Claims

Insurance claims – 1 in 5 Claims Repudiated

Insurance claims – 1 in 5 Claims Repudiated

New statistics claim that one in five home insurance claims is repudiated (not paid) by Insurance companies. The Association of British Insurers published figures to promote transparency and understanding with consumers and the general public.

Characteristics of fire and smoke and fire damage insurance claims

Characteristics of fire and smoke and fire damage insurance claims

The Dangers of Smoke Residue The fire triangle- Fuel, Oxygen and Heat. In laboratory conditions these 3 elements balanced result in complete combustion. In the real world of Fire insurance claims , the unequal balance of the 3 elements result in smoke residue (soot) being produced to some degree.

Cyber Liability Insurance Claim

Cyber Liability Insurance Claim

Cyber Crime A relatively recent number of claims are appearing and in ever increasing numbers relating to cybercrime. Information technology is prevalent in both our personal and working environments, and we rely on the use of computers and the web to store data every single day.

Navigating Insurance Claims After Hurricane Irma

Navigating Insurance Claims After Hurricane Irma

According to the Association Of British Insurers, claims that need to be covered by UK based underwriters from Hurricane Irma could be as much as £10 to £20 billion. It is also estimated that only 12 percent of homeowners affected have adequate flood damage and storm damage insurance.

Top Reasons An Insurance Claim Is Rejected

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Building Insurance Claims

Most 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.

Another reason insurers repudiate 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 s 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 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 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.

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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 repudiated.

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.

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.

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.

Making An Insurance Claim: Business Underinsurance & Valuing Plant or Machinery

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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.

Indemnity Settlement

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 Settlements

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.

Making An Insurance Claim: Dealing With Water Damage

Making An Insurance Claim: Dealing With Water Damage

An EOW or escape of water - a leak, to you and I - has been deemed the most common cause of home insurance claims. And the number one cause of water damage in the home is burst and frozen pipes. Even a small leak can do serious damage.

Jeweller only offered 50% worth of claim by Insurer for stolen jewellery

Jeweller only offered 50% worth of claim by Insurer for stolen jewellery

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. 

Different Ways To Prevent A Disaster In Your Home

Different Ways To Prevent A Disaster In Your Home

Insurance's are designed to help cover loss during a disaster. Having a good Insurance package that can cover all aspects of your home is crucial. Here is a list which we have put together that can help you identify any risks or potential hazard in your home.

Struggling With An Insurance Claim? Here Is How We Can Help You!

Having a disaster in your home or business, is to say the least, a very traumatic experience. 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 more often than not seem more frighting with great difficulties and stress in comparison to the actual disaster.

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. With the experience of over 160 years going back 8 generations of family ownership, we are able to handle all of the claim process from the beginning, until the end.

Every single claim will be unique in a certain way. Whether you have experienced a Flood or a Fire & Smoke Damage, we are able to handle all aspects of the claim where we can negotiate and ensure you are returned to a pre-loss position.

Process in 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!

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Anger as Insurer reject Maesteg family’s flood claim.

Anger as Insurer reject Maesteg family’s flood 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.