Why you should have a Loss Assessor represent you

Insurance claims are major business for lawyers, builders, salvage companies, Insurers, brokers, bank managers, Revenue, the Gardaí and loss assessors and loss adjusters alike.

Even though the vast majority of property and injury claims settle perfectly fairly, there is major fraud happening on both sides of the claims process.

 

 

 

 

 

 

 

This has been going on forever and will continue. The honest claimant is therefore at a major disadvantage in the claim process.

This is for a number of reasons – Insurers write the policy and they dictate what is insured but more importantly what is not insured. Insurers define the claim management process, they use experts and are experts in managing that process and their expertise is supporting their position. It is not in the interest of the Insurers to make it too easy.  Insurers adopted the position for many years that the claim process was under their total control and that the loss adjusters acted purely for the Insurer and in fact that the insured was not entitled to independent professional advice.

The game has changed to some extent but there is further to go.

The Consumer Protection Code went some way towards rectifying this position. It has not solved the problem fully.  It does require Insurers to notify the claimant that they are entitled to professional advice but at their own expense, i.e. it is not an insured fee.  Ironically, this is an area that insurers can, and in some cases do, actually cover in the policy – but they are few and far between.  The Insurers that do cover the fees generally try to control who they pay for, and at what price so it may not be a decision for the claimant to make in their own interest.

 

 

 

 

 

 

 

In my view, it is grossly unfair particularly in larger claims where the costs of processing the claim are driven up in many cases by the Insurers’ investigations.  It is wrong that the claimant who has suffered loss and damage to their property or business should have to bear this cost (loss assessors fees), when it is in consequence of the insured event and therefore should be insured.

It is absolutely clear that the claims process is extremely complicated.  Even a chimney fire today could involve a broker, an lnsurer, a loss adjuster, the fire brigade, and various builders who quote for repairs.  CCTV reports to clarify the extent of damage to the chimney flue possibly even forensic investigations in some instances. The only party who can co-ordinate this with the Insured’s interest in mind is the Loss Assessor.

It is most unreasonable for anyone to expect a person who works in a factory or the owner of a hotel business to understand all the complexities of an insurance policy.

It is a fact now that insurers are reviewing claims history, disclosure at inception of the policy, the cause of the damage, the likely cost of the claim, forensic investigations and many more aspects of the claim before accepting liability and offering to pay any money.

These processes can take many weeks at least and many months at worst.

 

 

 

 

 

 

 

In the past 10 years in Ireland even though many many claims are settled and paid by insurers and people are generally satisfied, there are equally many claims that end up in the in the Courts or Arbitrations.

Insurers have not, in the recent past, covered themselves in glory, the issues that FBD had in relation to the rebuilding of many of their clients chimneys in private houses hit the headlines a number of years ago.  The work was grossly unsatisfactory and it was identified by Engineers that some of the repairs were actually dangerous. This clearly was an exercise by Insurer in saving money that backfired.

We have also recently heard about the RSA issue with claims processing and reserves and how that impacted on the revenues for the company throughout Europe. It is also less known that this approach to processing claims actually filtered down through to the loss adjusters and claims handlers and the whole claim process in RSA slowed down dramatically and became grossly unsatisfactory.  The Chief Executive lost his job in consequence but that didn’t help the unfortunate whose house burnt down or flooded.

We are also all well aware of the Quinn Insurance methods and approach to their client’s claims and how the public view of the claim process in Quinn insurance was far from acceptable in the context of the requirements of the Consumer Protection Code and the needs of somebody whose house just burned down – had a mortgage – in negative equity – and there no access to alternate funds.

This is when you need your insurers to be on side and honouring the contract fairly and fully.  The doctrine of “utmost good faith” applies to insurers as well as insured but if you are on the wrong side of that issue, it is virtually impossible for a person making a claim to even consider trying to argue that point legally.

Cleary’s have found in the recent past that if your Insurer is causing problems in the claim process, where slow decisions of acceptance of liability or investigations going on for months and months – it is extremely stressful & highly technical.  This brings a financial pressure on the claimant that may force decisions one would otherwise not take.

