"Most insurance claims run relatively smoothly. But there are certainly times when an insurer will dispute a claim, or attempt to apply a clause that reduces or denies their responsibility.
"It's times like these that having 32 years of experience, 19 of them as a Claims Manager, really pays off. Especially when the stakes are high for the client. For example, several months back, an insurer argued that our client was not adequately insured for their $6 million fire claim, and endeavoured to apply the 'Co-Insurance Clause'.
"This would have left the client $2.5 million out-of-pocket.
On behalf of our client we put a case to the insurer stating that they were incorrectly applying this clause in the policy.
The basis of settlement applying to this clause was based on Declared Values for all Property Insured not individual sections of the property. Therefore our client was adequately insured and subsequently the insurer accepted our interpretation of the policy wording.
The client was paid in full for their loss sustained which allowed them to re-establish their business as soon as possible.
It highlights that unless your broking firm's claims team is fully conversant and experienced with the technicalities, you may not receive your full entitlement under the policy.
In another case, we argued successfully to win a claim for $11,600 on damage to a customer's motor vehicle arising out of faulty workmanship. The insurance loss assessor had obtained incorrect information that led to the insurer denying the claim.
We met with the underwriter questioning the basis of the rejection and were able to show them evidence that the initial work was carried out by our client's employee, not the sub-contractor who only rectified the damaged sustained.
Hence the insurers correctly overturned their original decision and our client's claim was paid in full."
"Unless your broking firm is fully conversant with all the technicalities, you may not receive your full entitlement under the policy..."