Issues found by Loss Adjusters and how to avoid them

Issues found by Loss Adjusters and how to avoid them

Most common issues found by a Loss Adjuster when assessing a claim

1. Inadequacy of Sums Insured, particularly in Business Interruption sections
2. Lack of early mitigation strategies
3. Delay’s in Insured’s providing necessary documentation to progress claim
4. Underlying proximate cause of damage often relates to deterioration or lack of maintenance
5. Unrealistic expectations of policy coverage and response

Easiest ways a policy holder could avoid these common issues

1. Ensuring good maintenance programs are in place and that buildings/equipment/contents are regularly inspected to identify potential issues
2. Having an action plan in place for common occurrences and the steps they can take to mitigate losses, including what they are allowed to do without prejudicing the claim. See back page for tips on mitigating losses
3. Have a step by step guide to what documents and/or level of evidence is required when making certain types of claims, so it can be prepared early to reduce delays. See back page for documents required for different types of claims
4. Making sure they communicate with their broker when there are material changes in the business that may affect Sums Insured

Tips for mitigating losses without prejudicing the claim

What you should do:
1. Call you broker ASAP – Ask for assistance from the insurer as they may be able to send someone to help within a few hours
2. Photos are key – take photos of the damage, it is easier now with the improved quality of cameras on mobile phones

Examples of containing the loss can include:

To stop the cause of the damage
• Call a plumber to stop a leak
• Get a builder to put a tarp over the roof

To stop the spread of the damage
• Water extraction and restoration
• Move stock and contents away from the damaged area
• Start cleaning up

Claim documentation checklist

Property Claims
• Photos of damage
• Report on the cause of damage
• Quotes or invoice supplied for repairs


Machinery Breakdown Claims
• Repair report specifying cause of loss
• Itemised account or quote provided with individual amounts for each part


Burglary/Theft Claims
• Police event number/report
• Proof of ownership (photos, purchase invoice, instruction manual, asset register) (NB. Statutory Declarations are not automatic proof of loss for general property claims. It is best to provide an inventory/asset register that is generally kept on file for BAS/depreciating requirements)
• Equivalent replacement quotes


Glass Claims
• Quote or invoice clearly showing the risk address at the location of loss


General Property Claims
• Police event number/report
• Damage reports
• Proof of ownership (photos, purchase invoice, instruction manual, asset register) (NB. Statutory Declarations are not automatic proof of loss for general property claims. It is best to provide an inventory/asset register that is generally kept on file for BAS/depreciating requirements)
• Equivalent replacement quotes

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