Reimbursing your loss

If you follow all the necessary procedures when filing your insurance claim, there's every reason to hope it will be settled efficiently

It is important to notify your insurance company or agent as soon as possible about your loss 

Policyholders often receive less than they expect from insurance policies because their property is not insured to value or they do not understand exactly what type of damage is covered. However, there is another often-overlooked problem that not only causes them to receive less than what they should but also delays reimbursements for their losses - the claims process itself.

On the face of it, filing a claim and getting reimbursed should be fairly straightforward. An incident occurs, you notify the insurer and file a claim, an insurance adjuster investigates the claim and you get reimbursed. However, it almost never works out that way and that is almost always because of something that has been forgotten somewhere along the claims process.

Immediately after a loss

Although it may be difficult to regroup and collect your thoughts while coping with a disaster or event like a break-in, it is important that you notify your insurance company or agent as soon as possible about your loss. If you must vacate your home, leave word of where you can be contacted. This is important, especially in a major disaster, as it ensures the insurance company representatives will be at the scene of the event soon and can liase with you, thereby speeding up the handling of your claims.

It is imperative that you file a police report as well, as this will be a necessary component in your claims process. If it is a fire claim, you would also need a report from the fire department. The insurance company will then assign an adjuster whose job would be to give an impartial assessment of the losses you have suffered. This includes investigating and coordinating the claim process and quantifying the loss.

Since the adjuster is primarily responsible for determining the fate of your claim, it pays to make his or her job easy. Present your claim as convincingly as you can, offering supporting data whenever possible, especially on higher-cost items. Also, as adjusters are usually handling dozens of other claims on top of yours, it always helps to be pleasant and straightforward in your dealings. If you need to make temporary repairs to protect your property from further damage while the authorities carry out their investigations, keep the receipts, as you would need them to justify your claim.

Preparing for the adjuster

The more information you have about your damaged possessions - a description of the item, the date of purchase and what it would cost to replace or repair - the faster your claim can be settled. 

Make a list of the damaged items. If possible, take photographs of the damage, and put together a set of records - old receipts, bills, even photographs - to help establish the price and age of everything that needs to be replaced or repaired. Write down brand names and model numbers of appliances and electronic equipment.

Even seemingly inconsequential items like clothing, tools and hobby materials should be listed down. Do not throw out damaged furniture and other expensive items, as the adjuster will want to see them. If your property was destroyed or you no longer have any records, you will have to work from memory. Try picture the contents of every room and then write a description of what was there. Try also to remember where and when you bought each piece and about how much you paid. It would also speed up the settlement of your claim if you find out how much it will cost to replace the destroyed items.

Try and identify the structural damage to your home. Make a list of everything you would like to show the adjuster - for example, cracks in the walls, damage to the floor or ceiling and missing roof tiles. If you estimate that there may be structural damage even though you cannot see any signs yet, discuss this with your adjuster. You should also get the electrical system checked. If possible, get written bids from reliable, licensed contractors on the repair work. The bids should include details of the materials to be used and their prices.

The more cooperative you are, the simpler the adjuster's job (and the faster your claim will be processed). If all the paperwork and claims are in order, an adjuster should be able to file a preliminary report within two weeks. Be sure to keep copies of the lists and other documents you submit to your insurance company. Also keep copies of whatever paperwork your insurance company gives you.

Payment of claims

If all goes well, your insurance company will send you a letter of offer for settlement within seven days of the adjuster's final report. If you are happy with the amount offered, all you need is to accept the offer and the cheque will be presented soon after - usually within 14 days. But if you are unhappy with the final sum offered based on the adjuster's report, there are channels of appeal.

You should, however, bear in mind that if you have under-insured your property, the insurance company been only pay you an amount proportionate to the value insured as opposed to the actual value. In these cases, the lower payment is necessary as you are treated as your own insurer for the under-insured amount.

But if that is not the case, you could appeal to the insurance company, which would most likely study your claims again. If you are not satisfied, you could also approach the Insurance Mediation Bureau (IMB). In fact, it is the duty of the insurance company to inform you of your right of appeal to the IMB if it declines your claim. However, this is subject to the amount of claim not exceeding RM100,000.

Failing all that, you could ask for arbitration - which is an expansive and time-consuming process. As a consumer, you also have the right to take the case to court for the amount you are claiming. However, these are all costly affairs and the insurance party would most likely prefer to settle directly with the claimant - who has probably suffered enough trauma from the disaster - on a fair and proper compensation of the actual loss. After all, the objective of insurance is to place the insured in the same financial position immediately after the loss.

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^ Article extracted from NST Property Times - Signed&Safe