We have a case in process at the moment where Insurers instructed loss adjusters to visit the site on day 2 after the incident. Loss adjusters reported within 2 weeks to Insurers. On day 16 a forensic investigator was appointed who visited the site, interviewed witnesses and also reported to Insurers and this took a further 4 weeks.  Four weeks after that, we heard from the Insurer’s lawyers asking further questions and looking for further detail about the site and the circumstances of the fire.  We believed complete detail had been presented already to the previous two parties.  A letter then arrives from that the lawyers looking for further detail giving us another six weeks to reply.  While all of this is going on, liability had not been accepted and the six figure loss is impacting on the client’s business. The client cannot make decisions because the Insurers have neither accepted liability nor repudiated liability.  It is now week 16!  The owner does not know where he stands.  He may actually prejudice his own position if he pays for the repairs himself.

This highlights the inadequacy of our current Consumer Protection Code and indeed the claim processes.  The only message is to get your representation early and hope that all goes well.

Sean Cleary
Managing Director
Clearys Claims ManaWhgers

2009 Storm & Flood Commentary

Clearys Claims Managers

In 2009, the whole country experienced severe flooding and storm damage.

It was called the worst event in 50 years – indeed, some suggested it was the worst in living memory. Global warming was blamed for the damage or, at least, for having contributed to it. Bad planning and development were also highlighted as causes for many of the properties affected.

Today, only 6 years later, things are as bad as ever – worse indeed, given that the proportion of properties having flood insurance cover is much lower now than it was in 2009.

Following the flooding in 2009, many buildings were repaired with the money paid by Insurers making buildings habitable, comfortable and usable again. Little thought was put into preparing for similar occurrences happening again and certainly not only 6 years later.

This is a tragedy.

Clearys have come across numerous cases of flood damage where there is no insurance cover this time around. TV programmes and interviews are highlighting the extremely difficult circumstances this type of slow, insidious, destructive damage has inflicted on many unfortunate householders, farmers and businesses. Others in vulnerable areas, though not yet affected, are fearful for the future.

Securing assistance from the state is a possibility but the funds available to successful applicants are very low. Even at that, compensation is available only to those who do not have insurance cover and have suffered clear and specific damage. The Irish Red Cross are also distributing funds and humanitarian aid to people exposed to flooding but similar limitations apply to that scheme.

After the 2009 event, there was much work done by the state, through local authorities and the Office of Public Works. Defined areas which would be categorised as flood zones for national flood mapping purposes were identified. The insurers then availed of this service and either withdrew flood cover for property in these areas or hiked premiums for those who were “lucky” enough to be offered cover. Of course they would – what would you do?

The ball was then dropped by the state. No planning was put in place to deal with the obvious: what would happen to all those areas and their inhabitants, businesses and farm owners when flooding returned? Far fewer of them would have insurance cover next time around.

The Irish solution to this Irish problem was for government to call a meeting with the insurance industry after the horse had bolted. Clearly, for many unfortunate victims of recent events, there was no access to funds, allied to which they had the worry and stress of possible further recurrences with no prospect of cover being reinstated. Even if cover was available, it would be prohibitively expensive.

It appears to me that a possible solution for the state, property and business owners, insurers and, indeed, charities is to define a plan for residents and businesses that are in this “Catch 22” situation: Let the state assist them in buying insurance cover going forward and stop all future development, without appropriate flood protection, in these areas.

This scheme could include loss of profits cover for farmers and businesses. Cover could be capped so the potential recoveries deal with ‘humanitarian’ issues if they arise. The claims would be dealt with by the insurance industry. The state would have no involvement in the process nor would the charities.

Ultimately, it should be clear to everyone that continuing to reside in flood zones carries a risk and that, over time, people should have the choice and wherewithal to move away from them.

Such a scheme would mean that the cost to the state could be evenly spread over time and insurers could remain on the pitch with all the structures to deal with this problem at no additional cost to them.

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Prepare for strong winds and cold temperatures this winter

Follow these tips to help prepare for high winds and freezing temperatures this winter.

