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| Below are a selection of stories from
our ARCHIVES that have featured Carmichaels: |
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| Slow
Claims Meet Their Waterloo Thanks To Wellington
Link-up (POST Magazine) |
 Lloyd's
insurance group Wellington has come up with a new
way in which to speed up claims for customers. The
Witney-based insurer has linked up with loss adjuster
Carmichaels, who provides Wellington with e-mail
and digital photographs, which speeds up the claims
process considerably. Wellington operates a customer
charter which states that the claim will be paid
within 24 hours of the adjuster's report and the
new system has cut days off the length of time between
the instruction of the adjuster and the report's
receipt.
Wellington and Carmichaels managers are pictured
demonstrating the new system. |
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| To
remove or not to remove.... (POST Magazine) |
Root systems from trees
and shrubs have been proven to be a contributory
factor towards subsidence claims, and the advice
from insurers is that if the roots are within the
zone of influence of the foundations of a property,
the tree or shrub should be removed or severely
pollarded.
But in the majority of cases, root
systems are by no means the sole cause of subsidence.
Chris Ray of Carmichaels has come across a number
of cases recently where roots or rootlets have
been found beneath the foundations of a damaged
property. The advice from engineers is that the
trees or shrubs be removed, even when there is
no conclusive proof that the vegetation is contributing
towards movement. Unfortunately, it has sometimes
been the case that when the vegetation is removed,
movement continues and underpinning is still required.
Policyholders and local authorities are becoming
aware of this situation and are raising doubts
about the need to remove vegetation. Recompense
is not offered to an insured or a third party
if it transpires that the vegetation was not the
cause of the subsidence, and some neighbours are
understandably very reluctant to remove their
trees or shrubs in the first place. A situation
can develop where no action is taken to repair
the damage to the policyholder's property while
negotiations with a neighbour continue. Hardly
fair on the insured. Eventually, the damage will
be repaired whether or not the trees or shrubs
are removed.
Arboriculturalist reports often contradict each
other as to whether trees should be removed. Some
insurers are now including provision in their
policies to allow for payment for tree works on
both the insured's and a neighbour's property.
It could be that some form of recompense will
have to be offered to an insured or a third party
if it subsequently proven that the tree was not
the sole or dominant cause of damage. |
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| House
Blast (POST Magazine) |
Insurers are still counting
the cost of a gas blast which ripped through an
Essex street earlier this month. One person died
and several were injured in the blast at Loughton,
and the final damage costs are expected to run well
into six figures. Maidstone based loss adjuster,
Carmichaels is dealing with claims from two houses.
Senior partner Paul Rolland said:
"One is
two doors up and one is opposite, while the terrace
two doors down, had little damage, the one opposite
a post war prefab, was structurally very badly
affected. In fact the occupants, who were watching
television at the time of the explosion, were
only saved from flying glass by some sturdy and
well secured curtains. The deceased's wallet,
window frames and fireplace were found in their
garden." |
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| Common
sense view prevails in wake of blaze (Insurance
Times) |
Like unhappy families,
no two claims are the same. While at first a fire
in a factory warehouse seemed ordinary enough, it
eventually turned out to be something of a test
case for Independent Insurance and loss adjuster,
Paul Rolland, a senior partner of Carmichaels.
Evidence
of a forced window and a plastic container containing
petrol was found at the blaze. Arson was suspected.
Checks on both the owners and the leaseholders
of the property showed that they were profitable
and stable companies that had the best credit
ratings, paid their bills and were pillars of
the business community. None of the fraud indicators
which ring alarm bells were present.
Rolland comments: "Although everyone concentrates
on the fraudulent aspects of claims - especially
in arson- many are started by strange or revengeful
individuals who get something akin to sexual pleasure
out of starting blazes. In this claim the property
owners wanted to knock down the badly-damaged
factory.
But they were also more than anxious to demolish
an adjoining barely-damaged office block.
This would effectively create a far more valuable
site which could have the most modern development.
Rolland believes the art of effective adjusting
involves taking a practical view of the flexibility
of the policy rather than getting bogged down
in the theoretical small print. Experience teaches
you when to hang back and when to move in and
strike the deal," he comments. In this case,
a cash deal was struck within three practical
view weeks. And the company agreed to knock down
the office effectively at its own expense.
The loss adjuster's report states: "We understand
that the robust stand we adopted in respect of
saving the office block assisted greatly during
the course of negotiations with insured."
