Insurance Claim Jargon — More Terms Explained

In my last blog, I explained a few insurance claim terms that might baffle you. At Allied Claims, we do our best to make it straightforward, but other insurance professionals, such as a Loss Adjuster, may not realise you don’t understand what they’re talking about.
Business Interruption
When business productivity is stopped by an unplanned event or disaster, affecting the company’s profits.
insurance-claim-business-interruptionIf your business has to temporarily stop trading, for instance during repairs following a fire or flood at your premises, a Business Interruption Clause can be activated. Your insurance claim under this clause will normally cover loss of income, and also loss of certain overheads over a specified period of time.
This isn’t always as simple as it sounds, since the insurance company’s Loss Adjuster may not be using the same definitions of costs and overheads as your accountant. Because of this, we’d recommend that you consult both an accountant and an Insurance Broker when determining your level of cover for Business Interruption.
Getting the right level of Business Interruption cover could mean the difference between your business surviving or going under after a disaster. It’s estimated that at least 70% of businesses that suffer a catastrophic insurance claim fold within two years, either because they have insufficient or inappropriate Business Interruption cover, or because they have none at all.
Claims and Underwriting Exchange
A computerised register of information from insurance proposals, claims and renewal forms, shared by insurers as part of their campaign against fraud.
insurance-claim-underwritingMost people don’t realise that every insurance claim made is recorded in full, whether or not it’s successful. If you have to complete an insurance application form, you’ll find they want to know whether you’ve made a claim in the past three or five years.
False information given here, such as saying you haven’t made a claim within that time when actually you have, could result in a future claim being refused, even many years later.
Co-insurance
An arrangement by which an insurance policy is shared by more than one Insurer.
reinsurance-insurance-claimYour Insurer may, in certain circumstances, choose to spread the risk by reinsuring part of your policy with one or more other insurers. This doesn’t really affect you as the Policy Holder, since you’ll only deal with the Insurer you negotiated the policy with, but it’s as well to be aware of how any insurance policy is working.
If you need any help with your insurance claim, ring us on 0800 999 5679 or go to the Contact@ section of the website by following this link >>>

Insurance Claim Jargon – A Few Terms Explained

Like any sector, an insurance claim has its own jargon, often completely meaningless to the lay-person. At Allied Claims, we try always to talk in plain language to our clients and explain any technical terms, but it’s as well to know some of the terminology for any contact with other professionals, such as a Loss Adjuster.
Over the next few months, I’ll be giving a guide to some of the most important terms. Here are three to start.

Accidental Damage

insurance claim accidental damage
Unexpected and unplanned damage or harm caused to a property or a person.
This seems obvious, but “accidental” doesn’t have quite the usual meaning for the purposes of insurance. For damage to be judged accidental, it must be clear that you haven’t substantially contributed to the damage by action or negligence.
For example, suppose you’re carrying a sealed tin of paint through your house. You stumble, the tin flies out of your hand and hits the floor hard enough to burst open. Suddenly, you have a carpet that looks like a Jackson Pollock painting.
This is definitely accidental, and your insurance claim should be accepted. If, on the other hand, you were carrying an open tin of paint with no lid, the Loss Adjuster may judge the damage as partially your own fault and advise the insurance company to refuse the claim.

Aggregate Limit of Indemnity

The maximum amount an insurer will pay for all insurance claims over a set time frame.
Understandably, an insurance company isn’t willing to commit an unlimited amount of money per claim. Most people only ever need to make one or two claims on an insurance policy, if any, but there are exceptions.
Most policies will include an aggregate limit of indemnity, which will set a figure on the limit they’re liable to pay out in total over a set period. This is usually the lifetime of the policy, but occasionally a different time-scale is specified. If the combined total reaches this cut-off point, the insurance company will no longer pay your claim, however valid.

Assurance vs Insurance

Assurance is against something that will happen; insurance is against something that may happen.
insurance claim v assurance
Have you ever wondered why you have Life Assurance but Property Insurance? That’s because you will die (though hopefully not for a long time), whereas you may never need to make an insurance claim on your property.
This obviously affects the way in which the risk is calculated, although assessments will still be made to calculate how long you’re likely to live, and therefore how many payments the insurance company can expect to receive. Ultimately, though, they will need to pay out.
If you need any help with your insurance claim, ring us on 0800 999 5679 or go to the ‘Contact@ section of the website by following this link >>>

Insurance Claims and “The Insurance Act 2015”

