Tag Archives: Loss Assessor

Legal Expenses Cover and Your Home Insurance

Most insurance claims are straightforward. If you’ve had a fire, your home’s been flooded or your roof has been blown off, there shouldn’t be a problem claiming — although the company’s Loss Adjuster may still find a flaw in your claim.

Sometimes, though, an insurance claim can be a lot more complex. You could find yourself having to seek legal advice, or even pursuing or defending a civil action.

This is a problem, since solicitors don’t come cheap. If you have legal expenses cover as part of your insurance policy, though, both legal advice and costs in a civil case would be covered.

How Does Legal Expenses Cover Protect You?

Having legal expenses cover can protect you against legal expenses in a wide range of situations, including:

  • Personal injury or death — If someone is claiming compensation for an injury sustained on your property, your legal expenses will usually be covered up to a specified amount.
  • Purchase or sale of property — You’re protected against expenses from contractual disputes during the sale of a property — with an estate agent or removal company, for instance.
  • Property disputes — The costs of a dispute over boundaries, noisy neighbours, damage to property and similar causes will be covered.
  • Consumer disputes — If you buy, sell or hire goods in your home, your expenses for disputes are covered.
  • Employment disputes — Legal expenses cover can pay the costs for an employment dispute, such as unfair dismissal, involving a tribunal.
  • Tax investigation — You can claim legal costs involved with HMRC investigating your tax affairs.

Legal expenses cover may already be included in your home insurance policy, but if you don’t know it’s there you could lose out. On the other hand, if you find your policy doesn’t include it, perhaps it’s time to rethink your home insurance cover.

 

What Is Non-Standard Risk?

In some circumstances, a normal home insurance policy may not be enough to cover your property. Reasons for this might include a history of flooding or subsidence, or that you’ve been declared bankrupt at some point.

These are defined as a non-standard risk, and the company’s Loss Adjuster may refuse your insurance claim if you only have a standard policy.

Examples of Non-Standard Risk

  • Properties with a history of flooding or in areas affected by extreme weather. You can get help from the government’s Flood Re scheme.
  • Properties that have been monitored for subsidence, landslip or heave, or had their foundations underpinned or reinforced.
  • If your home is used as a business property, as opposed to informal working from home.
  • If your home is going to be left unoccupied for a long period — usually over 30 days, but it’s important to check this.
  • If any occupant has ever been declared bankrupt, has unspent or pending criminal convictions, or has ever been refused insurance or had terms imposed.
  • A property whose roof is made of materials including asbestos, corrugated iron, felt on timber, fibreglass, glass, metal, plastic, shingle or thatch.
  • A property whose exterior walls are made from materials including timber, asbestos, metal, fibreglass, glass, plastic or prefabricated materials. If any part of your property is built from less usual materials, check with your insurance company.

Note that this isn’t an exhaustive list. Always make sure you check your policy carefully and declare any circumstance which could be relevant, or the Loss Adjuster might turn you down if you need to make an insurance claim.

Does Your Home Insurance Cover Neighbour Damage?

Whether it’s cutting off utility lines, damaging garden walls and ornaments, smashing windows or causing leaks, homeowners often suffer damage to their property at the hands of their neighbours. You might think their insurance policy is bound to cover this — but that’s not always true.

It seems quite straightforward. If your neighbour is responsible for damage to your property, they should be liable for putting it right. In fact, this depends entirely on the circumstances.

Just as the loss adjuster could refuse to pay out on your insurance claim if there’s something wrong with it, the same can happen with your neighbour’s policy, even if the damage is to your property. For instance, their loss adjuster could decide a leak was caused by poor maintenance to their home and refuse to pay.

That will leave you with the choice of trying to get your neighbour to pay out of their own pocket or trying to claim on your own home insurance policy — assuming, that is, that neighbour damage is covered. The key here is “insured perils”. Home insurance policies generally include these, referring to certain events such as fire and flood. If the cause of the damage can be attributed to an “insured peril”, then you may be in luck.

It’s also worth checking whether your policy has accidental damage cover, which may cover this sort of situation. Some policies have it as standard, but if not you can usually add it on for a premium.

Neighbour Negligence and Record Keeping

Even assuming your neighbour’s insurance policy does cover the damage, you’ll need to be able to demonstrate that they were responsible for it, whether through negligence or simply because the fault began on their property.

Prevention is better than cure, and assuming you have reasonable neighbours, they may be quite willing to fix the problem but simply not have noticed. So let your neighbours know about any damage you spot, and you could not only save yourself a lot of hassle in trying to get the repairs paid for, but also avoid the bad feelings that arise from a dispute over money.

However, it’s also vital to start keeping records of any damage as soon as it starts to develop, including notes and photographic evidence, all carefully dated. That way, if your neighbour still fails to take action after you’ve warned them, this will help you demonstrate that they were negligent.

And, just in case none of this works, check your own insurance policy.

Building Insurance and Subsidence

Subsidence doesn’t only involve spectacular holes that make the news. Any building in an area where the soil has a high clay content could be at risk of subsidence.