The deal was struck for a £500,000 for
the new building and the loss of rent and the
insurance company was also paying around £60,000
to have the site levelled for redevelopment.
Rolland observes: "As always, there were
various points of view.
The insured always wants more than he gets but
if he is reasonable he sees it like any other
business negotiation - something where give and
take occurs.
He had previously also shown an interest in up-grading
the office block which was the inspiration for
his wanting it demolished.
In the end, like all these things, the deal was
done because all parties showed a great deal of
common sense.
There is too much talk of confrontation in claims.
In the end, businessmen want to get on with their
business, insurance companies want to protect
their clients and loss adjusters want to strike
the deals which are fair to both parties."
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| Disaster
in Chalfont St Peter (Insurance Times) |
 Chalfont
St Peter, near Gerrards Cross, is usually regarded
as the ideal village - the place to set up home
and live in an environment of peace and tranquility.
But for the unfortunate policyholder, the nightmare
began when his water main dried up. His neighbours
were still connected, so a call to the water company
would probably solve it, and he set off to take
his daughter to her badminton club. When he returned,
the situation had developed apace. His wife had
heard a terrible crack, and in front of her eyes,
the front of their bungalow dropped a foot. When
the water company arrived, they confirmed that water
was escaping from the main. Chiltern Council's building
officer recommended that the front of the bungalow
should be propped up - but first task was to call
the policyholder's insurers, Independent Insurance.
They contacted Carmichaels, and partner Keith Curling
took up the challenge.
With a wide experience of subsidence in this
area, Keith was fairly sure of the cause. "I
had a shrewd idea that water had dissolved the
chalk and caused a swallow hole, into which the
front of the bungalow had dropped. But until detailed
site investigations are carried out, you don't
know how deep or extensive the area of ground
failure can be. Keith immediately contacted Carmichaels'
experts in ground stability problems - Peter Back
& Associates. "We found that the chalk
underneath the building was unstable across the
whole front of the bungalow, and extended rearwards
by 15 metres. With the building stabilised, a
race against time began."
New, piled foundations and a concrete raft had
to be constructed, but if the work was not carried
out immediately, the likelihood that the whole
building would have to be demolished increased.
The piling work was complicated by further collapse
of the underlying chalk, but the use of driven
piles minimised further disturbance, and allowed
rapid, but controlled, progress to be made.
Six months after that disastrous morning, the
insured and his family returned to their rebuilt
home. The total cost of the building works and
professional fees was well in excess of £100
000, but the only cost to the householder was
his policy excess.
Keith's summary at the conclusion of the joint
effort was that, "the key to the success
of this operation was the reaction of the insurer
in recognising that this was a real emergency,
and not another case where it was appropriate
to wait and see."
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| Beware
Neighbours Try-on (The Loss Adjuster) |
Loss Adjusters dealing
with building disputes which come under the jurisdiction
of the Party Wall Act 1996 should keep a watchful
eye on the neighbour's surveyors and engineers.
For they will often decide that since the Act allows
them to charge certain costs to the other side,
here is an opportunity for them to refurbish their
property at someone else's insurance company's expense.
Typically these 'garden fence' disputes occur when
underpinning is necessary.
"Unless you get
involved very early on with the other side's surveyor,
and his schedule of conditions, you can be in
for a great shock," says Keith Curling of
Carmichaels. "It is too easy for the owner
of a property which has become a little run down
to use this Act as a way of getting someone else
to do the repairs. It is allowed under the Act
for the adjoining owner to instruct an engineer/
surveyor to set out the condition of his property.
Of course it can save time and money if you can
get your own surveyor or engineer to do that job."
It is estimated that 5% of all Party Wall matters
end in disagreement. Here, the Act requires a
third surveyor's assistance and 1% get so nasty
that a neighbour's tiff ends in litigation. "Hopefully,
the new system should make everything a bit smoother.
By laying down an established procedure, the rights
and duties of the respective owners have been
clarified." says Curling. |
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| The
Paperless Office (The Loss Adjuster) |
Fires take hold very
quickly. Carmichaels don't burst into life quite
as rapidly, but when a major fire gutted part of
the centre of Maidstone in January 1995, they made
sure that G & R Clarke Limited received an interim
payment of £50 000 within a week. Within a
month, the material damage claim for £1.66m
was settled.
Carmichaels' ceaseless quest towards
'the paperless office' is part of the reason for
their prompt response rate when handling claims.
