This article looks at why insurance companies are not paying out on as many claims as they normally would, why inflated claims are not usually due to policyholders being greedy and how insurance companies can reduce costs by settling promptly.

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Insurance payouts on the decline

The Money section of The Sunday Times confirmed that insurers are using the current climate as an excuse to decline more claims than they normally would. The report confirms that 41% more claims are being needlessly declined, and this suggests a shift by all insurers to look at things with a “fine tooth comb”. The Association of British Insurers argues that insurance companies are always willing to pay valid claims quickly and speedily.

However, the Association of British Insurers do not deal with claims on a daily basis… I do, and I can confirm, categorically, that insurance companies are using any excuse and making people fight to get what they are contractually obliged to. Yes, your insurance policy is a contract, and they should be honouring the terms and conditions, rather than using spurious clauses to avoid making a fair settlement.

Someone is going to draw their weapon… smallprint?

One of the examples The Times reported was when an insurance company tried to decline paying a claim for damage caused by a water leak, by referring to woodworm that was found in the floorboards where the damage occurred. They stated that woodworm was not covered by the policy, and they are right. However, the claim was not for damage caused by woodworm, it was for damage caused by a leak, which every policy covers, unless there is a specific exclusion due to previous claims or unusual circumstances.

There is a good reason why this happens so often. Regrettably, people who are involved in the claims process sometimes make simple situations far more complicated than necessary. In this particular case, the builder decided to mentioned woodworm in their report, encouraging the home-owner to have the woodworm repaired. On one hand, you can’t really blame a contractor for mentioning it. On the other hand, small print in the insurance contract meant that the home-owner initially didn’t get paid for something they should have been paid for. Fortunately, they didn’t give up.

Can’t we all just get along?

A better way to deal with it would have been to issue a report on the water leak, and issue a separate report for the woodworm, or estimate for fixing the problem. Sometimes the insurance company appoint contractors, and whenever they do, my head starts to hurt. Recent cases I have dealt with include an appointed inspection company visiting a premises three times because they failed to carry out a correct “validation” on the first and second occasions.

Our nationwide Insurance companies and local contractors can, and should be encouraged to, work together quickly and cohesively, in order to help their mutual clients, because they are clients to both parties. Local work keeps costs down and quality contractors work hard because repeat business is really important to them. Insurers only make a profit on repeat business so it makes more sense to keep clients happy instead of leaving them hanging.

Wrap up: The Times article finished off by recommending that policyholders enlist the help of their insurance broker. I would not recommend anyone to report any claim to any insurance company, until they have taken the advice of someone who understands why insurers decline claims, and can make sure it never happens.

Top Tip

When you are choosing any insurance always call the claims line before you make a purchase. This will give you clues as to how your claim is going to be dealt with, especially if they fail to answer the phone quickly, put you in a call queuing system, fail to call you back, or are downright ignorant. It is the claims department who will ensure that you get what you deserve, so it makes sense to try before you buy.

Who to share this with: SME Business Owners & Contractors.