When strong winds are forecast:

  • Make sure that the property is well maintained and drains are cleared regularly
  • Roofs should be inspected regularly for loose slates/tiles and poor guttering.
  • Trees should be maintained and dead/vulnerable branches should be removed.
  • Outdoor items such as patio heaters, furniture, barbeques, bins and animal feeders should be secured or securely stored.
  • Gates, doors, sheds and fences should all be closed and locked.

What you should do after a storm:

  • Contact Clearys Loss Assessors on 1850 28 1850 to register any claim for damage and any discuss repair work required.
  • Do not re-enter structurally damaged buildings until advised that it safe to do so.

article-2530915-1A586FB200000578-664_964x641Preparing for freezing temperatures:

A burst pipe in your attic, if unaddressed, can be as devastating as a flood through the front door. It probably represents the greatest risk posed to your home by freezing conditions. Freeze thaw action can also cause structural damage.

How to prepare for the freeze:

  • Lag/insulate outdoor pipes, attic tanks and supply pipes.
  • If a property is unoccupied, the water should be shut. Run the hot taps to drain the attic tank. If your home is unoccupied for any period during cold weather, leave the heating on to protect pipes from freezing and bursting.
  • Open the attic door to allow heat into your attic. This helps to prevent the pipework and tanks in your attic from freezing.
  • Leave the underside of the attic tank un-insulated to allow warm air to reach the tank.

In the event of a burst pipe:

  • Turn off the water supply immediately.
  • Turn off water dependent appliances including your boiler.
  • If the water leak is from the attic/above ceiling level, turn off the water supply and turn on all hot taps to drain remaining water out of attic tanks as quickly as possible.
  • Engage a professional immediately to stem any flow and make repairs to prevent further damage.
  • Report the incident to Clearys Loss Assessors immediately and do not effect any permanent repairs until all damage has been assessed and repairs are agreed with us.
  • If appliances are affected, turn off the power at the mains board if safe to do so.

In the event of a leak:

  • Retain all damaged material as it may be crucial to establishing the nature of loss, assessing damage and validating your claim.
  • Contact Clearys Loss Assessors on 1850 28 1850 to register any claim for damage and to discuss repair work required.
  • Ventilate, gently heat and dehumidify the property.
  • Do not re-engage utilities until they have been checked by a competent and qualified professional.

What you should do if your property is affected by frost damage.

Frost damage is one of the risks of property ownership that many people overlook. Of course, if your property is well constructed and you live in a temperate climate, you probably don’t have anything to worry about. But even so, the last few winters in Ireland have been especially harsh with more and more incidences of frost damage occurring. So what should you do if your property suffers from frost damage?

Frozen Pipe

The most detrimental side effect of frost damage is burst water pipes, especially underground pipes. Not only can this lead to further problems such as high water bills, but there is no way of telling where the burst is or how bad it is without the help of some expert professionals, so it pays to be prepared. As a preventative measure, you should ensure that your property is adequately insulated, especially the roof. You should also consider insulating the walls.

In the event of frost damage, it is vital that you turn off all taps completely, as drips can freeze and block the pipe, adding further hold-ups and possibly damage. Also ensure that all stop taps and valves have been switched off or closed. Next, you should thaw any exposed pipes by placing a cloth soaked in hot water over them, or alternatively, a filled hot water bottle. Do your best to keep the property warm; use electric heaters if you have reason to believe your heating pipes may be damaged from the frost also (although this is unlikely if the heating been used recently).

The next step is to contact an underground leak detection professional who can search for any inaccessible pipe damage. At this point, you should also contact a loss assessor who will visit the property, gather records and make an inventory of damage, estimating the amount of losses as a result. Once the loss assessor’s survey is complete, you can submit an insurance claim and commence repair works; however, be sure to keep records of what repairs are carried out and all details about them, as this will aid your claim.

Once any damage has been repaired and your insurance claim has been processed, it is worth investing in pipe insulation to avoid a repeat occurrence. This is best done after the adverse weather has improved so it can be completed without delay and will not have any further impact on your property.

