possible faults which might be used to deny the claim.
Difficult Insurance Claims Lead to Repudiation
Did you know that 1 in 5 Home Insurance Claims are Repudiated (Not Paid Out). When facing difficult Insurance claims, it is common when policyholders do not not read the fine print in their insurance policies and may often find they have not met some of conditions in a policy.
Loss Assessors can handle Difficult Insurance Claims
Loss Assessors work and represent the policyholder in the event of an Insurance Claim. Loss Assessors are independent Insurance Claim experts who can take the stress away from your claim. They work for you the policyholder, and only you. They can use their expertise knowledge and skills to deal with Difficult Insurance Claims. Loss Assessors will aim to get everything you are entitled to.
How Oakleafe Can Help with Difficult Insurance Claims
Oakleafe is the only party in the claim process which is on your side. Insurers appoint their own specialists to look after their interests to limit the levels of their liability. We are interested exclusively in your interests, to ensure you receive everything you are entitled to under the policy.
Having handled hundreds of complex and difficult Insurance Claims with the experience of over 8 Generations. We are confident to handle all the claim process from the beginning, until the end. where we can negotiate and ensure you are returned to a pre-loss position.
Process in an Insurance Claim
As Insurance Assessors, we take our clients through every step of the Insurance Claim and we keep them up to date with every progress made. Difficult Insurance Claims can potentially be very complex but have made a quick list below that summarises the average process in handling an Insurance Claim.
Notification - After an incident your Insurance Company needs to be notified of the incident.
Mitigation - All policies place a responsibility on the policy holder to mitigate or prevent the damage from worsening.
Appointing an Assessor - Our experienced in-house Assessors would be assigned to your claim who will use their wealth of experience to manage all aspects of the claim.
Restoration - Depending on the type of claim, a professional restoration approach would be undertaken to ensure material damage is kept to a minimum.
Scope of Specification - Charted Surveyors, Structural Engineers, Contamination Experts and other professionals prepare detailed quantification of the loss. All reports and claim documents would then be submitted to the insurer.
Negotiation - We will undertake all meetings, phone calls, communications and negotiations to achieve a satisfactory settlement.
Approval - Once Insurers or their representatives approve the claim we prepared and submitted to them, funds are released to enable works or professional services to commence.
If you require any information, feel free to contact us and we would be happy to help you!
Insurance Claim Services
Domestic Insurance Damage Claim
Commercial Insurance Damage Claim
An Insurance Company has been accused of "giving the industry a bad name" for rejecting a Flood Damage Insurance Claim by a family whose home was hit by flooding near Bridgend. How Insurance Companies Operate Insurance Companies can often interrogate you and make you feel like you are the one to blame.