Three years ago, senior partner Paul Rolland's
vision was the production of a report on the same
day the adjuster visited the scene of the loss
or damage. In 1998, that vision has become reality.
Carmichaels loss adjusters can now send information
direct to their office in Maidstone via their
laptops, where staff can deal with the files immediately.
Photographic evidence is collected using digital
cameras and the images are also relayed straight
to the office.
One man's vision has become reality. Reports
can be printed on the same day as the loss occurred,
or sent via email to all interested parties. To
complete the circle, claims can now be relayed
to the Maidstone office from.........anywhere
in the world via this internet site. |
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| Spray
Baffled Officers (The Loss Adjuster) |
When the police anived
at the headquarters of the World of Leaffier, located
on the North Circular Road, ffiey found evidence
of a very professional burglary.
A neat hole
in the back wall. Ten threesiece suites worth
over £30,000 taken and no witnesses. The
mystery was why hadn't the modern and switched
on alarm system done its job?
For loss adjuster Chris Ray from Carmichaels
there was an added problem. If the alarm system
didn't work, then the shop chain would be out
of wananty and the claim would not be paid.
The loss adjuster snooped around and noticed
that the thieves had only struck in one specific
part of me showroom. Closer examination of the
passive infra red detector showed that it only
worked at six inches. The thieves had the day
before the raid sprayed a transparent substance
on the lens which had fatally weakened the infra
red beam.
Ray takes up the story: 'The police are used
to foam and the rest but had never come across
anything like mis before and were very interested
in what the spray might have been. So are we.
Forensics are doing the analysis.' |
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| Water
Testing Time for Loss Adjuster in Tangled Affair... |
SOME claims are more
personal than others. And some insurance claims
are really something quite different. And often
it is the loss adjuster who has to make sense of
transactions which are often contradictory and far
from straightforward. A call two years ago to Maidstone
loss adjuster, Carmichaels, from Albion Insurance,
took partner Chris Ray to the East London riverside
in Becton E16.
The claim was complicated and
came to £50,000. Essentially, Johnathan
Brooks was claiming that his riverside property
had been maliciously damaged by barge owners who
moored next to his and his mother's house. Such
had been the damage and distress caused that his
mother's health had deteriorated and, with it,
the house causing considerable consequential damage.
After one visit, Chris Ray wrote to his principals:
"During my conversation with Mr Brooks he
also mentioned the involvement of the Church of
Scientology and a person named MK who, he alleges,
is endeavouring to asset strip him having been
a shareholder in one of Mr Brooks' companies which,
he alleges, is worth £9m. "This is
a very complicated matter and it could be that
Mr Brooks is an eccentric millionaire or, alternatively,
a complete nut case."
The correspondence between the various parties
ran, literally, into several volumes, most of
it of the most puerile and libellous nature. Typically,
in one letter, Mr Brooks wrote to one of the boat
owners:
"I am aware that you have an interest in
Spiritualism and you hold seances where you are
assisted by a Red Indian guide from the spirit
world. "I have not been invited to attend
such an event...
"For reasons best known to yourself, you
have created an ugly and malicious situation,
such that an old lady (Brooks' mother) has been
completely over-awed in her own home and browbeaten
by you and your friends."
One reply to Brooks referred to "inaccuracies.
halftruths and innuendoes" another to the
"utter baseness of your nature." Thousands
of words of accusations and counter accusations
- all hammered out on manual typewriters - went
back and forth. Somewhere in the middle stood
an insurance claim and an increasingly perplexed
loss adjuster. What did stand out, however, was
that Mr Brooks had been trying to enlist outside
help from the police, British Waterways, Waltham
Forest Council, Thames Water- anyone in his feud
against the water people he considered were out
to get himself and his mother. For Chris Ray there
was the all-important matter of the insurance
claim. He comments:
"The whole thing dragged on for two years.
"But in the end, in insurance terms, it
boiled down to a water pipe which had been cut
and badly vandalised.
"Since Thames Water repaired this as part
of their service, there was no claim not least
because the policy did not cover consequential
damage which, anyway, was difficult to prove.
"However, Mr Brooks was not one to take
no for an answer and he kept coming back with
more irrelevant information and even more outrageous
accusations.
"He wanted us to pay the money and then
go after the barge owners and bankrupt them.
"He was basically trying to recruit us as
his vigilante posse.
