The Seven Steps of Claims Filing

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Source Newsletter for Business and Operations Header Image

Business and Operations//

February 5, 2010

Step One: Follow the steps in your "Crisis" plan and notify authorities. Your first priority is to protect health and life. If someone is injured, call for emergency services and/or perform first aid as needed. When calling in an emergency, be clear as to the situation, (what has happened and where on campus it happened), give your address and ask that the person on the other end repeat what you said, to be certain that all the critical information was given and heard. If your loss involved theft, robbery, or an auto accident, notify the police so you have a report to show to the insurance agency. If a fire occurs, ask your local fire department to inspect the area even if you put it out. And, do not let anyone back into the building, or around the incident site until you have been told it's ok by the first responders.

Step Two: Report the loss to your insurance company and to your agent. As the insured, you have certain duties under the insurance policy. Most liability policies include a reporting provision, which requires insureds to report a possible loss as soon as possible. Even if you think it won't be covered by your plan, report the incident.

Step Three: Prevent further damage. If a repairable condition contributed to the accident, fix it or prevent access to prevent another incident. However, don't make any permanent repairs until your adjuster says it's okay. They might need to see the location in its near-original condition to evaluate your claim.

Step Four: Document, document, document. As soon as possible after the incident or loss, create a written report. If you witnessed the event, include what you saw in your report. If you weren't on site at time of the incident, try to interview witnesses and include what they saw in your document. Make sure you accurately document the date, time of day, location, and conditions that could have contributed to the loss. Photographs also help to document the incident. For example, if the incident involved an injury, take photos of the surrounding area, including any conditions (wet floors, loose carpeting, etc.) that could have contributed to it.

Step Five: Be prepared to work with a variety of people. If you experienced a substantial property loss, the insurer might assign an adjuster to your case. The adjuster will investigate your claim by interviewing the claimant and witnesses, consulting police and hospital records, and inspecting property damage. The adjuster may also consult with other professionals including accountants, architects, construction workers, engineers, lawyers, and physicians who can offer expert evaluations. After the adjuster's report concludes a policyholder's claim is legitimate, the claim goes to the claims adjuster who negotiates with the insured to settle the claim. If the claims are contested, adjusters will work with attorneys and expert witnesses to defend the insurer's position. Have a plan as to how to communicate with the media, and have a single spokes-person.

Step Six: Be satisfied before accepting a claims check. If your claims adjuster offers a settlement, don't sign a full release unless you're satisfied with the amount. The claim will need to remain open if you wish to collect more payments.

Step Seven: Use your agent as a resource from begining to end. If you have any questions during the claims process, contact your broker or agent—that's what they're there for. He/she will be able to provide you with claim forms and help guide you through the process.

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