Insurance Claims

An important part of any insurance product is the way in which the insurance provider handles insurance claims. The various elements of claims handling include what proportion of claims are settled, how fast they are settled and how easy it is to make a claim. Poor claims handling can negate a low price. In some cases a low priced insurance provider can be aggressive in denying claims. This can be found out in various ways, from the importance the firm places on claims handling in their promotional literature, what an insurance broker says about a company’s claims handling and consumer rankings. If a friend or colleague has had a positive or negative experience of a claim being handled then this should also be taken into account.

When dealing with an accident insurance claim, particularly a car accident insurance claim, it is important to know whether the claims department has out of hours coverage, particularly 24 hour claims coverage. It is better to make car insurance claims at as early a stage as possible.

It is important to contact the insurance company as soon as possible as some policies can have time limits on insurance claims. This can also apply to accidents which will not be claimed for but are reported to the police. It is easier to contact immediately after the event, which is another reason why a twenty four hour claims service can be useful. However a proof of loss, which is a written declaration needs to be lodged with the insurance company within about three months, 90 days, of the accident. After this then the insurance company may refuse to honour the policy.

Another area where a good claims handling experience is vital is for life insurance claims. Here there is a need for sympathy as well as efficiency. This is something that an insurance broker can advise on.

Some insurance companies have a good reputation for paying out on reasonable insurance claims, while others take a more aggressive line. Loss assessors, sometimes called loss adjustors, can also be an important part of the insurance claims process. Loss assessors investigate insurance claims often with the aim of reducing the payout. This can be by finding new uses and owners of the goods now owned by the insurance provider, but more often it is by trying to find ways of cutting down the amount of damage covered or to find reasons as to why the claimant should hold some of the responsibility for the insurance claim. This can mean a reduced payout. Another area that a loss assessor can look at is whether the insurance claimant was in breach of their insurance conditions which can invalidate a policy, even if the breach was not material to the insurance claim.

In general an insurance claim can often affect future insurance premiums, as the claimant is now judged to be more at risk of future insurance claims. This is often given as a reason not to make small claims.

With car insurance claims it is important not to voluntarily accept responsibility for the accident. This can lead to loss of coverage in most auto insurance claims. In Ontario there are a set of “fault determination rules” which decide where fault must lie in certain circumstances.