Insurance Claims: Tips and Advice
By Karl Robinson
Insurance is a necessity of modern life and business and hopefully something that you can set and forget. However, unexpected events do happen unfortunately and when they do you want to know that the policy you have been paying all those premiums for will respond and your insurer will come to the party and pay you for your loss.
So, it can be very disappointing and frustrating to find that, at what is likely already a stressful and difficult time, your insurer takes a different view of your policy and either says you are not covered, or that they will pay significantly less than what you thought you were entitled to.
There are many reasons why insurers decline claims. The type of damage or loss you have suffered might not be covered by the insurance policy, the particular cause of damage or type of loss can be excluded, or there could be some conduct that disentitles someone from making a claim.
Sometimes insurers are correct in their decisions about claims, but other times they are not. Your insurance policy is just a contract, albeit with some special rules, and ultimately your insurer is just applying that contract and rules to the circumstances and making a decision on what it thinks it should have to pay.
Those decisions are always open to challenge and you might be entitled to cover even though your insurer has said your claim is declined, or you might be able to recover more than what your insurer says it is liable for.
Some important things to think about that can help at claim time are:
- Document the circumstances. For example, if there is physical damage, like a flood, make sure you take photos before cleaning.
- Always be honest. There can be very severe consequences for claiming something more, or different to what you actually lost, omitting to disclose relevant information, or lying.
- Get some independent advice. It should be no surprise that insurers are experts at insurance and particularly the terms and conditions of their own policies, assessing many claims every day. If your claim has been declined, or you have received less than what you thought you should, you should get some independent advice to level up that playing field. Your broker or a lawyer should be the first places