"There is no doubt in his own mind he had
a perfectly genuine claim. "There was no
attempt at deceit or fraud.
"However, there are people who see the insurance
industry as just another arm of the Welfare Services."
It was with some relief that after two years
- and two more volumes of correspondence after
his first visit - Chris Ray could write to Albion:
"In the circumstances, we consider that
this file should now be closed."
But down in E16 it's more than likely the wounds
are still very open. As the man from Carmichaels
says: "Adjusters can do a lot of things.
"But they cannot change human nature."
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| Investigations
need time (The Loss Adjuster) |
Loss adjusters and insurers
can be at cross purposes when it comes to carrying
on the costs of an investigation. Fraud, however
obvious to an experienced loss adjuster, can be
very difficult and expensive to prove.
The £50,000 jewellery claim made by a Mr
Webb was never quite what it seemed. For a start,
the policy specifically said that jewellery would
not be covered unless it was kept in a safe. The
safe was bought the day before the burglary. Then
the jewellery was never seen either by the named
valuer or the relative who was meant to be present
when the sparkling inheritance was given.
But Mr Webb was sticking by his story and playing
the police, the adjuster and the insurer off very
smartly against each other.
Keith Curling, partner with Carmichaels, says,
'We really couldn't prove a thing and the insurer
was within 24 hours of settling when we managed
to get them to extend the investigation until
we fitted together one or two more details.
'We found that Mr Webb was seen leaving the house
just before the burglary. We then found that Mr
Webb, under a different name, had convictions
longer than his arm and was wanted by the police.
We told him that we believed that the existence
of the jewellery was fictitious. Once he was confronted,
Mr Webbl or whoever he really was, just disappeared.
'It can be difficult to get insurers to pay for
a thorough investigation but on this occaslon
they got very good value.' |
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| Carmichaels'
Checklist |
Although more and more
insurance claims are being handled on insurance
companies' fast track systems. for many claimants
there are still seemingly unnecessary delays before
their claims are settled.
Loss adjuster Carmichaels says that some estimates
suggest that as many as threequarters of all insurance
claims are held up for one reason or another.
Carmichaels has now drawn up a 10-point checklist
to help speed up claims.
Partner, Chris Ray, comments: "Most claimants
have not made a claim before and, therefore. have
no experience about what is involved and how to
go about making a claim.
"This creates the bulk of the delays as
insurers have to make checks.
"Claimants feel that claims should be settled
like equipment guarantees - immediately on demand.
They are nght, but with equipment guarantees you
have to have the correct paperwork for that kind
of service, so it is with insurance claims."
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| Cash
Going Walkabout |
In the retail sector
many claims are to do with the physical loss of
cash. Shop owners often do not understand their
insurance cover.
Whatever the type of high street shop, loss of
money, whether due to theft, dishonesty of employees,
or even armed robbery, is one of the most common
risks that leads to claims.
A number of factors can contribute towards this
trend such as the long shop opening hours which
mean, particularly late at night, the premises
can be easily seen from a distance and are a target
for thieves. There may be a quick turnover of
staff, which can imply a lack of commitment to
the security of money and, of course, there is
the ultimate responsibility of the manager, who
must ensure that money is banked regularly and
safely.
It is natural for the insured to be concerned
with the running of the business but distractions
can mean he or she is not alwavs on guard where
money is concerned. If money loss involves the
dishonesty of an employee, this can go undetected
for some considerable time. Losses tend to be
fairly substantial and, in a franchise situation,
the incident can cause hardship and temporary
financial problems where cover is limited.
Special warranties and provisions Carmichaels'
loss adjusters have dealt with many loss of money
claims for high street chains including Kentucky
Fried Chicken franchises and Clinton Cards and,
in certain cases, their experience shows that
a better understanding by the insured of special
warranties and provisions of the policy, could
help to reduce the cost of some losses substantially.
In one case, a Kentucky Fried Chicken franchisee
had employed an assistant manager who, nine months
later, fled the country to the United States with
£11,400 takings. Whilst the fidelity guarantee
section of the policy covered the loss up to £5,000,
the policy detailed a special provision that states
'it is a condition precedent to liability that,
in respect of each new employee, the insured shall
obtain written references or similar confirmation
of good character'.
References had heen taken, although this was
some six months after the employee had started.
Whilst considered honest and trustworthy hy his
ex-employers, he had been involved in a situation
where it was discovered that a £30 float
was missing.
