Insurance claim: how it works?

Insurance claim

Insurance claim: how it works?

One of the more positive impacts of COVID-19 has been fewer accidents and property damage losses and claims.

“We’ve seen an average 30% decline in insurance claims since the start of the pandemic and between March to May last year, claims were down almost 50%,” says Derrick Ajmo, Vice-President of Claims Operations at DSB Claims, a nationally recognized award-winning claims management company.

“With the shift to work-from-home, people tend to mitigate risk more and detect losses the moment they happen, so we’ve seen a decrease in severity of property claims,” says Ajmo.

“People driving less also meant less car accident claims. The trend has continued into this year, but we’ll see what happens as everything slowly reopens – we’ve seen claims increase as soon as lockdown measures are eased,” Ajmo adds. If you need to make an insurance claim, here’s what to expect.

How does it work?

Once you report a claim to your broker or direct to your insurance company after hours, an insurance adjuster will call you within 2-4 hours, to obtain the details of what happened. Here’s what will happen next:

PROPERTY CLAIMS

Step 1: Contractor and/or adjuster comes to your business/house to assess the damages and take pictures. Any pictures or documentation you provide are helpful in speeding up the claims process. For minor claims or wind claims, likely only a contractor will come out and an adjuster will handle the claim via phone and email.
Step 2: Estimate to repair damages is drawn up and reviewed by the insurance adjuster.
Step 3: Once approved, you can authorize your insurance company contractor to do the work or get your own contractor. If you use your own contractor, their quote and scope of work must match your insurer’s preferred contractor quote.
Step 4: If contents are damaged, then the adjuster will request a list of the damaged items with pictures and receipts. Most Personal Insurance policies have replacement costs, so you’ll be entitled to replacement items of the same quality. Once replaced, you’ll be reimbursed. Many companies offer a cash-out option between 75% - 85% of the replacement cost – with this option no proof receipts are required and you can use the cash to replace items at your own pace.
Step 5: Once repairs are completed, the final payment is issued by the adjuster after you’ve either signed a completion certificate, or the adjuster inspects the repairs to confirm they were properly done.

AUTO CLAIMS

Step 1: You’ll be asked to go to a preferred auto body shop for an estimate of the damages. If you’d rather use another body shop, your insurer will send an appraiser to inspect your vehicle and record an estimate of the damages.
Step 2: Your car gets repaired. If you have rental coverage, you’ll be able to use a rental car during the time your car is in the body shop. If there are delays at a preferred shop, additional rental time is generally paid by your insurer, whereas you’ll have to pay for the rental should you still want to use it if there’s delays at a non-preferred shop.
Step 3: If your car is a total write-off, your insurance company will calculate an Actual Cash Value of the vehicle at the time of the loss and send you an offer. Most insurers allow an additional 3 days of  rental car usage once an offer is made, but know you’re not entitled to additional rental days while negotiating with your insurance company. If you have a ‘waiver of depreciation’ endorsement, then your insurer can decide to settle your claim in one of three ways (usually the lowest option)
1) The actual purchase price of the vehicle and its equipment,
2) The manufacturer’s suggested list price on the original date of purchase
3) The cost of replacing the car with a new one of the same make and model, similarly equipped. The insurer will elect the lowest of the 3 options.
THEFT CLAIM
If your car was stolen, your insurer will generally wait 7-30 days to see if the vehicle is recovered (time frame depends on insurer). If not recovered (and you have a ‘waiver of endorsement’) the value of the vehicle is determined as per Step 3. If recovered, any damages related to the theft will be covered under your policy.

Your broker is your claims advocate. Reach out to your broker if there are any concerns about the handling of your claim.

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