The Claims Process

The Claims Process

Insurance is a contract between you and your Insurer. If you suffer a loss or damage that is covered by your insurance policy you will need to contact the insurance company. Contact details can be found in your policy booklet and your policy schedule.

There is a common misunderstanding as to what is covered and what is not covered. It must be clearly understood that household insurance is not “fully comprehensive”.

Firstly, you should check the perils that are covered, typically these will be Fire, Flood, Storm, Impact, Subsidence, Heave, Landslip and sometimes Accidental Damage. There are of course certain exclusions and some general principles that you should also check, again by reference to your policy document and schedule.

The primary things you need to appreciate is that all policyholders have a binding duty to mitigate any loss as far as possible, which means you have to take steps to keep your claim to a minimum. The other thing to remember is that an insurance policy is not a maintenance contract and that ultimately, it is your duty to demonstrate a claim exists. However, in most cases today, Insurers will usually (but not always) take the necessary steps to establish or deny that a valid claim exists.

Assuming that there is potentially a claim to answer, you should advise your insurer. If possible you should note the date and time the loss or damage occurred or was noticed, describe the problem and if appropriate take photographs.

Depending on the nature of the problem, your Insurer may appoint a Loss Adjuster. The process that follows will vary depending on the Insurer and their preferred claim handling method.

It is common for many claims to be handled on a “project managed” basis. This typically means one person deals with your claim from beginning to end and follows a prescribed process defined by the Insurer.

In traditional claim handling, an Insurer appoints a Loss Adjuster who provides reports and information to the Insurer, seeking instructions throughout the process and advising the policyholder of those decisions. Where engineers or surveyors are needed, they are appointed and deal with specific tasks.