This in itself would not necessarily alarm the
insured; his duties had included handling and
accounting for cash which always proved satisfactory
to his ex-employers. However, had the insured
known about the missing float, he may have had
second thoughts about employing the manager, thus
saving himself £6,300.
Shop managers can never he too careful when it
comes to the correct procedures for handling money.
Cash in the till should always be regularly removed
to a safe place within the premises before banking.
Staff who are asked to take the daily takings
to the bank should not allow their uniform to
be visible, or make it obvious they are carrying
money. It is also better that the routine of banking
is changed regularly using, if possible, different
employees and changing the time the money is taken
to the bank.
Extra vigilance is also needed at particular
times of the year such as Christmas, when the
takings are likely to be much higher. It is often
better to bank twice daily so that the amount
of money carried is kept to a minimum, a lesson
learned by one Clinton Cards' franchisee.
Snatch
The manageress of the shop had sensibly arranged,
as a safety precaution, for two employees, rather
than the usual onc, to bank higher than avcrage
takings. However, it did not stop thieves on a
motorbike from snatching more than £6,000
from the two employecs, who were wearing suitable
clothing to disguise uniforms and using a plastic
bag to carry the money. The premises had probably
been watched for several days and evell though
the shop's banking routine had hecn delayed by
half an hour duc to the Christmas rush, patience
paid off handsomely for the thieves.
Retail chains who have long opening hours over
the weekend are particularly vulnerahle to theft
and this can be compounded hy the failure to hank
or to place money in a bank safe deposit. Many
policies limit the section that covers monev on
the premises outside husiness hours. In one case,
the franchisee of a Kentucky Fried Chicken outlet
had closed his premises in the early hours of
Mondav morning after depositing £4,872 in
the safe on the premises. fXrriving at his home,
he was kidnapped by two men and was taken hack
to the shop, ordered to open up the safe and the
thieves made off with the takings. Unfortunately
for the insured, the policy only paid a maximum
of £3,500, less the £250 excess, which
meant he sustained a loss in excess of £1,100.
Paul Rolland, senior partner at Carmichaels,
believes there is no easy answer to educating
the insured to he generally more 'cash aware',
particularly in a franchise situation where the
insurance is arranged through the franchisee's
own channels such as the hank or their insurance
broker.
He adds, "Perhaps there is an opportunity
here for an innovative commercial insurer willing
to work with franchisers to develop an educational
campaign on "secure money" - it would
be of real value for everyone!" |
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| Countdown
to restoration of bomb-hit card centre |
The dust is still settling
on the IRA's bombing of Manchester. estimates of
the cost of the outrage range from the ABI's £400m
initial reserve figure put out by members of the
Chartered Institute of Loss Adjusters. the final
cost, adjusters are still busily working on the
ground. Chris Ray, a partner with Carmichaels, kept
this diary of events.
June 15: I was on the golf course in Bearsted
the Saturday the bomb went off. I was pretty sure
we would be getting something, not least because
we have a number of national accounts, including
Clinton Cards.
June 17: Sure enough, Legal & General phones
us with instructions to handle Clinton's shop.
It is in the hardest hit Zone 6 - about 400 metres
from the centre of tbe blast. We receive several
other instructions. But Clinton is our biggest.
Over the next week despite repeated efforts and
a visit to the security perimeter of the site
- P&O Properties, the landlords, refuse to
let anyone go near the damaged shops. This means
we cannot start the process of calculating exactly
what is lost; what is recoverable; when, where
and if the business can get going and the rest.
Our role is to give answers to the insured, the
insurance company and the broker. Without access
we are in a very frustrating position. However,
given the problems of structural damage and the
looting which took place after several of the
major London bombs, I am not complaining about
the security and resulting delays.
June 24: We are finally told we can get access
to the shop in two days. Usually, by this time,
we have had several meetings with the chent, broker,
insurer, assesor, surveyor and the rest. P&O
asks us to bring a surveyor and an asbestos expert.
They fear there may be some danger from that area.
June 27: Finally we are allowed into the site
The first impression is completely surreal. It's
like stepping on board the Marie Celeste Althought
the front of the shop is blown away, the back
is barely touched. Our worst fears about structural
damage are unfounded. Sandwiches lie half-eaten
where someone just dropped everything. The tills
are full of cash. Cards lie on the counter waiting
to be wrapped. The radio plays pop music. Air
conditioning fans are still going round. Everything
is there. Except the people. We arrange for the
stock to be sent to Clinton's headquarters in
Loughton, Essex.
