One simple way to avoid a claims dispute

Some claims disputes can be prevented entirely with better communication between clients and insurers, suggests an engineer for a firm that investigates property damage.

“I couldn’t put a number on it, but I would say a large number of the disputes that we see are related to not communicating, not sharing everything, or perceptions that people are being unfair for whatever reason,” said Jeff Reitsma, vice president and practice lead for remediation at 30 Forensic Engineering.

Disputes between property owners and insurers frequently arise after catastrophes. A case in point is the community of Dunrobin, Ont., about halfway between Ottawa and Arnprior, which was hit by an EF3 tornado last September. Several homeowners in the Dunrobin area are still involved in claims disputes with their insurers, Postmedia reported this past June.

It helps to have a collaborative approach when dealing with a claim, Reitsma told Canadian Underwriter. He was commenting in general and not on the 2018 tornadoes that hit the Ottawa area.

“As long as we agree that the intent of an insurance policy is to make that person whole again and to do that fairly, there really is no reason for disputes, as long as everything is clean and clear and well communicated,” said Reitsma.

It can help when claims professionals share data – such as photos and engineering testing results – with a clients after a loss, he suggested.

Some disputes would not have happened in the first place if the communication had been better.

“In some cases, it’s hard,” said Reitsma. “An independent adjuster who has done 1,000 hail storms may not think about it from the perspective of the insured party. [The insured may be] stressed and may not know what the steps are, and may not be as sophisticated [as the adjuster] in handling that. We work with a lot of independent adjusters who have thousands of files. It’s especially hard when there is a cat loss event.”

30 Forensic has customers in the insurance, law and government sectors.

“We get asked to do peer reviews of other parties’ work,” said Reitsma. “Usually people are open to that. They are willing to pay a few dollars for those services to avoid any kind of ill will or concerns around one party assuming negative intent on the part of the other.”

Some claims disputes end up in court, but mediation and arbitration can be a quicker and cheaper way to deal with a dispute.

“My experience, by and large, has been that an extra little dose of good positive intention at the outset, and a lot of communication at the outset – and getting parties involved in a more collaborative sense at the outset – can be a really important thing to help avoid disputes down the road,” said Reitsma.

That means an adjuster saying to a client: “‘Here is where we are at. Here is where we are going and why. Do you have questions?’”