Insurance Claims

For many businesses, filing a claim is just the start of their problems

For any business, the risk of a fortuitous event causing major damage to property or disruption to normal trading resulting in loss of profits is enough to persuade management to seek protection through insurance. But just having a policy does not mean that, in the event of a loss, claims will be dealt with expeditiously, investigated independently or settled fairly, if at all. Indeed, for many businesses, whether they are a large local company or an MNC, filing their claim is just the start of their problems.

Who’s who in the insurance industry

The international insurance market is complex but essentially the major global insurers and reinsurers control the way most large or complex claims are handled and settled. Almost without exception these large insurance conglomerates adopt a tough and uncompromising stance to large claims and fairness, speedy claims handling and prompt settlement are the least of their concerns.

In many countries the local insurers are merely fronting the risk in order to adhere to domestic insurance regulations with the real financial risk transferred to global insurers through reinsurance. Claims control clauses means the international insurers control the way claims are investigated as well as the pace of progress. Their typical claims response is to appoint a myriad of claims expertise whose primary objectives are at best to avoid the claim or at worst, to reduce their liabilities and to delay any settlement as long as possible.

Specialist insurance litigation lawyers are appointed immediately to scrutinize the cause and origin reports. In many cases the lawyers are given responsibility to run the claims investigation, albeit behind the scenes, pushing the loss adjusters, forensic scientists, engineers and other experts to find information that will assist in a repudiation or an avoidance of the claim. Then come the Forensic Accountants whose brief is to dig into the financial viability of the insured, looking for evidence to support allegations of fraud or, if the claim cannot be avoided, to bombard the insured with information requests looking for innocent disclosure of information that can later be used to reduce or further delay settlement. This all puts tremendous pressure on the Insured and its often limited management resources, in a post loss scenario where the business is already struggling to deal with the interruption to trading. Dealing with a large or complex insurance claim is something that is entirely outside the scope of the Insured management’s experience and, without expert assistance, most commercial insurance claims can become immersed in delays and end up as disputes. This leaves the Insured to mitigate the loss and get back to trading as best they can and the claim to be progressed in litigation or through Alternative Dispute Resolution (ADR), mediation or arbitration, over considerable time and at great cost.

Accord Solution can help you immediately after a loss scenario

  • Hands-on management experience that provides the insured with straight forward advice on what to expect and what they will have to do to get their claim paid.
  • A means of balancing the scales by matching the expertise that the insurers deploy.
  • Proven strategy and methodology that avoids the pitfalls and strives to ensure that the claim is dealt with honestly, fairly and expeditiously.
  • An additional resource that will enable the insured to concentrate on their primary business, leaving management of the claim to Accord
  • A solution that ensures that you achieve full value for your claim within the limitations of the cover you have purchased.
  • Strategies for third party recovery outside the scope of the insurance cover.

Accord Solution also offers services for claims already at the dispute stage

  • A rapid review of coverage and a quantum evaluation
  • A recommendation on a way forward with planned stages linked to an identified time line and value objectives.
  • Strategic dispute resolution and support services.
  • Expert reports on coverage and quantum in litigation and ADR

5 reasons why Accord Solution is good at what we are doing

  • We know the insurance market and all the players.
  • We have a track record of success, collecting over US$1 billion in claim settlements.
  • We sell expertise, experience and an honest opinion.
  • We show our clients the most cost effective way to make Insurers deliver on their promise.
  • Our reputation is hard earned but it is never for sale.

Case studies

Case Studies