July 1: first meeting with Clinton. We are lucky
that the shop is only 10 months' old and so stock
and fixtures are relatively easy to calculate.
The shop does a lot of business. It is Clinton's
only one in Manchester. We put our initial reserve
for the insurance costs - which includes three
months' lost business - at around £500,000.
Other adjusters go for a worst case scenario when
thev calculate reserves. As a firm, we try to
be as realistic as possible. Of course, this means
sometimes we are in too tight. But case in, case
out, we are providing a better service for the
insurer by this position. I feel those who took
the worst case route with their reserves may be
seen to have exaggerated.
July 19: Some parts of the Arndale Centre start
to trade. Shopfitters finally go into Clinton
Cards.
July 21: Another meeting in Manchester. Bomb damage
is totally unlike major fire or flood damage.
The ceiling has buckled and the lift shaft lost
its cladding in the blast. But a large amount
of stock is completely untouched. Typically, dust
and deris are among the biggest causes of loss.
We are lucky that the fans and air conditioning
kept going otherwise the heat would have set the
sprinklers off and the losses would have been
even worse.
August 15: Another meeting our fourth. By now
we would normally have had 10. In most disasters
you can literally be taking pictures while the
emergency services are at work. This time access
has been the major difficulty. Many retailers
will also have to look at their loss of attraction
cover since it may take some time for Manchester
to recover as a retail centre.
Clinton Cards' shop is due to reopen at the end
of this month. |
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| Dedicated
Loss Adjusters |
Carmichaels Loss Adjusters
are appointed by us on many Club Elite claims. They
deal with quantum investigations over and above
those dealt with by our own in house Property Claims
Inspectors, Clare Dobbie and Janice Collins. Typically,
these will be claims in excess of £5,000,
generally of a Commercial nature.
Carmichael's
have been quick to recognise the benefits of technology
and their adjusters all use laptop computers,
now incorporating voice recognition dictation
systems. Just being introduced are digital cameras
and a sophisticated colour printer allowing instant
printing of photographs. All written communication
between Carmichaels and CU is by Electronic mail.
Paul Rolland, (Carmichael's principal) says -
"We recognise that technology is only an
enhancement of, and not a substitute for basic
adjusting skills...
I do not see us employed to simply reduce claims,
but to ensure that there is an ev en handed settlement
where appropriate. Obviously we must work within
the constraints of policy cover, but we can certainly
engender goodwill towards brokers and insurers
by dealing promptly with claims... Same day attendance
is guaranteed on all 'urgent' cases "
Carmichaels have always been associated with
speed. Gary Lewis of Coach House Breading had
a first class experience of this when he was driven
around Silverstone circuit in the Carmichael's
Porsche racing car. Whilst very quiet on the first
lap, Gary was soon back to his usual voluble ways!
On Insurance Charities Day, 14th May, Commercial
Union will be joining Coach House Breading and
others in Sponsoring the Carmichael's racing car
and driver (pictured), to raise funds for the
Insurance Benevolent Fund. They will be taking
passengers round the Brands Hatch Indy circuit
at a cost of £5 per Iap. Look out for booking
details on posters distributed by your Cll rep.
Alex Moors
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| Cut
Your Losses |
An insurance policy
is not a maintenance contract. Hugh Thompson explains
some of the do's and don'ts of making an insurance
claim.
A recent survey showed that nearly half the population
felt insurance companies were "too intrusive
in their investigation of claims" and more
than half felt "insurers avoided paying valid
claims".
Understandably, insurance companies do not see
it quite like that and most can put hand on heart
and say they believe the swift and efficient settlement
of claims is the best marketing tool they have.
However, if insurance companies sent cheques out
by return of post as soon as they received a claims
form, they would not be doing their duty to their
shareholders or to their millions of other policyholders.
After all, the more they pay out, the higher premiums
must become.
It may well be that the only section of the community
who should be polled are those who have recendy
made a claim. In the same survey (by Swiss Re)
it was shown that 34 per cent have recently made
a claim on their contents and one in five have
claimed on their buildings insurance. Of these,
85 per cent were "happy with the way the
insurer handled the claim".
However, this is not always the case. Last year
the insurance ombudsman looked into 4,000 complaints,
although in only one-third of these did the judge
find in favour of the insured; in the rest of
the cases, although the insured felt justified
in going through all the aggravation of making
a formal charge, the ombudsman found for the company.
