Misconceptions About the Claim Process

Posted on 16/02/2012 by George Keys

What is the role of the insurance company assessor and what are your rights as a policyholder? George Keys, an insurance assessor with Risk Worldwide, looks at some common misconceptions.

Like many businesses, the adjustment and resolution of an insurance claim is a give and take process. The fact that an insurance company has offered a large amount of money to a policyholder does not mean the policyholder is receiving everything to which they are entitled.

A common misconception about the claim process is that the people sent out by the insurance company are acting to protect the policyholder’s interest and to maximise the policyholder’s recovery. To the contrary, the assessors, contractors, and engineers that the insurance company sends out all receive their paycheck from the insurance company. There is no one in the process advocating for the policyholder to maximise their claim.

Insurers require you to justify and detail every dollar you expect them to pay. It is not the responsibility of the insurance company’s assessor to do that.

There are many ways to value commercial property, many decisions you must make as to what to include in the claim, and how to include it. The insurance company’s assessor is not going to make those decisions for you, and if he or she does, those decisions may not be in your best interest in pursuing the full benefits of your insurance policy.

A strategy of sitting and waiting for the insurance company to make an offer, and then going on whether or not it “feels” right, is not your optimal course of action. Not only does it allow the insurance company to drive the process, it allows them to do it at their pace- one which is not likely to meet the standard of a business owner who needs to be back up and running as soon as possible. Too often, this strategy translates into a sub-optimal offer that, because of its timing and because of the vagaries of the policyholder’s own business operations, many policyholders feel compelled to accept.
A second misconception about the claim process is that you have to sign a release or other document waiving your rights under your policy in order to receive payment from the insurance company.

Though most policyholders know intuitively that something is amiss, circumstances often compel them to jump through this last hoop for the insurance company in order to get repairs under way and their business back up and running.

The fact is, however, that you have already “paid” for the right to receive the benefits of its insurance policy by paying annual premiums to the insurance company. You do not have to give the insurance company any further consideration for its promise to pay in the event of a loss. The insurer is obligated to pay what they owe under the terms of a particular insurance policy without requiring the policyholder signing away any further rights to recovery.

George Keys is an insurance assessor who works for Risk Worldwide as an advocate for commercial policyholders. Risk Worldwide is an international consulting company, with a Christchurch office, that specialises in insurance recovery. Gkeys@riskworldwide.com