The ultimate goal of a claimant: to be in the same position as before the loss occurred. The insurer has an obligation to compensate you after a loss, but not at any price. You also have obligations under the law to prove your loss by filing a claim. Your interest and that of your insurer are different, and your insurer is in a poor position to help you obtain the maximum reimbursement, since it is he who will have to assume the costs. They also want to settle the case as quickly as possible, but it is essential that an agreement on costs be reached before any work is done. Here is a chronology of the steps to follow for an optimal settlement.
There are different coverages in your insurance contract for which a claim must be filed in this order:
This chart was created to illustrate a typical post-loss residential claim path that is managed by our firm in accordance with the obligations of an insured.
Click on the arrows to see the descriptions
Month 1
It is your obligation to take the necessary steps to avoid further damage. For example, you are responsible for the security of the premises, barricading, heating in cold weather and other similar work. In case of negligence, subsequent damages may not be covered by your insurer. This step is often entrusted to a contractor by the insurer's representative or by the fire department on the day of the disaster.
Duration: 1 day
Level of difficulty: 1 out of 5
Month 1
Your home is no longer habitable and you will have to relocate while your claim is being settled until your property is rebuilt. You can also temporarily move in with a friend or relative on a per diem basis. It is preferable that you be in a place where you are comfortable for a period of 4 to 6 months. It is also important to ensure that the costs involved are not too high if your policy amounts do not allow it.
Duration: 3 to 6 months
Level of difficulty : 2 out of 5
Month 6
Supplemental living expenses cover only excess expenses caused by the loss, during the loss settlement period. All expenses that allow you to maintain the same quality of life you had before the loss must be accounted for. Supporting invoices must be submitted and previous bills that were discontinued once your home was reinstated must be deducted. Supporting documentation must be submitted for all expenses claimed.
E.g.: cell phone costs, travel costs, electricity and heating costs during reconstruction, etc.
Preparation of the claim
This involves preparing a claim containing the costs you have had to absorb that would not have occurred in the absence of the loss, together with all the required supporting evidence and appropriate explanations.
Trading and settlement
You will present your claim and the insurer's adjuster may accept, reject or request further explanation of some of the claimed sections in order to assess their admissibility.
Duration: 1 month
Level of difficulty : 3 out of 5
Month 1
The extent of the damage and the work required to restore the building must be determined. This means taking a complete survey of the areas of the various components to prepare an estimate of the cost of rebuilding the building. The materials used must be the same as those in place. The insurer will do the same work and by comparing the two estimates, it will be easier to verify that the extent of the damage, the quality or quantity of materials, the hourly rate and the rates for a construction contractor are the same as those of the insurer.
This step, although important, is often overlooked by claimants in favor of insurers. Using your insurer's estimate to solicit bids afterwards will not achieve the same results because the variants of the estimate will not be questioned, wrongly assuming their accuracy.
Duration: 1 month
Level of difficulty : 5 out of 5
Month 2
It is the role of the claims adjuster to negotiate a settlement that favours the person who commissioned him. A claims adjuster who works for an insurer is accountable to the insurer, whereas a claims adjuster who works for the claimants will try to obtain additional compensation for the insured. It is a matter of applying the provisions of the insurance policy and presenting detailed estimates reflecting its coverage.
Therefore, you must be aware of all the clauses and assert your rights to obtain optimal reimbursement whether or not you rebuild your property. If you do not rebuild, depreciation based on wear and tear of the materials may apply.
It is essential that an agreement be in place before reconstruction work begins to avoid surprises.
Duration: 2 weeks
Level of difficulty : 5 out of 5
Month 2
Whether you take the time to rebuild the building or prefer to purchase another permanent home, the insurer must allow you a reasonable amount of time to complete the work. However, it is common for a time limit to be established and for an agreement to be reached with the insurer on a completion date. It is after agreement on the building that the reconstruction period begins and the living expenses will end on the scheduled date.
Duration: 3 months
Level of difficulty : 2 out of 5
Month 6
The insurer who wants to verify that the work has been done according to the claim filed will send an estimator to do an end-of-work inspection. Once the estimator's report is received, the insurer will accept or negotiate the payment of the amounts previously negotiated for the granting of the balance of the replacement value. It is important to remember that in most insurance contracts, it is necessary to demonstrate the expenditure of the sums and the work claimed in order to obtain the replacement value. The materials must be of the same quality as they were before the loss, unless otherwise agreed with the insurer.
