Claims
Claims Management
Claims are handled in-house at Commercial Reality by the Account Manager responsible for the placement and ongoing service of your account. This means you are dealing with someone familiar with your account and your expectations.
Effective negotiation and efficient handling of claims is a critical part of the service Commercial Reality offers our clients. We have a proactive approach to management of claims and focus on the effective flow of communication between You, Commercial Reality and the Insurer.
Our Account Managers are all industry experienced professionals that have proven claims handling capability. Below we provide a number of examples where we have held insurers accountable and have had successful outcomes.
Successful Claim Settlements
A large commercial plumber caused millions of dollars of damage in a new apartment building in Melbourne as a result of a water pipe bursting and causing water damage to 11 floors. The insurer after reviewing the claim denied indemnity citing a particular exclusion relating to construction, alteration, extension etc. We disagreed with this interpretation and successfully argued that the construction exclusion was incorrectly applied and that indemnity should be provided. Within the space of 7 working days the insurer agreed and indemnified our client.
A client in the food packaging area sustained a claim to customers’ goods with the chosen limit of cover exceeded by the loss.With the client looking at a potential shortfall we looked to how other policies might respond. We successfully lodged a claim for $100,000 under the accidental damage section of the clients ISR policy. Despite the fact that customers goods were not a declared value within the asset schedule, we argued the insuring clause (tangible assets) and bailee liability for customers goods came into play and after four rounds of discussion the insurer agreed. Our client did not sustain any shortfall.
A client in the food processing area released product to a major supermarket chain, the product was rejected by the supermarket chain as the food product was “blown” or “off”. The potential loss was in excess of $220,000. We had recommended and arranged an accidental contamination policy for our client. The insurer was of the view that no claim had occurred as there must be actual or potential bodily injury, sickness or disease, further a Food Laboratories report had been commissioned by the insurer which concluded that whilst the product was “off” they did not believe there was a risk for humans as a result of consuming the product. We successfully countered this view citing differences in food poisoning and food spoilage, the bacillus bacteria within the product was within the range known to have caused illness, cooking does not necessarily destroy the bacillus spores and the consumption of unwholesome food can cause nausea and vomiting. We also pointed out that the policy did not contain a specific definition for illness and therefore the general meaning as found in a dictionary applies. The insurer agreed to our submission and paid in excess of $220,000.
A client sustained a total loss (fire) to his 7 series BMW. The insurer agreed to settle as a total loss and offered a fair market value as settlement. However the structure of the insured’s finance on the vehicle meant that there was a gap of approximately $15,000. With the insured looking at this shortfall he looked to us for guidance. We discussed the issue with the insurer and pointed out the relevant insurance legislation to them that in the event of a total loss and the insured has not been fully indemnified, the insured and not the insurer is entitled to the salvage value of the wreck. Upon checking and despite their early protestations the insurer had to agree and the potential shortfall was significantly minimised.