What to do in the event of an escape of water below ground.

An escape of water below ground usually comes in the form of burst pipes or damaged plumbing systems which cause damage to properties either by water seeping into the building from below, or in less severe cases, by affecting water pressure and flow in the plumbing system of the property.

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In both cases, if the problem is left unnoticed or unfixed in the long term, significant damage can occur. If such an incident occurs, here is some advice on how to handle the situation:

  • Find the location of the leak (or leaks): This should be done by a plumbing professional. The operator will locate any leaks by closing off controlling valves, which will reduce or stop the flow to the affected water main. At this stage you will have a reasonably accurate idea of the impact and severity of the escaped water. Once this has been done, shut off the water valve until repairs have been completed.
  • Find what caused the leak: In the case of water escaping below ground, this could be many things; the age of the pipes and material they are made from, soil conditions that may have caused corrosion of the pipes, ground or water temperature causing the pipes to expand and contract, or changes in water pressure exacerbating weak spots in the pipes..
  • Making an Insurance Claim: Most insurance policies will cover escape of water claims. Contact Clearys Loss Assessors to get a professional account of the damage. Take photos or videos of the affected parts of the property as soon as possible, in case there is a delay in arranging for the assessor to visit the site. He or she will take a full record of all damage and the losses inflicted in order to process an insurance claim. Contact with the loss assessor should be made as soon as possible, preferably before repair works have begun.

In cases where below ground escape of water has been occurring for years, subsidence can be a problem. This is when the soil under the property’s foundations has become unstable due to water washing away the soil particles. As a result, the foundations of the building begin to subside. A thorough check on this should be carried out in any significant case of escape of water below ground.

Drying up your home after the floods is a challenge

The Office of Public Works recently published a guide to restoring your home or business from the recent floods in Ireland.  We suppose that almost a month after the disaster the initial restoring works like cleaning are already done, but if you still struggle with the longest process of all – drying you place, then we can help you. Here is a short guide to how to deal with remaining water or moisture in your home or business building.

House Flood

Air circulation is the best way to dry out a property and clear the air inside. Be patient and make sure the property is completely dry before you move back in.

Some Do’s and Don’ts:

  • Do open your doors and windows to ventilate your home.
  • Do ensure your house is secure.
  • Do unblock airbricks and vents.
  • Do wash your hands with disinfectant if you came into direct contact with water.
  • Do check external walls and the roof for structural damage before entering a property.
  • Don’t attempt to turn on any services until they have been checked by an expert.
  • Don’t attempt to move any heavy or unstable objects by yourself – get help.

Drying the property:

  • You can allow your property to dry naturally, but that can take months. Forcing the drying process can speed it up so that it only takes a number of weeks. Whatever way you choose to dry your property, make sure that the moisture trapped within the structure of the property is removed. Sometimes the walls may feel dry on the outside but they are still damp internally. If in doubt get a professional in to ensure that your property is completely dry.
  • If your heating has been tested by a professional and is certified safe to use, it can be turned on to help dry the house. Keep the temperature at around 20 to 22 degrees celcius. Excessive temperatures should be avoided as rapid heating may lead to cracking of plaster work, etc.
  • Be aware that temperature alone will not dry your property. Air circulation and humidity are critical factors to consider.
  • Good ventilation is essential so keep windows and doors open during good weather and ajar during wet weather.
  • If you are using a dehumidifier leave external windows and doors closed, especially during wet weather.

If you haven’t still contacted you insurance company for a claim settlement, you can always first refer to an expert loss assessors company like Clearys Loss Assessors. Hence, you might get an additional advice and guidance for obtaining a better settlement.

Central Bank publishes findings on Household Property Claims in Ireland

At the end of October 2013 the Central bank of Ireland published a report with findings of a themed inspection into household property claims resulting from water damage.Given the increased frequency of floods in recent years the Central bank considered it important to make an inspection of the compliance with the Consumer Protection Code (the Code) between 1 July and 31 December 2012 in 10 of Ireland’s largest non-life insurer’s (approximately 90% of the Irish property insurance market).

