How do we treat claims?

To quote every claims manager “every claim is dealt with and treated on its own merits.”

However we are here to help so we do try to ensure that any claim, where we are asked to help, is presented to the insurer the way they would like to see it presented.

If we go back 20 years, most insurers ‘wanted to pay claims’. Actually that attitude has not changed but with increased regulation insurers have to be very careful about setting a precedent or settling a claim where the circumstances do not ‘fit with the policy wording’.

Over the years we have taken up aspects of a claim where we have felt that there is an opportunity for underwriters to settle but where the initial reaction from insurers has been to reject the claim.

This does not happen often but out of all the cases where we have taken issue with insurers there have only been two occasions when we have not ‘won our point’ and achieved the right result for our client.

There have been a few situations where the claim was the result of a storm but general weather conditions in the wider area have not been that bad. However, when we have challenged the declinature of the claim, examination of the weather conditions in the specific area where damage occurred has shown that it was, indeed, the storm that caused damage to our client’s property and the claim has been settled in full.

In the case of motor insurance following an accident, which was our client’s fault, the vehicle went to two different repairers and had two different engineers inspect the vehicle. It was not until we had it taken to a third bodyshop that the service manager noticed that one front wheel was two inches further back than the other one because the chassis was bent. Eventually the vehicle was properly repaired and full settlement arranged.

On another occasion, at our suggestion, photographs of our client’s damaged vehicle were taken and these were used to prove that the damage could not have been caused by our client unless she had been able to drive sideways into the third party. The third party insurers accepted the claim in full.

In a commercial situation, we encouraged an insurer to reject a claim for personal injury from a third party as the injury was the result of trespass and not even on property belonging to our client. The insurer had, initially, considered accepting the claim.

As for investments, ‘past performance does not give any indication of future success’ but we will always encourage our clients to insure properly and to claim properly. A claim will always result in the client being out of pocket in terms of time if not financially. We have never had an insurer object to our reopening a claim if there is good cause to do so.