PNP Group offers a unique tailored approach to addressing specific circumstances surrounding an incident or event, and maximising insurance claim support. When lodging an insurance claim there are several key steps that need to be undertaken to ensure your claim is lodged correctly. It is important all these steps are followed so that your claim is settled in your best interest rather than the insurer’s shareholders.
Gather Evidence and Information
When claiming insurance after an event it is essential that accurate and detailed information about your event is collated, to ensure that appropriate information is available for the necessary paperwork. It is important to keep a detailed record of the incident including videos, pictures, location, and an accurate description. If other parties are witnesses to the event, it is also important that their information is collected, as the insurance company may need to speak to them regarding the incident.
Ensure you have read and understand the Product Disclosure Statement (PDS)
With all insurance policies, there is an accompaniment known as a Product Disclosure Statement, which details what is and is not included within your insurance policy. This is important in relation to the filing of your claim, as it details whether the circumstances of your claim are eligible for insurance coverage. Within the PDS, there are also usually exclusion clauses, which outline certain circumstances under which the claim will not be covered. It is also important for you to be aware that there may also only be partial coverage of the claim, in this case, additional costs will need to be covered. If you have any questions about the Product Disclosure Statement, it is important that you contact your insurance provider for clarification.
During this time, it is also imperative that you speak to your broker, lawyer, or contact PNP Group to ensure that your policy will respond to the event or incident.
File your Claim with your Insurer
When filing a claim with your insurer the appropriate channels to follow are usually stated on their website through the claim form. Before lodging your claim, it is important to ensure that you have all necessary documentation, in the form of paperwork and evidence that the insurer may ask for. When filing an insurance claim, it is important that correct terminology is used. In the case of phone calls, it is important to be aware that all calls to your insurance company are recorded for training purposes, but also any information you give may be reverted. If you are not confident or unsure about certain aspects of the incident, your insurer will engage assessors and relevant experts to address and assess the damage. When referring to matters relating to property damage it is recommended that a builder or consultancy firm is contacted to assess if the matter falls within the insurance policy.
It is important when filing an insurance claim you ensure that the claim is accurate so that it expedites the policy response process. To do this, we recommend examining the amount you are eligible to claim in comparison to the excess amount you are liable for. It is also recommended that you refer to the General Insurance Code of Practice, to gain a better understanding of your rights and the timeframes in which the insurer must respond to the insured. In the event you are not confident with lodging the claim, you can appoint a person to represent you or your business in relation to the claim by issuing an authority to act. Alternatively, if you have a broker, your broker will lodge the claim on your behalf and cross check the information.
After filing your Insurance Claim
After filing your insurance claim within a specific timeframe, your insurance claim must contact you to either reject, approve or inquire for further information. If your claim is approved, the insurance company must provide a clear timeline for when the issue is to be rectified. For any rejected insurance claims, your issue must be rejected in writing. In the case of rejection, it is recommended you seek independent advice before activating the dispute resolution process.
If your claim is initially denied through the insurers dispute resolution process, you have the rights to contact the Australian Financial Complaints Authority (AFCA.) Using the General Insurance Code of Practice, it is imperative that you also monitor and detail the consequential impact of the insurance event. If insurers are not responding in a fair and reasonable time frame, this can additionally be lodged within the claim. If you are successful in your lodgement for ACFA, these items can be compensated in some cases whether inside or outside the policy.
How PNP Can Help
The PNP Group are leading experts that work in the certification of business, products, and facilities. Working across different industries allows us to draw on a substantial amount of knowledge, experts, and case matters to support the insured with evidence and reports that the insurer takes note of. We provide clients and their brokers with support in claims assessment, preparation, project management and business interruption where applicable. We ensure the claim settlement is in your best interest and not the insurer’s shareholders. PNP Group strives to achieve the best results for our clients, going above and beyond to achieve the best outcome in your interests.
To learn more about our work in insurance claims management read more here: https://pnpgroup.co/2022/06/happy-client-settles-with-a-six-figure-insurance-claim-payout-after-a-six-year-fight/