With regard to this inspection the Director of Consumer Protection, Bernard Sheridan  said that the  Central Bank expects all regulated insurers to work in the consumer’s best interest by selling suitable insurance policies, providing clear information and handling claims properly when they arise, directly or through a third party such as a loss adjuster. He expressed concern by the findings of this inspection which show a lack of transparency around the claims retention policy and policy terms that consumers need to be aware of at time of purchase and when making a claim.   The Central bank considers that policy booklets contained a number of terms and conditions which may not be fair or transparent to consumers.”Consumers can often feel vulnerable when they experience damage to their home and that it is important that firms deal with their claims in a prompt and fair way.  ”  said also Mr. Sheridan.

One of the most important findings from the review were that most common reasons for insurers declining claims were either no insured peril or wear and tear that had occurred to their property, e.g. the sealant on a shower tray having fractured over time.  It was also noted that many consumers had withdrawn their claim on learning that an excess of up to €1,000 would be deducted from any claim settlement offer, as well as the impact that the loss of no claims bonus would have on future renewal premiums.

The Central Bank also considered that insurers’ policy booklets contained a number of terms and conditions which may not be fair or transparent to consumers, and therefore insurers have been requested to review aspects of their respective policy booklets. Examples of the terms that insurers were asked to review include references to policy excess amounts or administrative fees without actually stating how much these are or where the consumer can find this information and failure to include information about retaining a portion of the settlement until after reinstatement will be a condition of the claims settlement agreement.

A review of insurers’ policy booklets revealed that only one of the insurers clearly describes the practice of retentions in its policy booklet. All of the insurers have a practice whereby a retention amount may be applied to a claim settlement offer and typically the retention withheld would be between 20% and 30% of the settlement amount.  In order for a retention amount to be paid, consumers are required to provide either receipts, invoices or other proof that the repairs have been fully completed.  The Central Bank noted that 23% of the monetary amount of all household property (water damage) claim retentions applied by the 7 inspected insurers during 2012 were never claimed by the consumer.

What Clearys advises you is to always read very well your insurance policy and in case you have any doubts or ambiguity, do not hesitate to contact a loss assessor.

Electricity -the major cause of accidental fires

Government statistics show that electricity causes more than 20,000 fires a year – almost half of all accidental UK house fires. Each year, about 70 people are killed and 350,000 are seriously injured due to an electrical accident in the home. Although many incidents are caused by faulty appliances rather that the electrical installation itself, a properly-installed and well-maintained installation could significantly reduce the possibility of an accident or injury. So, it is important that any electrical installation work is carried out only by people who are competent. This means people who have the knowledge, skills and experience needed to avoid dangers to themselves and others that electricity can create. It’s easy to make an electrical circuit work – it’s far harder to make the circuit work safely.

How old is your wiring?

Electricity is usually out of sight, out of mind because cables are conveniently hidden inside our walls and switches and sockets. So it’s not surprising that we forget to check our electrical installations for wear and tear. Faulty and aging wiring is one of the major causes of electrical fires in the home. You can avoid these by having regular checks carried out on the condition of your cables, switches, sockets and other accessories. There are clear signs that can help you tell the age of electrical installation in your home. These are:

  • Cables coated in black rubber (phased out in the 1960s);
  • Cables coated in lead or fabric (before the1960s);
  • A fusebox with a wooden back, cast iron switches, or a haphazard mixture of fuse boxes (before the 1960s);
  • Older round pin sockets and round light switches, braided flex hanging from ceiling roses, brown and black switches and sockets mounted in skirting boards (before the 1960s); and
  • Wall-mounted light switches in bathrooms (before the 1960s).

Another reason you need Professional Representation!

This article is from the Independent newspaper on Tuesday 22nd April, 2013 and shows how policyholders are shortchanged by Insurance Companies.

http://www.independent.ie/irish-news/insurance-firms-not-offering-claimants-full-entitlements-29211793.html#comments

Contact Clearys on 1850 28 1850 is you feel you need help with your insurance claim.