Many experts consider The Insurance Act 2015, which comes into force later this month, and what it means for insurance claims, to be the biggest shake-up in insurance law for over a century. Its changes are aimed at businesses and corporations, rather than consumers, and most crucially changes the principles surrounding disclosure and penalties for non-disclosure.
The Act changes correct practice in dealing with insurance claims amongst other areas for insurance companies as well as for insured parties, but the most important things for businesses to be aware of are:
  • Instead of a vague obligation to reveal all circumstances affecting the insurer’s decision, the Act introduces a “duty of fair presentation”. This defines matters deemed to be known as those held in their records, those available to senior management and those available to a responsible person, such as a broker.
  • Previously, insurers could declare the policy invalid for any non-disclosure (e.g. if windows weren’t locked as declared, even if the insurance claim were for flood damage). The Act gives a sliding scale of remedies for insurers, depending on how serious the breach is, ranging from invaliding the whole policy to reducing the cover.
  • The Act specifies that, while a specific insurance policy may be agreed by both parties outside the terms specified in the Act, the insurance company must clearly explain the differences and their implications.
insurance claims commercial premisesThe Act makes it even more crucial than before that all relevant parties are involved in setting up a commercial insurance agreement, to ensure that nothing that should be disclosed is overlooked. This is always best undertaken with the advice and expertise of a professional insurance broker.
Allied Claims, who offer an expert loss assessor service specialise in property and business insurance claims, encounter situations that stretch the imagination, but that’s nothing to excuses given in other sectors. Here are just a few of the reasons we avoid car insurance:
  • “To avoid a collision I ran into the other car.”
  • “The telephone pole was approaching and I was attempting to swerve out of its way when it struck the front end of my car.”
  • “First car stopped suddenly, second car hit first car and a haggis ran into the rear of second car.”
Advice from Our Blog
Our blog gives regular updates on the insurance sector, though regrettably we’ve no advice on how to avoid being hit by a haggis.
If you want to know what insurance claims have in common with treating cancer, check out the post on the many uses of thermographyThermography, while our explanation of the Proximate Clause is essential reading to anyone who wants to make sure they have all eventualities covered in their policy.
Have a Great Month
We look forward to doing business with you or seeing you at networking events — or perhaps someone you know has a insurance claim. In the meantime, feel free to check out our website and read our blogs.

The Proximate Clause in an Insurance Claim, understand this?

Anyone who’s read through the small print on their insurance policy, especially if their insurance claim is rejected, will know how incomprehensible it can be. Unfortunately, it’s essential to understand, and nothing more than the Proximate Clause.
What Is the Proximate Clause?
A key principle of insurance, the Proximate Clause is used by Loss Adjustersto assess the exact cause of the damage or loss and determine whether that particular cause is covered by the policy.”
insurance claimTwo key court judgements* illustrate the kind of distinctions made. In both cases, a wall was blown down in a gale after having been previously damaged. In one, where the wall was blown down shortly after being struck by lightning, the lightning was ruled to have been the cause, whereas in the other, where the wall was damaged by fire a few days before being blown down, the fire wasn’t considered the cause.
The distinction here is because, in the second case, the wall stood for several days after the fire, and it was only the gale that made it collapse. In the first, though, it could be assumed that the gale might not have had such an effect without the lightning-strike.
How Might a Proximate Clause Affect You?
A decision by the Loss Adjuster on what’s counts as a proximate cause could depend on what’s actually covered by the policy when making that insurance claim. For instance, it may seem reasonable for an upper-floor office not to be insured against flooding.
Water damage insurance claimHowever, if the ground floor is damaged by flooding to the extent that the whole building has to be closed, the company using the upper floor may not receive compensation for loss of business because the situation was caused by flooding.
On the other hand, consider a case where a fire in a plastics factory results in particles spread by the wind damaging the stock of a nearby clothing factory. You may expect this to be covered by the plastic factory’s fire policy, but the Loss Adjuster could consider the actual cause to be wind-borne pollution, which isn’t covered.
Know Your Risks
The moral? It’s vital to make sure any insurance policy you take out covers all possible proximate causes if you need to make that insurance claim. Nothing should be ruled out without careful examination.
This is one of many reasons why it’s essential to consult an insurance broker, who’ll help you sort this out, and to use a Loss Assessor for your claim. If you need help with a claim, follow this link >>>.
* Roth v South Easthope Farmers’ Mutual Insurance Co. (1918) and Gasgarth v Law Union Insurance Co. (1876)

