Help!……I need somebody

Definition of ‘HELP’: “to make it easier or possible for (someone) to do something by offering them one’s services or resources”. As an Insurance industry, we need to offer HELP, not wait until it’s too late, or someone is screaming out for it, or feels stressed (or screwed) by the process.

Why does the insurance industry make filing a property damage claim a ‘self-service’ process? They specifically exclude the cost of claims preparation from the cover, when they cover most other costs associated with a loss. Wouldn’t it be preferrable to provide cover to ensure equal representation was afforded to their policyholder to ensure customer satisfaction with the process?

Every good Insurance Broker knows that if a client needs help with a fire, flood or business interruption claim, they will recommend a regulated insurance loss assessor. It makes economic sense and represents good value for money, otherwise we would not get so much of our business from referrals from happy clients.

By appointing Balcombes to handle a property damage claim, the unfortunate consumer will have someone on their side, not only to help, but to offer support, advice and assistance. We put the policyholder’s interests at the centre of everything we do, to ensure they receive their rightful and maximum entitlement under the terms of the policy.

Insurance is a vital risk transfer mechanism that underpins society and the economy as a whole. Claims Departments have often been described as the shop-window of the insurance company. A perception is created by the slick advertising campaigns is that the process will be seemless and all will be restored without a hitch. The cold reality can often be very different.

It is unfortunately true that many policyholders are fearful or intimidated by the insurance company, and can have a deep mis-trust of their Insurer’s appointed loss adjuster. The mind-set of claims department and loss adjusting staff, is to treat every claim as potentially fraudulent or over-stated. Claims staff spend most of their time gathering information, asking questions and pointing out what’s not covered, the policy excess, and the effect that a claim will have on their ‘no-claims-bonus’. Loss adjusters devote much of their attention checking the Value-at-Risk to see if the sums insured are adequate, or checking compliance with policy conditions, even if they have nothing to do with the loss, e.g. cheking for smoke detectors at a water damage claim. They will check Insurance Link to see if there are any previous claims that may not have been disclosed, and generally check to see is there a way of declining or limiting the claim payout.

The policyholder, meanwhile, is left to compile and submit their claims paperwork themselves, before the loss adjuster will respond (help).

It is only when a response is given (assuming policy cover is in order) that a claimant will be presented with an view of the scope and cost of the repair/replacement by way of a settlement offer. That is presented in writing, as the loss adjuster’s opinion of their entitlement under the terms of the policy, with a note that they have 10 days to accept or reject the offer as provided for by the Consumer Protection Code. It is very difficult for a consumer of an insurance product to challenge the expertise engaged by their Insurers with any degree of confidence. It is the classic David v’s Goliath mis-match. The mighty and powerful, against the little man.

It may be OK to treat Third Party claimants with an adversarial response, or treat a ‘slip, trip or fall’ or whip-lash personal injury claim with suspicion. However, it is about time the Insurance Industry offered real ‘HELP’ to own-damage household and commercial property claimants. How can they know what they are entitled to claim for? Most claimants have never had to go through the process and do not know what paperwork they need to supply, or how to ‘prove their loss’. Words in a policy like ‘reinstatement’, ‘day-one clause’, local authority clause’ ‘average’ and ‘business interruption’ mean very little to most people. They can even be confusing to many staff in the Insurance industry.

In order for proper Consumer Protection to apply to these financial products, at the point of a claim, the policyholder needs to have someone on their side, ensuring a level playing field. Until that ‘HELP’ is provided, the satisfaction levels of claimants will remain low, affecting the brand image of General Insurance companies, and Loss Adjusting companies in Ireland.

Meanwhile, clients of Balcombes continue to receive and appreciate the help they receive from us in getting them through the process with high levels of satisfaction.

Balcombes Claims Management “Protecting the Policyholder’s Position” 1800 506 700



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