Who’s Involved in a Home and Contents Claim?

Let’s be honest, lodging an insurance claim always feels like it comes at the worst possible time – whether you’ve just gone back to work, the kids are on school holidays, or you’ve got relatives making their annual pilgrimage across the border for a planned vacation. In saying that, we all live busy lives and realistically it will never feel like the right time to make a claim as the process in some way or another will clash with social, family or work commitments.

As builders, we commonly encounter frustrated insureds who – at no fault of their own – are unsure why they have received multiple phone calls from different parties requesting to attend their property. We understand this can be frustrating, however it is pivotal in making the correct determinations surrounding the claim.

Leading us to the point of this article; ‘who are you, and why are you calling me?’ We thought we would attempt to provide some clarification by explaining the major parties involved in a home and contents insurance claim.

Insurer

The role of an insurer is to provide financial compensation when you, as the customer, suffer a loss. In this instance, this loss pertains to home and contents damage as the result of an insurable event. The insurer will be your initial contact in lodging your insurance claim, and as your insurance provider, they will be highly focused on meeting your needs as their customer.

The insurer will either elect to independently manage your claim through a team of internal claims managers, or they will outsource this role to one of their third-party Loss Adjusters (we’ll get to them shortly). The insurer will determine at their own discretion if your claim will be outsourced to a third-party or managed internally. Either way, the role of an Internal Claims Manager is similar to that of a Loss Adjuster.

Loss Adjuster

The role of a Loss Adjuster is to assess the amount of compensation that should be paid to the insured after a claim has been lodged on their insurance policy – this also includes overseeing the completion of rectification works (building and contents) and acting in the best interests of both the insured and the insurer. The Loss Adjuster also navigates your policy to determine your coverage in relation to the event that has caused damage to your property.

Likely to be the first phone call you will receive after lodging your claim, the Loss Adjuster will either arrange an attendance, or notify you that a representative builder or restorer will be in touch to schedule a time to inspect your property.  In some instances, the Loss Adjusters are required to send two or more builders to inspect your property depending upon the size and complexity of the job.

You should anticipate liaising with the Loss Adjuster often and they will be an important contact throughout the duration of your claim.

Restorer

The role of a Restorer is to attempt to minimise damage to your property or contents in the case of an insurable event. This may involve the installation of industrial drying equipment, mould remediation, cleaning of smoke damage and contents restoration. Specialist equipment may be used to remediate the damages to your property, and they may be left at your residence for an extended period of time to ensure that a thorough clean-up has been completed. The equipment may be air movers and dehumidifiers, used to specifically dry water damaged building materials. The Restorer will appoint their own Technicians or subcontractors to complete these works.

If required, you should expect to hear from a representative of your appointed Restorer early in the progress of your claim.

Builder

After the Restorers have finished their scope of works, this is where we enter the picture. The role of the builder is to reinstate the dwelling on a like-for-like basis to its original condition. This will include all general building works, encompassing all trades that you would typically encounter if you were renovating your property.

A representative from the builder would be in contact after the completion of restoration works – or alternatively, immediately after speaking with the Loss Adjuster if restoration works are not required. This typically includes organising an attendance to provide a scope and quote to the Loss Adjuster. The builder can also be requested to incorporate causation reporting as part of their allocation to your property, which may include inspecting the roof, performing leak detection testing or general causation reporting to determine how the damage has occurred.

All assessments will be completed by the builder’s Estimating and Project Management team. On occasion, depending on the complexity of the reporting, the builder may also appoint specialist subcontractors to attend on their behalf. The subcontractor may sometimes contact you directly to schedule an attendance, however you will be notified by your builder if you should expect to be contacted directly.

The builder should be in regular contact throughout the duration of the works as all repairs will be conducted by internal trades or subcontractors that have been organised and scheduled by the builder.

Throughout your claim, all parties will be working to restore and repair your home to its former glory. We know at times it can seem like a never-ending stream of people calling and requiring access to your property, however it is all part of the process to provide you as the insured with the best possible outcome.

By Ryan Smith