Thermography — Saving Lives and Saving Your Insurance Claim

Thermography is one of the wonders of modern science. It’s a technology which can save your life can also save you from losing out on your insurance claim. Thermography is among the tools offered by Allied Claims to make sure you’re getting what’s due to you, but it has a wide range of other applications.
What Is it?
It is a type of thermal imaging, which can produce a picture showing any object that’s hotter than what surrounds it. Everything produces heat in the form of infrared radiation and, although it can’t be seen by the human eye, thermographic imaging equipment can pick it up and use the data to create a computer-generated image of the object.
thermographyUnlike many forms of imaging, thermography is 100% safe. X-ray imaging, for instance, involves firing X-rays at you, and although the risk is usually small and acceptable, there is a risk. This system only passively measures what’s already there and is no more dangerous than a camera.
Uses
Thermography has been around for many decades and is put to a wide range of uses, from military surveillance to allowing firefighters to “see” in a smoke-filled building. One of its main applications, though, is for medical diagnosis, where its safety makes it particularly useful.
Medical thermography works because many issues inside the body, such as tumours and inflamed blood vessels, are marginally hotter than the surrounding tissue. The small difference is hard to measure by conventional methods, but it shows up on a thermographic image. So, it can be used to diagnose cancers, deep-vein thrombosis, and back issues. It’s even used in dentistry.
How Thermography Can Save Your Insurance Claim
You may know there’s been damage done to your property, but how can you be sure you’ve found every issue? The problem is that, if you don’t include hidden damage in the claim you give your Loss Adjuster, it can be extremely difficult to convince the insurance company to pay for it later.
thermography
Kitchen Water Damage

In the same way that the method is safe in medical diagnosis, it can be used to see the unknown in your property with no risk at all of causing damage. It can pick up places where heat is being lost, or where insulation is wet or missing, and detects water damage or mould. It can also pinpoint electrical hotspots and refrigerant leaks.

Detecting hidden damage before you present your claim to the Loss Adjuster could potentially save you tens of thousands of pounds. To take advantage of this wonder of modern science, just follow this link >>>

Summer Holiday Insurance Claims on Home Policies

INsurance claims socxial media postingSocial media is one of those things we can’t seem to live with or without. It has plenty of plusses, but there are traps, such as prospective employers being able to find the photos you wish you hadn’t posted. Now, though, it’s beginning to have an effect on insurance claims, too.
Home insurance policies have always tended to include a “Reasonable Care” clause, which allows the insurance company to refuse insurance claims if your own carelessness has contributed to the incident. This has traditionally been used mainly in burglary cases where doors or windows haven’t been adequately secured.
insurance claim home policyLately, though, Insurers and Loss Adjusters have increasingly been invoking the Reasonable Care clause for burglaries that happen while the owner is away on holiday. The Insurers are checking the claimant’s social media accounts for postings about the holiday, whether announcing it in advance or posting selfies while away.
The problem with this, of course, is that anyone making such posts is advertising publicly that they’re going to be away from home. If your house is burgled after you’ve done this, there’s a good chance of your insurance claim being rejected by your Insurance company.
It isn’t just Insurers who’ve noticed the trend. Police forces all over the country are warning us to be careful not to post on social media about being away. It seems that web-savvy burglars have taken to scouring social media sites to find out which houses in their area are likely to be empty.
So be careful. If you give away too much on social media, the Insurance company could reject your claim under the Reasonable Care clause, on the basis that you haven’t been careful enough in protecting your property. Either call us on 0800 999 5679 or follow this link >>> to discuss any help you need with your claim.

Insurance Claim and Occupancy Clause on Household Policies

Water damage insurance claim

Before you make an insurance claim on any insurance policy you have, it’s essential to read through all those fine-print clauses. Yes, it might be boring, but not nearly as bad as being hit by a restriction you weren’t expecting when you try to make a claim.

A case in point is the Occupancy Clause.

Most home insurance policies, and the majority of policies for commercial properties, include a clause that addresses the “occupancy issue”. The exact wording will vary from policy to policy, but what they all say boils down to stipulating a maximum length of time the property can be left unoccupied, if you need to make an insurance claim is usually 30 days.

If you’re intending to leave the property unoccupied for longer than this, the Insurer must be notified, preferably in writing or by email, and specified actions must be taken by the Policy holder. The most common are that the heating must be kept on, bi-weekly visits must be made, and that an alarm must be installed.

However, it’s vital to check exactly what your policy says and make sure you know what needs to be done, in addition to informing the Insurer if the property is going to be empty for more than 30 days.

This can apply to any circumstances when the property will be unoccupied, but it’s particularly relevant to anyone letting out a property. The landlord must notify the Insurer as soon as the tenant has moved out. In many cases, the landlord will be making repairs or decorating before the new tenant moves in, and this can easily stretch out beyond 30 days so watch out if you are about to make an insurance claim.

Whether your insurance is for a domestic or a commercial property, make sure you know your obligations under the Occupancy Clause. If you don’t, there’s a good chance that you’ll be left without a penny if you have to make a claim.

Property Insurance — Building or Contents?

HouseFire
If you’re sensible, you’ll have both building and content insurance for your home, and that should cover any loss caused by fire, flood, criminal or accidental damage. But do you know what’s covered on which policy?

All too often, homeowners and tenants are unclear about this, and there are cases when the Insurer’s Loss Adjusters refuse to pay out on a claim, on the grounds that the item isn’t insured.

So why is that?

