Navigating the Insurance Claims Process

The claims process can be complex and overwhelming, with multiple parties involved—each acting in the insurer’s best interests. To complicate matters further, every insurer has its own approach to handling claims, making it difficult to know what to expect.

This guide provides an overview of the claims process, but it’s important to remember that insurance practices are constantly evolving, so outcomes may vary.

Step 1: Reporting Your Claim

Most commercial policies are sold through insurance brokers, so your first point of contact should usually be your broker. They will likely:

✔ Gather claim details over the phone to pass to the insurer.
✔ Provide a claim form for you to complete.
✔ Ask you to contact the insurer directly.

While it’s ideal to involve a Claims Consultant before reporting your claim, you must also comply with policy conditions—most policies require prompt notification. If you need time to appoint a consultant, go ahead and notify your insurer first to avoid delays.

Once reported, your claim is assigned to an appropriate handler, which may be:

✔ A desk-based claims handler (for low-value claims, usually under £5,000).
✔ A loss adjusting firm (typically larger firms like Crawford & Company or Sedgwick, but also smaller firms).
✔ An insurer’s in-house Loss Adjuster or Claims Specialist.
✔ A specialist firm (e.g., forensic accountants for business interruption claims, engineers for machinery damage).

Step 2: Claim Assessment & Acceptance

Insurers will need detailed information on what happened. This might involve:

✔ Additional phone interviews.
✔ A site visit by a Loss Adjuster or Claims Specialist.
✔ A forensic investigation (e.g., in fire-related claims) to determine the cause and assess policy compliance.

At this stage, having your own expert representation is critical. We ensure that:

✔ Your interests are protected during site investigations and interviews.
✔ Insurers assess your claim fairly and accurately.
✔ A strong case is presented upfront to maximise your chances of claim approval.

It’s much harder (though not impossible) for us to step in after insurer investigations have taken place—early involvement is key.

Step 3: Negotiating Your Claim Settlement

Getting your claim accepted is just the first hurdle. Insurers and their Loss Adjusters will:

✔ Scrutinise claim values and challenge costs.
✔ Seek errors or policy breaches to reduce payouts.
✔ Apply conditions, exclusions, and penalties where possible.

While Loss Adjusters claim to be ‘independent’, the reality is that they are appointed by and act for insurers—which can lead to conflicts of interest.

A Claims Consultant fights for your best interests, ensuring:

✔ You receive the maximum settlement under your policy.
✔ Insurers do not unfairly reduce or reject your claim.
✔ You are supported throughout negotiations and any necessary appeals.

It’s Never Too Late to Get Help

While it’s best to involve a Claims Consultant from the start, we can assist at any stage of your claim—even if issues have already arisen.

If you’re facing delays, disputes, or an unsatisfactory settlement offer, contact us to discuss how we can help.