So why is there such a gap between what insurance
companies are trying to do and how the public
perceives them at the time of the claim?
The ombudsman's office points to several contentious
areas: ¥ Disclosure. If you have a cnminal
record, a tenant or run a business from home,
or if you have made claims on other policies and
haven't declared them, the insurance company is
legally entitled to cancel the policy and not
pay up. Remember that most companies are plugged
into the computer-driven Claims Underwriting Exchange
where all insurance claims records are stored
and checked against each other.
Make sure you know what you are being covered
for. Not all policies cover accidental damage
- that can of paint which falls over and ruins
the carpet, for instance.
Reasonable care. If you leave your keys in the
door, the back door is left open, or you forget
to turn on the burglar alarm, you may jeopardise
your chances of being paid after a break-in, particularly
if you have broken the security warranty which
is part of most contents policies.
Storm damage. If the roof leaks then the insurance
company may pay if there is damage to the furniture,
but may not pay for the roof itself. Insurance
companies argue that an insurance policy is not
a maintenance contract. Wear and tear is very
different from storm damage. This area of contention
is very common with flat roofs, which are generally
felt to have a ten-year lifespan. However, the
real fun and games about how much a policy will
pay out come if a badly maintained roof or wall
is damaged by a storm, as many were in 1987 and
1991. If a compromise is going to be hammered
out, it is usually a loss adjuster who does the
sums. This professionally qualified body of men
and women are duty-bound to find a fair solution
to insurance claims. But remember, read the policy
you are being offered in full before signing on
the dotted line. This will ultimately help you
if you ever need to make an insurance claim.
How To Claim
We asked chartered loss adjuster Keith Curling,
a partner with Carmichaels in Maidstone, Kent
to come up with a checklist which will increase
the chances of a policyholder being paid both
promptly and in full:
Prompt notification. This enables any investigation
to take place when memories are fresh and witnesses
still around. Vagueness leads to a need to check,
which leads to - at best - delays.
Obtain estimates for repairs as soon as possible,
as delays can lead to costs rising - especially
in today's fast-moving market.
Notify the police in the case of theft - this
is a standard clause in most policies.
Keep records of your insurance history - previous
insurers, claims etc.
Do not overstate the scope of repairs - any suspicion
that you are trying to slip some maintenance work
in as well may lead to a more thorough investigation
of the whole ciaim.
Whatever you think insurers want to pay out, many
settle smaller claims over the phone. Be fair
and reasonable wrth the insurers, their representatives
and loss adjusters if relevant and they will reply
in kind. Claimants who become angry quickly are
treated with suspicion.
Keep photographic records and receipts of property
- particularly valuables - as this will help you
substantiate any loss.
Tell a neighbour when you are going on holiday
so they can check your home daily.
If going away in the winter take precautions against
burst pipes - lag pipe work and keep your heating
on in order to prevent freezing.
In cases of claiming on subsidence, remember the
insurance company has to work in partnership with
you land your engineer) regarding the investigation
and cause of damage, so be as helpful as possible.
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| Loss
adjuster with the gentle touch in wake of tragedy
|
In the past, loss adjusters
had something of a fearsome reputation. And some
are, today, better known for their ability to calculate
than to adjust to the human side of any loss. However,
customer friendly and consumer led have become the
bywords of modern loss adjusting. And no-one needed
the softer human skills more than Richard Toplis,
of Maidstone-based loss adjuster, Carmichaels, when
he was called out recently.
"I was in the car when I heard of the tragedy
first," he recalls.
"In a terrible accident in Buckinghamshire,
someone had been playing with guns during an argument,
accidentally killed themselves and, in the panic
which then ensued, a cigarette had burned down
the family house.
"Like any adjuster it crossed my mind that
Carmichaels might be involved.
"And, sure enough, when I went in the next
day, senior partner, Paul Rolland, said I had
got the job."
At first, because of the size of the potential
claim, the fact the policy was new, and the fact
that the insured was not available, one or two
fraud indicators started to flash for Toplis.
The mother - who had been at the bedside of her
son as he died of gunsbot wounds and burns - had,
initially, been too distraught to talk to anyone.
But police discovered that there had been an argument,
an act of bravado and then a terrible accident
which resulted in the million-to-one fire taking
place. Toplis adds :
"Eventually I had to meet with the insured.