It usually comes down to defining whether or not an item is a fixture or contents, and this can be open to interpretation. If your fitted carpets, for instance, are damaged by fire or water, it may depend on whether they were in place when you bought the house, or whether you’ve had them laid since then, in which case they’d be classified as contents.

On the other hand, there’s no guarantee of this, and Loss Adjusters may also define carpets as contents even if they were in place at the time of purchase. There’s no rule written in stone on the subject.

Laminate flooring ought to be more straightforward. It’s glued together and fitted under the skirting boards, so it should be regarded as a fixture. Most Loss Adjusters do use this interpretation, but occasionally even laminate flooring may be ruled as contents, and therefore ineligible under the buildings insurance policy.

This kind of uncertainty can apply to a range ofthings in your house, not just flooring. Items varying from antennas on the roof or fitted units in your rooms could be fixtures or contents, depending on the Loss Adjuster’s interpretation.

If you want to be sure whether your possessions are correctly insured, you need to study the policy or ask the Insurer to clarify. Even better, use an insurance broker in the first place, who’ll make sure everything’s in place.

Can My Insurance Broker Help With My Claim?

Can My Insurance Broker Help With My Claim?

If you take out an insurance policy, the only person you have much contact with is the insurance broker who arranges it. So it seems to make sense, if you have to make a claim, to turn to the broker for assistance, but can the insurance broker really help?

The Insurance Broker

The short answer is yes, they can. But that doesn’t mean it’s the best option.

An insurance broker’s role is to find you the best possible policy in a market place fraught with choices and dangers. This is a complex and highly skilled job that takes up a good deal of time, and may not leave them with the capacity to take on a different complex and highly skilled task.

Think about it. If you needed repairs or renovations for your home, would your first thought be to go back to the estate agent who arranged the sale? If they’re a good company, they might try to help, but this would probably just involve referring you to someone who’s expert at the job in hand.

And that’s exactly what your insurance broker will probably do.

The Expert

The expert your insurance broker will most likely recommend is a Loss Assessor, an independent professional whose role is to negotiate with the insurance company’s Loss Adjuster on an equal (if not greater) level of expertise. Having got you the best possible settlement for your claim, many Loss Assessors, including Allied Claims, will then project manage the entire process and bill the insurance company directly. You’ll have little to do except watch your property being restored to its appropriate state.

Insurance brokers and Loss Assessors make perfect allies. Both are there to make sure you get the best deal possible, but at different stages of the insurance process. The insurance broker does it by knowing the market place, while the Loss Assessor does it by knowing how to deal with claims and insurers.

At Allied Claims, we often work closely with the client’s insurance broker, pooling our knowledge to ensure the best possible outcome for the claim.

Call Now

So the answer is yes, your insurance broker can help you with your claim — by putting you in touch with us. But you don’t have to wait for that. Call Allied Claims now and let us help you with your claim from the beginning.

Call 0800 999 5679 now and discover how Allied Claims can help you in your emergency.

Can I call a Loss Assessor After Submitting a Claim?

Can I Call a Loss Assessor After I Have Submitted a Claim?

You already know, hopefully, that the best way to manage your insurance claim for property damage is to appoint an independent Loss Assessor, who can steer your claim through the often confusing process. But when is the best time for it? Can you be too late, or too early?

The Earlier the Better

The ideal time to contact a Loss Assessor, such as Allied Claims, is as soon as you’ve reported your claim to the insurance company and received your claim number from them. Although you could theoretically get in touch before this, there wouldn’t be a lot of point. You couldn’t appoint us as your Loss Assessor at that stage, and we’d be unable to act for you.

As soon as we have your claim number, we can swing into action straight away. We’ll contact the Loss Adjuster appointed by the insurance company to find out how they’re viewing the claim. If that’s less than ideal, we’ll argue your corner with at least as much professional insight as they have.

At the same time, we’ll be organising quotes and dealing with the companies involved, and then project manage the repairs and renovations and submit invoices to the insurer when it’s done. Best of all, as you probably know, it won’t cost you a penny.*

Can I Call Later?

You’re completely entitled to appoint a Loss Assessor at any stage during your claim, and if for any reason you haven’t done so at the beginning, by all means put that right as quickly as possible.

There are definite disadvantages to leaving it late, though. By that time, you’ll have probably dealt with the Loss Adjuster yourself, whereas you’re better off if the Loss Assessor negotiates with the Loss Adjusters. It’s far better having a professional interpreting the fine print and the various clauses in a policy as early as possible.

If you do come to us late, after your claim has been thrown out on a technicality, we’ll do our best to renegotiate it. But that will be considerably harder than if you’d contacted us right at the beginning.

Call Us

Why take the risk? For peace of mind, call 0800 999 5679 the moment you have your claim number.

* Your Policy Excess always applies.