Insurance Claims

Unfortunately many problems can occur in your home which will incur costs to remedy, some of which might be covered under your insurance policy, so it is important to fully understand your Insurance policy and what to expect in the event of a problem.

How Can We Help You?
We have extensive experience acting as an expert advisor to both the insured party and insurance companies in disputes arising from insurance claims. We can assist you in gaining a clear understanding of what is covered and what is not covered and what the problems might be when dealing with an insurance claim and how to go about this properly keeping in mind the points outlined below.

You may consider that your interests following any problems which might be covered by your insurance policy will be a priority for your Insurance Company … however, you must consider and understand that your insurance policy is a direct contract between you and your Insurance Company.

Your Insurance Company set out their terms and conditions and they make money and maximize their profits making as few and as little payments as possible.

How ‘Comprehensive’ is a Comprehensive Policy?
Frequently, when clients contact me in relation to assisting them in dealing with problems which might be covered by their insurance policy, they are often under the assumption that they have a “comprehensive insurance policy”. This term is often confused with a similar term relating to motor insurance and they are often both surprised and disappointed to understand that their understanding of a comprehensive insurance policy might not match that as advertised by various insurers.

What You Need To Be Aware Of:

Policy Wording
Insurance policies are usually written by the Insurance Company in a format which best suits their commercial viability, so it is important you get an understanding of the actual content and context of your policy.

Exclusions
Policy documents will set out, often in obscure language, the level of cover provided. This will be conditioned by very specific exclusions which the Insurance Company will rely on to decline your claim which you might reasonably expect to be valid.

Terms and Conditions
You will be well aware of the phrase: “Terms and conditions apply”. This is very much the case in relation to insurance policies and the “small print” will be designed to protect the interests of the Insurance Company and to limit their exposure and hence the costs which they might incur, if at all, in dealing with your claim.

Insurance Claims
The types of claims which exist will vary, depending on the policy wording and what are known as “perils” that the Insurance Company will identify. These can range and differ significantly from Insurance Company to Insurance Company but will generally involve cover relating to problems arising from things such as:

• Subsidence – cracking in your home arising from very specific causes, the wording of which and the description of which is very carefully crafted by the Insurance Company
• Fire damage – this can be full and total disruption to smoke damage
• Water damage – leading or escape of water will cause significant damage

The Insurance Company will only consider claims which ‘fit’ in to the often very specific descriptions set out in the policy and will all rely on the provision of supporting proof to sustain a claim.

The Process
The Insurance Company will take professional advise and employ different people to act on their behalf to scrutinize and assess your claim including Loss Adjusters, Engineers/Surveyors etc. It is very important that you are represented professionally, from a technical view point to ensure that the technical aspects of any claim are presented correctly and to guard against any unsustainable effort by the Insurance Company and their agents to decline or limit your claim. We can assist you interpreting the policy wording, exclusions, terms and conditions etc and advising you if your claim is consistent with the cover provided.

What Then …
When it is established that your claim is valid and reasonable and all necessary investigative works etc are carried out, we can then prepare a technical specification or scope of works designed to reinstate and remedy the problems arising.

We can work with you to get quotations from competent contractors and negotiating a settlement with the Loss Adjuster or other agents acting on behalf of the Insurance Company. Such a level of engagement will normally require you to provide a Mandate, which is a simple exercise to inform the Insurance Company that we are acting on your behalf to assist you in the process.

Once, a settlement is reached which is to your satisfaction, we will help you to ensure the works are implemented properly by carrying out site inspections and supervising the work, concluding by providing you with a final report outlining the various steps engaged in when dealing with the Insurance Company and confirming the outcome of the works, particularly with reference to any final tests.

” I asked for assistance from John Mac Carthy B.E. & Partners, Consulting Engineers, to resolve a very complex and intricate insurance claim. The service provided has been diligent, thorough and a successful outcome was pursued and achieved in very difficult circumstances.”  – Patrick O’Donoughue, Magazine Road, Cork.

Give us a call today and let’s see if we can help you …