"In the end I had to ask certain questions
about the contents, previous insurers, date of
birth and the like.
"It was very distressing. But it was a good
example of the skills an adjuster needs. I made
sure we got to know each other a bit before I
even started to ask questions.
"We both have dogs so we talked about them
and slowly and gently I went through my list.
"Adjusting isn't about marching in and asking
20 questions and making some kind of technical
analysis. "It's about handling lots of different
people in many different situations.
"You don't handle a Jack the Lad from the
East End the same way as you talk to a bereaved
mother from the Home Counties." |
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| Money
(The Sunday Times) |
Do not adjust your body
language. Do not try to befriend your friendly loss
adjuster he will only accuse you of Iying.
Over-friendliness is one of 1O "giveaway"
clues loss adjusters use to spot fraud in domestic-insurance
claims, says Carmichaels, a loss adjuster in Maidstone,
Kent.
The 10 clues show the thinking of one of the
most suspicious minds in the personal finance
industry. Loss adjusters are employed by insurers
to cut your insurance claims and theirs is the
thankless task of weeding out liars.
Some of their clues are fairly obvious: poor,
dim-witted thieves make embarrassing claims for
a "stolen" new video with a 10-year-old
invoice, for a TV when there is no aerial or a
ruined carpet when their floors are covered in
vinyl.
Loss adjusters deploy more subtle methods of
lie detection. They note body language. For example,
if you wave your arms and roll your eyes or visit
the bathroom five times in as many minutes, your
behaviour will definitely be seen as suspicious
- you can be fairly sure they'll suspect you of
lying.
But dare to befriend a loss adjuster and you
will be taken to the cleaners. Above all, never
call him by his first name. As you earnestly discuss
your stolen helicopter or ruined Astroturf, stick
to formal address and use his title.
Mr K. Curling, a loss adjuster at Carmichaels,
explained: "Claimants do try to get on first-name
terms, and get us thinking they're a nice person
and above committing a fraud.''
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| Choosing
the right people saves a dream |
For most people, living
in the pretty village of Chalfont St Peter, outside
Gerrards Cross, is a kind of suburban dream. But
when transport manager, Peter Humby, woke up one
sunny moming. something of a nightmare was beginning.
First, his water mains were not working. A check
with his neighbours confimmed only his bungalow
was affected. He phoned the water company. Then
he took his daughter to her badminton club. When
he returned he was met by his wife in an acute state
of distress. She had heard a terrible crack. And,
as she watched, the front of the bungalow, the paved
area and the wall sank about a foot. The water company
arrived. They confirmed water was escaping from
the main. A building officer from Chiltern Council
recommended that the front of the bungalow should
be propped up. The building's insurer, Independent
Insurance, was told and it quickly called in loss
adjuster Carmichaels.
Partner, Keith Curling, recalls:
"We have a wide range of subsidence expenence
in the area.
"Given the sudden mode of structural failure,
I had a very shrewd idea we could be involved
with a swallow hole caused by water dissolving
the chalk. The trouble with this kind of subsidence
is that without detailed site investigations you
don't know how deep or extensive the area of ground
failure can be."
Curling immediately phoned consulting structural
engineers Peter Back & Associates experts
in ground stability problems.
"The superstructure of the building had
to be supported and extensive investigation undertaken,"
adds Curling.
"We found that the chalk underneath the
building was unstable across the whole front of
the bungalow and spreading, rearwards to a depth
of 15 metres."
Once the building's superstructure was stabilised,
a race against time began. Ifthe new piled foundation
and reinforced concrete raft took too long to
put in place or were put in too crudely then the
existing structure would be irrevocably damaged
and the entire bungalow would have to be demolished
and rebuilt, explains Curling.
However, the faster the investigations and building
works are done, the more expensive it becomes.
And, unfortunately, there were complications.
The early stages of the all-important piling work
were set back with the collapse of the underlying
chalk. Driven piles were used to minimise vibration
damage to the superstructure. Despite all this,
work was finished in six months and today Peter
Humby is back enjoying his suburban dream. Curling
observes:
"By pulling in the right people and keeping
them moving - we managed to finish within budget
at no financial expense to the insured save, of
course, the policy excess. The total cost of the
building works and professional fees was well
in excess of £100,000.
"The key to the success of this operation
was the reaction of the insurer in recognising
that this was a real emergency and not another
case where was appropriate to wait and see."
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