The damages caused by Super Storm Sandy have resulted in a heavy load of assignments from underwriters with regard to damages to marinas, boats and associated infrastructure. It has been a pleasure working with our underwriter clients who all have been very eager in resolving often very complex damage issues as rapidly as possible and a pleasure to be able to work with boat and marina owners, who often have had no prior experience in claims presentation, but are eager to get their issues resolved. It is also quite heartening for us to note that the underwriters are almost insisting that we help the insureds along in the claims process.
While M&O consultants live and breathe claims on behalf of both underwriters and insureds, the vast majority of all people and companies have very little experience in presenting insurance claims and therefore many claims simply get hung up. While, in theory, all claims need to be presented to underwriters, in practice, the claims that people might have some experience with, such as car and home claims do not really get presented, but are rather carried along in a defined process that has been developed by underwriters to serve the public at large for car and home claims. However, that process cannot be applied to the marine industry for a number of reasons and therefore the process for receiving proper reimbursement in a marine claim requires the presentation of a claim.
Claims presentation is not a magical process, but it requires that certain specific steps are taken.
While occasionally the process can become very complicated (and Sandy has made certain aspects of the insurance process quite complicated) unavoidably the following steps need to be taken in a classic marine claim:
1. The underwriter has to be made aware (often through your broker) that you think you have a claim. In practice an email is a great record and it is very helpful if all the below steps are recorded with a short email.
2. The underwriter will then notify you as to how and when you can show your damage to a representative of the underwriter. (and this representative is often a surveyor)
3. Whether the underwriter’s representative shows up or not, you are still supposed to act like a prudent uninsured, which means you have to take reasonable actions within your abilities to remediate damages. (and generally those efforts are reimbursed under the claim)
4. Check your policy or talk to your broker to determine what can be reasonably claimed and recovered and what is not covered under the policy.
5. The underwriter’s representative is not clairvoyant, so you have to show them your damages and tell them how you think the damages occurred.
6. As soon as possible show the underwriter’s representative how you plan to repair the damages. Often the underwriter’s representative can suggest or help evaluate options, and might even help you write up a repair specification but it is not the representative’s job to organize the repairs; that is the Owner’s job.
7. Listen to what the underwriter’s representative would like to see before the repairs are started. Generally that is some plan of repair with a repair cost estimate or offer.
8. Make sure the underwriter’s representative agrees with your proposed repair approach.
9. If the underwriter’s representative agrees with your approach, make the repairs.
10. If for any reason the repair process needs to change, let the underwriter’s representative know and ask what they think about an alternate approach.
11. When the repair is complete provide a copy of the paid invoice(s) to the underwriter for reimbursement (through your broker or through the surveyor depending on who has agreed to accept the invoice for further processing)
This is the simplest process for the simplest claim. Unfortunately often things become much more complicated due to CTL, ACV, payment on account, complex repair options, co-insurance, depreciation or literally thousands of other issues. If things become too complicated, or if it appears there are more options than answers, or if it appears that the underwriter is not responding to reasonable requests, do not hesitate to give us a call to see if we can help out. We often find that the process has been interrupted due to a relatively minor failure to communicate and we can help you get back on track.
Remember a claim is a process; it has a beginning (the notification), a middle that consists of taking continuous steps, and an end (the reimbursement by the underwriter). But the end cannot be reached if the step by step process is stopped and generally it is up to the insured to make the first move at each step and that is why it is called insurance claims presentation.