In a recent thematic Inspection of the Motor Damage Claims Process by the Central Bank of Ireland, the report confirms,
“53% of Claimants surveyed said, when prompted, that they were dissatisfied with some aspect of the motor claims process. However, less than half (43%) of these claimants said they informed the insurer of their dissatisfaction”
While there currently is a lot of finger pointing by the insurance industry as to what the actual reasons are for the rising cost of insurance, the aforementioned statement highlights major concerns into the practices of insurance companies in relation to treatment of consumers when making an insurance claim. As the old saying goes “every time you point your finger, three points back at you, well this detailed reports leads on to state the following concerns,
• Policyholders were not informed of settlements paid to third party claimants.
It is essential that policyholders are made aware of the amounts paid to third parties so that they can uphold the basis of insurance which is supposedly “Uberrima Fides” (Utmost Good Faith)
• Lengthy process to decide on a declined claim.
Provision 7.7 of the code requires firms to have in place a written procedure for the effective and proper handling of insurance claims. In some cases, it took up to 16 weeks for insurance companies to inform the claimant of the decision to decline a motor insurance claim, even though the insurers had all the necessary information and documentation to decline the claim much earlier in the process. Consequently, some claimants were without the use of their cars for extended periods of time.
• Claimants were not always provided with relevant contact details.
In numerous instances, claimants were not informed of the contact details of the insurers claims assessor and / or expert appraiser appointed to examine the damaged vehicle as required by provision 7.9 of the Code, and the subsequent guidance issued in December 2012.
• Settlement payments were not paid within 10 business days.
As insurance companies can take payments in many different electronic forms which allow prompt payment to their accounts, it is disturbing to read the above.
• Numerous claims handlers dealing with a single claim.
This is a total inefficiency on their behalf, claimants had to initiate contact with the insurers on many occasions which did lead to a poorer claims experience overall.
• Complainants were not given the opportunity to use the insurers complaints procedure.
In a number of instances where claims handlers had verbally dealt with complaints made by claimants during the claims process, claims handlers hand not complied with Provision 10.8 of the Code by failing to:
Offer the complainant an opportunity to have their complaint investigated through the insurers complaints procedure; or
Make a note on the claim file that the complainant had been given the opportunity to have their complaint investigated.
The Central Bank is concerned that this practice may result in legitimate complaints not being properly addressed, to the detriment of the claimant.
• Claimants were not always provided with a scope of works.
Claimants, who chose to have repairs carried out by an approved repairer of their insurer, were not always provided with details of the repairs to be undertaken as part of the claim settlement of, i.e. the scope of the repairs, on paper or on another durable medium, as per Provision 7.16 of the Code. Some insurers had relied on the approved repairer to provide the claimant with a copy of the scope of repairs to be completed, but the insurers had not maintained a copy of same on the claim file as per Provision 11.5 c) of the Code. It is important that claimants are provided with a scope of works in order to have a record of the specific repairs made to their car, so that in the event of any problems arising form the repair at a later date, the scope of works will enable them to have the work verified.
The Central bank is engaging directly with those firms where issues have arisen. Formal supervisory requirements, with specific timelines for remediation are being imposed on those insurers where areas of concern were identified. The Central Bank will have regard to contents of this letter when conducting future supervisory engagements.
Furthermore I note the report also states, only 28% of claimants, whose cars were repairable, said that they were informed that they could appoint their own loss assessor.
As a registered loss assessor this is quite worrying on my behalf, that insurance companies fail to inform the public of their rights under the protection code, and even when they do notify them that they can appoint their own loss assessor, they then highlight “at your own cost.” However I would respectfully reply in the context that having an appointed loss assessor at your side will highlight the true benefits of your insurance policy and indeed increase your settlement amount to justify their fees and leave the policyholder with a better settlement offer after their fees are paid.