Duration: 2 weeks
Level of difficulty : 3 out of 5
Month 1
A financial advance will allow you to deal with life's hazards until your property is restored. You will need to purchase basic necessities and probably also pay the costs associated with the loss without affecting your financial capacity. It is better to agree on reasonable amounts than to have to ask for more later. Otherwise, it may result in additional delays or justifications.
Duration: 1 week
Level of difficulty: 1 out of 5
Month 1
A survey of each asset should be done on site or from memory if the premises are completely destroyed. Whether it is a small pencil or a large appliance, everything must be put on paper with as much detail and precision as possible. Photos should be taken to demonstrate your losses. Even goods that have little or no value to you have a contractual value that should be claimed. Great care must be taken at this stage.
"Take the example of the toolbox, we shouldn't claim a lump sum that includes the tools in it, but rather each one separately."
This entire claim will be analyzed by the insurer. It is therefore important to have their approval before disposing of your evidence.
Duration: 1 week
Degree of difficulty : 5+ out of 5
Month 1
Transcribing to a software program such as Excel will allow a better layout and organization of your inventory. A grouping by alphabetical order, for example, will allow an easier search and will avoid duplicate items claimed. A presentation by room is a method that also facilitates the verifications to be made later.
Duration: 2 weeks
Level of difficulty : 2 out of 5
Month 1
You must find the equivalent replacement cost of each of the goods in your claim, according to your purchasing habits, respecting their quality and nature. We are not talking about the price paid, but about the cost of buying back the goods, including taxes. Be careful not to try to claim goods you did not own or to increase their value. An intentional misrepresentation could invalidate your property claim.
Duration: 8 weeks
Level of difficulty : 5 out of 5
Month 3
Goods that have been brought in by vendors for cleaning, electronics repair or cabinetry that are unrecoverable should be tracked to incorporate these lists into your claim. This will constitute warehouse losses or non-recoverables from vendors.
Duration: 1 week
Level of difficulty : 2 out of 5
Month 3
Quotes, invoices or justifications must be provided for the higher priced items. Furniture suppliers often keep invoices for goods purchased. They may also provide the adjusted price for the replacement item. If not, quotes and proof of ownership will be required. Remember that it is your contractual obligation to prove your loss to your insurer.
Duration: 1 week
Level of difficulty : 2 out of 5
Month 4
Depreciation must be established according to the quality and life span of each item. In the insurance contract, in order to be entitled to your replacement value, you must present the replacement invoices for the goods claimed, otherwise the value on the day of the loss (depreciated) will be paid. It is preferable to present a calculation with a depreciation per item rather than going globally for all the goods.
Duration: 1 week
Level of difficulty : 4 out of 5
Month 4
As with the building, the insurer analyzing your claim may obtain calculations or replacement values different from your claimed values. It is a matter of negotiating a proposal that will be favorable to both parties and accepted by them. There is also the possibility of obtaining a lump sum payment to avoid having to submit invoices and to submit another brief claim for the replacement value portion of the property. This waiver of your replacement cost coverage must be calculated by taking into account the difference between the depreciation and replacement cost of the items you wish to buy back. The lump sum will inevitably be higher than the result of this calculation.
Duration: 2 weeks
Level of difficulty : 5 out of 5
Month 6
Once you are back in your home, you will get your goods back cleaned and you will also have bought back most of your goods. You will have to verify if the returned goods have been cleaned properly and also if some of the goods were not damaged during transport or treatment by the suppliers. In the case of a breakage or a badly cleaned item, you will have to make an agreement with the supplier or the insurer.
You will need to prepare a claim for the difference between the amount paid for the replaced goods and the amount paid for the repurchased goods, unless you have waived your replacement value in exchange for a lump sum payment (see previous point).
This step is laborious, since it involves claiming the difference between the lesser of the value paid and the value claimed, and the amount obtained. This step requires a lot of time, which is why many insurers and insureds opt for an agreement to facilitate this process in exchange for an allowance.
Duration: 4 weeks
Level of difficulty : 3 out of 5
Living expenses, building and outbuildings, movable property....
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