One of my major duties as a loss adjuster and claims expert is interpreting and applying the strict wordings of an insurance policy to a claim situation.
To put it bluntly, I am probably the reason your claim was honored, or turned down (insert sad face). And all I did was to bring to the limelight the intentions of your insurance policy in relation to your loss situation by explaining and expanding on the terms and conditions stated therein irrespective of your feelings. Ouch! That hurts right?
One of such policy conditions you need to be mindful of in your home insurance policy is the Single Article Limit (SAL).
If your insurance company ever told you they wouldn’t pay you a certain amount you felt entitled to, having included the value of the object in your household contents, it is probably due to the application of the SAL clause.
The protection against flood damage is an integral part of any Fire & Special Peril Insurance Policy, Material Damage Insurance Policy and a Home Insurance Policy on a building and or its content.
This is often not amplified unlike the fire risk probably due to the fact that fire tends to create a more vivid image of danger and urgency than flood. Therefore many policy holders do not know that they can recover under their policy should they suffer a flood damage. Continue reading YOU DON’T NEED A SEPERATE FLOOD INSURANCE COVER!→
It is a general belief among the insuring public that the purpose of taking up an insurance cover is to be returned to the position previously enjoyed before the occurrence of a loss event. In my years of experience I have found this to be largely a theoretical truth as in actual fact, there are many factors that could prevent full indemnification.
A claim is the occurrence of an insured peril, upon which the liability of an insurance policy is engaged.
An insurance contract is a promise by one party to indemnify the other upon the occurrence of a predetermined event. As an insured, having fulfilled your portion of the contract, you have an absolute and incontestable right to your claim (indemnification).
Immediately notify your insurance company. As soon as is it is possible, contact your insurer to notify them of the loss. A telephone call, text message or email will suffice.
Obtain a fire brigade’s report: Especially in the event of a major fire. Fire fighters, apart from combating fire are sometimes able to trace its origin. This is necessary for the documentation of your claim.
Obtain a police investigation report: This is important where the damage was caused by a negligent third party which could be either an impact or malicious damage.
Property damaged by third part vehicle: In addition to (3) above, you are to obtain the negligent 3rd party’s letter of undertaking accepting responsibility for the damage and also collect copies of the vehicle particulars (especially the motor insurance certificate of the vehicle).
Take adequate snapshots of the damaged scene showing the extent of the damage.
Obtain a bill of quantity or estimate of repairs and purchase invoice of items damaged.
Take reasonable measures humanly possible to reduce the extent of the damage.
What is claimable under Fire & Special Peril Insurance?
Reinstatement of the damaged property: this is usually in monetary terms as it is cheaper than actual reinstatement (insurers effecting repairs themselves)
Cost of debris removal: however, such amount is subject to the provisions of the policy.
Cost incurred in the course of combating the spread of the insured peril be it fire, flood, explosion.
Expenses incurred in complying with standards laid down by relevant authorities while reinstating the damaged premises.
Damage to properties by fire fighters while combating spread of fire from adjacent premises.
Damage to property by the police force in an attempt to restore order following an uprising.
Some policy provisions that determines the degree of your indemnification are;
Under-insurance; This means that the sum insured (or value placed) on the subject matter of insurance is inadequate. It therefore implies that the premium the insured paid at the inception of the cover is not commensurate to the risk and the insurer has been placed in a disadvantaged position.
Poor moral hazard: a hazard is a condition or situation that creates or increases the chance of the operation of an insured risk. Poor moral hazard refers to human behaviors that could fuel an insured peril. Examples of poor moral hazard includes poor housekeeping, improper storing of flammable materials etc.
Others are the operation of specific policy clauses which would be the subject of our next discussion.
Thank you for reading. We would like to have your view and also know if this post has been of any benefit to you. Kindly leave a comment.
We started a new discussion last week on Fire insurance and we pointed out that what is operational in the Nigeria insurance market is a standardized cover referred to as Fire & Special Peril Insurance. This encompasses other perils that were hitherto subject to request and payment of additional premiums.