Guide to Finance

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What Is Insurance Claims

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I've said it before, and I'll say it again ? working in discount travel insurance you hear of some pretty bizarre policies and claims being made. But of course, travel insurance is just scratching the very surface, and in fact other areas of insurance have even more strange insurance policies ? and sometimes it's the companies and not the customers with the odd decisions!



Football Fever

At the last world cup, passions ran high, and weird insurance policies followed them. Dutch insurance company SEZ ran a policy offering companies in the Netherlands protection against staff ?pulling sickies? on the days surrounding big matches for the national team. The firm would pay out for the first two days of sickness, if any employee was absent from work on the days surrounding Holland's big matches.

But it wasn't just abroad that World Cup fever dominated the strange insurance policies. On these shores, Paul Hucker of Ipswich took out an elaborate ?1,000,000 insurance policy against England going out of the competition early. British Insurance offered the ?105 policy, which would pay out a seven digit sum if England were knocked out in the first round, if 5 sports commentators believed the exit was premature and if Mr Hucker could provide medical evidence indicating severe mental trauma! In the end, Mr Hucker was left disappointed - both with England and with the odd insurance policy after they went out to Portugal in the quarter finals.

Quirky Car Insurance

Car policies bring up their share of weird insurance scenarios too. For example, in Denmark, the Danish Automobile Association has two schemes to protect drivers from fines ? the speeding insurance, which will cover drivers for up to four offences, of a total of ?900 (?90 per year) or parking ticket insurance, which covers four tickets or ?182 worth of fines for ?36 per year. Unsurprisingly, the Danish Council for Traffic Security is less happy about these strange insurance policies, believing it'll make fines less of a deterrent for some reason.

There some heart-warming scenarios behind the cynicism though ? in Belgium, a car insurance premium has given one of its customers a heavily reduced rate thanks to 80 years of accident free driving! 100 year old Cyriel Delacauw still drives everyday and plans to continue for another 10 years yet ? though never above 25mph!

The Winner, by a Nose

Lloyds of London made a weird insurance policy specifically for the nose ? valuing it at ?3,900,000! Not everyone's nose is worth that much though, this unusual insurance package was specifically designed for wine maker Ilja Gort of Bordeaux's Chateau de la Garde, and covers him against loss of both his nose and his sense of smell. He described his nose as ?his most important asset?, pointing out that the tongue only has fiver areas of taste, in contrast to the nose which can pick up millions of different scents.

Sex Costs Insurance Companies Dear!

Not so much an unusual insurance policy, as an interesting stat. According to a poll commissioned by Ann Summers, the British cause ?350,000,000 worth of damage through energetic sex per year! How does this relate to insurance? Well, who do you think foots the bill for the 10% brave enough to make odd insurance claims after breaking items?

As well as damage to items, like lamps, cases, beds and pulled down curtains, 41% of people suffered carpet burns, 33% pulled their backs and 12% twisted their ankles or wrist. Most eye wateringly of all, 10th in the list of sex injuries was broken bones? the mind boggles!

When Absent Mindedness Costs You ?180,000

We've all been in a situation where we've forgotten to take something with us when we leave it somewhere, but you'd have thought with an item worth ?180,000 you'd be a little more careful! Not so, Robert Napier of Wiltshire, who last month managed to leave a 17th century violin on the train back from London ? where he'd just had a valuation of the antique!

Insurance company Allianz have offered a ?10,000 reward for the safe return of the item ? which, after a thorough search of the carriage was declared missing at the next stop.

?And this is the stuff just appears in the news. Imagine the odd insurance packages that don't make the headlines!
What Is Insurance Claims
1. Non Disclosure of material fact;

2. Failure to abide by the doctrine of the utmost good faith;

3. Fraud and/or overcapitalisation of loss but the latter only applies to deny that part of the claim;

4. Arson as a subset of fraud;

5. An inability of the insured to provide any or adequate strict proof of loss;

6. A breach of policy conditions;

7. A failure by insurers to properly apply policy conditions (eg. co-insurance, average or a misapplication of theft or burglary sub-limits as applied to jewellery or the misapplication of the condition precedents, or condition subsequents to the policy);

8. A failure by insurers to properly investigate and assess a claim.

Unfortunately some insurers lack real insurance claims expertise as too many people are leaving the insurance industry. Despite the rhetoric most claims are treated as commodities. Many customer service officers, individual client service managers or claims clerks have very limited experience whether they are dealing with corporate, commercial, business or personal lines or domestic claims. The reality is that there are more claims to be processed and less capable or experienced people to deal with them which affects claims decisions. This is not helped because some insurers are so totally shareholder and cost driven they overlook the need to protect their client base. Insurers talk about their retention rates which is the percentage of policies renewed annually with them yet many are struggling to maintain retention rates of between 85-90% with only a few performing in the low ninety percents. What this means is that insurers are losing annually anywhere between 5-15% of their client base. Most insureds are unaware of this as the only time they know the value of what they have bought is when they have a claim. In some cases they are less than impressed.

Internal disputes resolution was introduced by insurers to provide a better outcome for their clients. Unfortunately some insurers treat claims as a process and have commoditised them. This is supposed to produce a better outcome for clients and, to be fair, in some cases it does, yet in others it cannot as one process does not fit all claims. Some insurers believe that by treating claims in this way they are able to provide better customer service, speedier resolution of claims, more effective control over costs, reduced claims settlements and improved retention rates across all classes of their business. It cannot work for all as it does not take into account the individual circumstances of individual claims which fall outside the norm and which therefore require a different approach. It is in this area where real expertise is needed and as is so often the case many insurers do not possess it due to high staff turnover as claims is not seen as being “sexy” nor providing a secure career path. Unfortunately inconsistent claims decisions means that sometimes the insured fails to achieve true indemnity under the policy whilst the insurer loses a client. This could amount to having the claim denied, refused in part, incorrectly quantified or misunderstood. Whether you be an insurer or an insured and you become involved in a problem claim seek independent legal advice from LAC Lawyers.
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About Author
Both Patrick Chong & Frank Egan - Lac Lawyers are contributors for EditorialToday. The above articles have been edited for relevancy and timeliness. All write-ups, reviews, tips and guides published by EditorialToday.com and its partners or affiliates are for informational purposes only. They should not be used for any legal or any other type of advice. We do not endorse any author, contributor, writer or article posted by our team.

Patrick Chong has sinced written about articles on various topics from Travel Insurance, Travel and Leisure and Travel Insurance. Patrick Chong is the Managing Director of Journey's Travel. Their commercial travel insurance website, Insuremore, offers packages for families, si. Patrick Chong's top article generates over 60500 views. to your Favourites.

Frank Egan - Lac Lawyers has sinced written about articles on various topics from Culture and Society, Employment Law and Legal Matters. Frank Egan is the Chief Executive Officer of and has over 27 years of experience as a lawyer.. Frank Egan - Lac Lawyers's top article generates over 9900 views. to your Favourites.
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