Of course, insurance companies know all about this, and if your home is at higher than normal risk of subsidence, your insurance policy will include a higher excess than normal. In fact, most policies specify a higher excess for subsidence than other risks.

Avoiding Subsidence

If you live in an area like this, the best way to avoid having to negotiate with the Loss Adjuster for a subsidence insurance claim is not to plant large trees or shrubs near the building. However, if there are already trees when you move in, you may need the Council’s permission to cut them down, so you’ll need to talk to them first.

It’s not always just a matter of cutting down the obvious trees, though. Allied Claims have encountered cases when repairs have been made only for other trees to cause more subsidence. In any case, trees aren’t the only reason for subsidence. Leaking drains beneath or near the house can also be a cause.

After subsidence has occurred and been confirmed, the first thing is for the cause to be determined. This is likely to involve a period of monitoring, which can be for as long as eighteen months, before any repairs are made. Only when you know all the facts can Allied Claims present your case to the Loss Adjuster.

Building Insurance for New Builds

It’s important at any time to be sure about what you’re insuring your home against, but it becomes even more complex if you’re moving into a new build. At Allied Claims, we sometimes come across policy-holders who’ve lost out on insurance claims for new builds because they’ve confused NHBC with building insurance.

If you’re buying a new build, it’s vital to ensure that the builder is registered with the National Building Council (NHBC). This will mean your home is covered by Buildmark, a ten-year warranty.

Any structural damage will be covered by Buildmark for the full ten years, although other damages and defects have to be claimed within two years of buying the property. Buildmark is a warranty on the building itself, and can be transferred to a new owner if it’s sold within the first ten years.

The problem is that many owners of new builds seem to assume that their NHBC warranty is equivalent to a full building insurance. It’s not. The warranty is only valid against damage and defects that stem, directly or indirectly, from the builder’s errors. Anything external that happens to your property, from subsidence to being hit by a lorry, is outside the NHBC terms.

For any incidents of this kind, you need a regular building insurance policy. You’ll still have to convince the insurance company’s Loss Adjuster to pay up (that never changes) but without building insurance you could be left to pay for the full repairs yourself.

Ensure You Have Correct Cover for Your Building Insurance

There are many reasons for clients calling us in to act as Loss Assessor for their insurance claim. All too often, it’s because the Loss Adjuster has told them they’re under insured and has invoked the Average clause, meaning they’ll be paid less than expected.

This most often results from using an old valuation in the insurance policy. It’s not unknown for a 30-year-old valuation to be used, though in today’s volatile property market even a two-year-old one could be worthless. This will mean the building is under insured, and the Loss Adjuster will only allow a proportion of the insurance claim.

When you’re establishing how much to insure a building for, first find out the current building costs that would be required, either by speaking to a local contractor or by checking the RICS (Royal Institute of Chartered Surveyors) website.

Then add a few percentage points — we all know this figure will have increased by your next renewal date.

You also need to take account of any additions or alterations. In any case, the policy holder is obliged to inform the Insurer if any alterations are about to be made. It could help you, too, if you need to take legal action against a contractor for causing damage through bad workmanship.

And finally, remember not to include the value of the ground in your building insurance. You’re insuring the building, not the ground it’s built on, and you’ll be paying extra premium for nothing.

High-Value Possessions — How to Make Sure They’re Covered by Your Insurance

Our last newsletter, on setting the right level of contents cover, seems to have sparked a lot of interest, judging from the questions we’ve received. Many of these have been about the thorny issue of high-value possessions.

What Are High-Value Possessions?

Put simply, a high-value item is any possession valued at above the allowed level specified in your insurance policy. Most people think in terms of jewellery and watches, but it could be books, art, collections, equipment or even clothing. And they’re not only at risk of burglary. Fire or flood can destroy possessions of high monetary or sentimental value.

You may have some idea of the value if you’ve bought the item yourself, though it may still be higher than you thought, but if you’ve received it as a gift the chances are you won’t know the value. If you’re in any doubt at all, it’s best to get items valued, and they should be specified in the policy if they’re above the value — otherwise, the Insurer’s loss adjuster is likely to refuse payment for them.

In almost every case Allied Claims comes across, the policy-holder assumed it would never happen to them. In one recent case, for instance, the claimant lost out on an entire £91,000 claim because they were under-insured and hadn’t specified several high-value items.

How Do I Make Sure I’m Covered?

It would be easier if there were a one-size-fits-all procedure, but the reality is that each Insurer has different criteria for what constitutes high value and what kind of proof you need for claiming. It’s up to you to check this, but the basic steps that are usually needed are:

  1. Identify the high-value amount per item set by the Insurance Company.
  2. Disclose and itemise each relevant piece in the policy.
  3. Photograph each item and keep all the photos in a safe place.
  4. Keep the original invoices if you’ve bought the item yourself.
  5. Have valuations done every few years for each item by a reputable dealer who knows what they are doing.

This won’t necessarily be all, though. The Insurer may well impose extra conditions, such as burglar alarms and safes, or they could require particular items to be kept in a safe depository. They need to be aware of the value to determine what’s necessary, though, and if you don’t inform them your insurance claim could be invalid.

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.