Over the last two years, residents of the Whitsunday and Mackay region have felt the impact of the various storms, cyclones and floods that have emerged during the wet season. After the events of the 2008 floods and the 2010 and 2011 cyclones it is not only essential that you have home building and contents insurance but that you understand the process to making an insurance claim and the problems that you may face when dealing with your insurer.
Prior to lodging an insurance claim for damage to your home building or contents it is important that you gather sufficient evidence to support the basis of your claim. In circumstances where your claim is for a building claim your insurer may require an expert report which details the cause of the damage, the extent of the damage and the steps to rectify the damage. In minor claims, a list of the damage or destroyed items, including details of its model type, date it was purchased and copies of purchase receipts, invoices or bank statements, will be required.
In the absence of such evidence, you can rely on statements from other people who have seen the items and who are not a party to the insurance claim. In large scale disasters, such as a flood or fire, you should first contact your insurer before removing, touching or moving any items. In the case of a storm or flood it may be essential that emergency repairs are carried out on the property to prevent further damage from the weather. If you do carry out repairs, you should take before and after photos of the building and contents as evidence of the repairs conducted. If you keep copies of the payment receipts you can submit them to the insurer at a later stage.
Most insurance claims start with a telephone call to the insurer. It is important that you remain calm and provide as much information as you can to support your claim. Recording details of these telephone conversations with your insurer, including details of what you and the representative of the insurer said, is important and may prevent any future dispute with your insurer. Once the claim has been lodged, the investigation process begins. For larger claims, such as building claims and claims for home and/or contents, the insurance company may send an assessor to examine the damage. You should take all reasonable steps to cooperate with the assessor but if you feel you are being unfairly treated or you disagree with the assessor’s version of events you should immediately contact your insurer and express your concerns.
It is important that you do not sign any document presented to you by the assessor without having properly read it. You may be signing a document in which you are consenting to your claim being withdrawn, for example a Deed of Release. If you are having difficulty understanding the document you can ask the assessor if you can take it away. If you are still unsure about signing the document, you should seek legal advice immediately.
Over the last couple of years many people have been tricked with thinking that their insurance policy covered flood damage. It is important that you read your policy carefully because if your house and contents were damaged by an overflow of water it is possible that your insurance policy will not pay for flood damage. It may, however, pay for other types of water damage such as rain and storm water. If for example, your property was damaged by rain and storm water before it was inundated by flood water you may be able to proceed with your claim provided you have sufficient evidence, such as witness statements and/or details of the water levels during the incident, supporting a claim for water damage caused by rain and storm water. Again, it is important that you read your policy carefully because it will state specifically the risks your insurer has agreed to pay for.
In disasters where there are a large number of claims the insurer may not be able to meet all of the usual timelines. You can however ‘fast-track’ your claim if you can demonstrate to the insurer that you are in urgent financial need, for example, alternative accommodation is required. The standard time frames under the General Insurance Code of Practice (‘Code’) once a claim has been lodged are:-
a) A decision must be made to accept or reject a claim within ten (10) business days of receipt of a claim provided all assessment is completed;
b) Notification within ten (10) business days of receipt of a claim that an assessor will be appointed to examine the claim or a request for further information.
The insurer should advise you of the approximate period in which the claim should be completed. If you do not receive notice from your insurer within the ten (10) day period you should contact your insurer.
Once the insurance claim has been processed, and if it is successful, you will be required to pay the excess (if applicable) that you have agreed to pay. If you are unable to pay the excess straight away you should contact your insurer to arrange a payment plan. Your claim will still be processed despite your inability to pay.
If your insurance policy has been refused or partially rejected and you believe that you have reasonable grounds to contest it, you should obtain independent evidence which supports your claim and submit it to your insurer’s Internal Dispute Resolution Department. If your claim still cannot be resolved you are entitled to make a complaint to the General Insurance Division of the Financial Ombudsman Service. If a decision is given by the Ombudsman that is not favourable to you, your last options would be to either take the matter to Court or accept the decision.
Understanding your insurance policy and your flood insurance rights is a very important step in protecting your property during this wet season. If you require assistance dealing with your insurer we can assist you with furthering your claim or any dispute that you may have with your insurer.
