No one likes being involved in an accident or having something break, but that’s exactly what your insurance policy is here for – providing you with the support you’ll need to get through what can be a tough time. This article discusses what an insurance claim is and the general process you can expect if you ever need to make a claim yourself.
What is an insurance claim?
In a nutshell an insurance claim is the process of you telling your insurance company about an accident or event and the process undertaken by the insurance company to repair the damage or replace the item by following your insurance policy terms and conditions.
A typical insurance company may spend well over half of the premiums collected to pay claims and will process thousands of claims per annum. For many of our customers however, making a claim is not something they’ve ever done and it may all be a bit overwhelming. The following paragraphs will provide you with an understanding of the process so that you’re well prepared should you ever need to make a claim yourself.
The claims process can be split into six stages;
- The event
- First notification of loss
- Checking your policy
- Accepting the claim
- Settling the claim
- Seeking recoveries and salvage
Let’s look at each of these stages in detail.
1. An event happens
When you have an accident, drop your phone, or there’s a storm that’s damaged your home, you’ve ‘triggered’ your insurance policy.
Think of this as turning it on or activating it. It may have been sitting idle for months or years before this point, but as soon as you’ve suffered a loss or your property has been damaged you’re able to lodge a claim for consideration under your policy.
The very first thing you need to do if something like this has happened to you is make sure all people and pets are safe and away from harm. This is way more important than the property that may or may not still be being damaged.
After everyone is safe, any injuries attended to etc. you should be looking to prevent further damage occurring. Is the vehicle off the road and in a safe place? Has the water been turned off to prevent further flooding after a pipe burst? Has the fire service been called when smoke is discovered?
Once you’re confident that you’ve done all you can to prevent further damage occurring, it’s time to contact us. To make things run smoothly it’ll pay to be prepared with the information we’re going to need to lodge your claim.
Here’s a snapshot of some of the questions you may get asked when you lodge your claim:
- What is your policy number?
- What date and time did the damage occur?
- How did the event happen?
- Did someone cause the damage? What is their name and contact details?
- Were there any witnesses? What are their names and contact details?
- Where are you now? Where is the damaged property?
- Have you already taken the damaged property to a repairer? If so, who?
Having all this information to hand when you contact us will make it quicker for us to get your claim up and running and processed efficiently.
2. First notification of loss
This is a fancy name for the first contact you make with us to tell us something has happened. You can contact us on 0800 COVE HQ, via live chat, or for non urgent claims, you can tell us via the form on our website here.
This step is where we collect all the information about the loss – the how, the who, the where, the what.
- How did it happen?
- Who was involved?
- Where and when did it happen?
- What has been damaged?
If you’ve got good clear information this step will be simple and straightforward and will allow us to move to stage three immediately.
Contacting us as soon as you know something has gone wrong is critical to a smooth claims process.
It is important to know that all insurance policies exclude cover for additional costs or damages that result because of a delay in notifying us of the damage. Some policies even have time limits that apply – be sure to check our claims pages and your policy wording for more details here.
3. Checking your policy
Once we’ve collected all the information we need to understand what has happened we’re going to make sure you’ve got a valid policy for a claim to be lodged against.
We’ll be checking to make sure your policy is active, your premiums are up to date, that the owner of the property has rights to cover under the policy and that it is the right type of policy for the property that has been damaged.
We’ll also be checking that the information you gave us when you purchased the policy is still correct today.
This step is simply to make sure the policy can be claimed against. We’re not yet considering the terms and conditions of the policy, this happens in stage four – accepting the claim.
4. Accepting the claim
So far, we know what’s happened and we have confirmed there is a policy in place that the claim can be lodged against. Now we need to consider all the terms and conditions of the policy to understand whether or not your loss can be covered by the policy.
This step can be simple and can often be completed at the same time as stages two or three – a cracked windscreen for example, usually doesn’t need further investigation. An earthquake on the other hand can be an incredibly complex event and it may take time to accept the claim.
We may need to talk to experts or send someone in person to take a look at the damage. We’re going to do everything we can to get through this stage as quickly as possible and provide you with necessary support where we can. We understand that no one likes the uncertainty that can come from being in limbo here.
In a very small number of circumstances your claim may be declined. One of the most common reasons for declined claims is a breach of the policy terms and conditions.
5. Settling the claim
Once the claim has been accepted we can then move into resolution – the getting things sorted stage.
How a claim is resolved will depend on the type of policy you hold and the terms and conditions of that specific policy. A typical motor vehicle accident will require the vehicle to be repaired, and your policy will cover the costs of the panelbeater. A claim under a contents policy may require items to be replaced or sometimes a cash settlement may be appropriate. It all depends on what has happened and what the policy offers.
To fully understand how a claim will be settled you should read your policy wording – these are the conditions we’ll follow to resolve the claim in different circumstances.
6. Seeking recoveries and salvage
Sometimes we can reduce the total amount of money we spend on a claim by holding someone else responsible for causing the damage or by selling the damaged items (if we’ve replaced them or paid you their value).
Where someone else is responsible for causing the damage – for example, where your vehicle has been hit by another driver – we will contact them to pay the claim costs. Where they accept responsibility and agree to pay the claim costs we will refund your excess to make sure you’re not out of pocket.
Where the cost to repair a damaged item exceeds the value of the item, the item will either be replaced or you will be offered a cash settlement (depending on the specific terms and conditions of the policy). When this happens we take ownership of the damaged property and we’ll sell it for parts. Sometimes we might just get you to dispose of it. Doing this allows us to keep premiums as low as possible by ensuring we keep our claims costs as low as possible.
We love paying claims. It’s our chance to filful the promise we made to you when you purchased a policy. Nothing gives us greater satisfaction than being able to help our customers in their time of need and the sooner we can get you back up and running the better.
The main two things for you to remember to make this process easier is to firstly collect as much information as you can; the who, how, what, where details, and secondly, to get in touch with us sooner rather than later so that we can provide assistance to you ASAP.
The content presented on this page is provided for informational purposes only. Cove Limited makes no representations or warranties as to the accuracy, completeness or timeliness of the information. Each person should consult a qualified advisor for advice specific to their circumstances. Cove Limited assumes no liability for actions taken in reliance upon the information contained herein.