Insurance claim

Understand the idea

The policyholder reports the event and supplies information such as dates, photographs, invoices or repair estimates. The insurer checks whether the policy was in force, whether the loss is covered and how the benefit should be calculated. A loss adjuster or another specialist may investigate. Limits, exclusions, deductibles and underinsurance can affect the result even when the reported damage is genuine.

An example

Suppose a shop reports J$3 million of storm damage to its insured premises. That is a requested or assessed loss amount, not automatically a J$3 million payment. If the damage is covered and the applicable deductible is J$200,000, an otherwise fully covered claim could pay J$2.8 million, ignoring other adjustments. If some damaged items are outside cover, the calculation changes further.

Sources

• CILA: Introduction to claims handling

In the news

Jamaican insurers report J$54.35 billion in Melissa payments; 983 claims remain