Get insurance claims paid correctly

When people ask me if they should lodge a claim on insurance for some misfortune, I always remind them that, "you purchase insurance, so you can make claims". As long as the claim is genuine, not frivolous, and not something that really would have been reasonable for you to foresee and prevent, then you should claim on your insurance.

But a common problem is in the next step: how do you lodge a claim and ensure that it receives the respect and consideration that it deserves?

Step 1 - Assess

This might sound silly, but a lot of people skip these steps.

• First step is to work out what has gone wrong?
• Next, as a high level only, what do you need to set yourself back right again?
• Are there alternatives? Which option would you realistically choose to pursue if you had to foot the bill yourself?
• Lastly, what steps do you need to put the plan into motion or work towards quantifying your loss?

Step 2 - Plan the Submission

In my experience, this is where the claim lodgement falls down and starts to go wrong. The worst thing you can do is lodge a claim with incomplete information - what happens is that the claims examiner asks a question or two, and the submission goes back on the bottom of the pile.

1. Does the nature of the loss fall within one of your insurance policies?
2. Which one? What are the terms of settlement and any sub-limits that may apply?
3. What are your obligations toward the insurer - are you required to notify them immediately of the misfortune, or are you permitted to settle the matter yourself and look towards them only for reimbursement?
4. What proof will you need to provide to show that a loss has occurred?
5. What evidence do you have of the dollar amount claimed?

Unless you're required to by 3, best practice is to hold off submitting a claim until you have these 5 things in hand.

Step 3 - Control the Conversation

Lodging an insurance claim shouldn't be onerous, but it is still at heart an adversarial process. You're asking another company to put their (metaphorical) hand in their pocket on your behalf. They absolutely will do that - but they usually know the terms of the insuring agreement better than you, and will need to completely satisfy the terms of that agreement before settling.

In my experience, people at insurance companies are people. They're usually well-meaning and want to help, but they have obligations and rules to follow, and they'd be fired (or worse!) for breaking those rules.

So make it easy on them - control the claim submission and the conversation around settlement so there's no realistic alternative but to accept your request. Much like a business negotiation, you win by making it easier for the other party to say "yes" than it would be to say "no".

Techniques like:

• Provide a full description of the loss, including a reference to the chapter and verse of the policy agreement which indemnifies it.
• Provide a proper accounting of the financial loss, and a plan for reimbursement or replacement - including quotations or invoices.
• Address all legal matters such as ownership of damaged property, GST entitlements, and EFT bank information for settlement.
• Provide any other supporting documentation as would be reasonable to prove that the loss is the subject of this insurance.

Step 4 - That's it!

It sounds harder than it is - but the process is quite logical and worth pursuing. I've seen too many claims lodged with incomplete or incorrect information - which causes unnecessary heartache and delay. If you plan your claim submission like a business transaction - where doing the wrong thing would be much harder than a win/win outcome, your claim will be handled faster and better as well.

Outsource to me - with decades of experience in complex claim matters, I will guide you towards making an insurance claim be as simple as possible, and to maximise your entitlements.