Nobody wants to think about making an insurance claim, but when life throws you a curveball – whether it’s a car accident, house fire, serious illness, or injury – knowing how to navigate the claims process can make the difference between a smooth experience and a stressful nightmare.
This comprehensive guide will walk you through everything you need to know about making insurance claims in New Zealand, helping you get the best possible outcome when you need it most.
Understanding Your Insurance Policy
Before you ever need to make a claim, it’s crucial to understand what your policy covers and what it doesn’t. This knowledge will save you time, stress, and potential disappointment later.
Key Policy Elements to Know
Policy Schedule: This document outlines your specific coverage limits, excesses (deductibles), and any special conditions that apply to your policy.
Policy Wording: The detailed terms and conditions that explain exactly what is and isn’t covered. Yes, it’s long and sometimes complex, but understanding the key sections can be invaluable.
Exclusions: These are specific situations or circumstances that your policy doesn’t cover. Common exclusions include pre-existing medical conditions, intentional damage, or certain natural disasters.
Step 1: Immediate Actions After an Incident
Safety First
- Ensure everyone’s safety and seek medical attention if needed
- If it’s a car accident, move to a safe location if possible
- For property damage, secure the area to prevent further damage
Document Everything
- Take photos of all damage from multiple angles
- Get contact details of any witnesses
- For car accidents, exchange insurance details with other parties
- Keep all receipts related to the incident
Contact Authorities When Required
- Police: For car accidents, theft, or criminal damage
- Fire Service: For fires or dangerous situations
- Medical professionals: For any injuries, no matter how minor they seem
Step 2: Notify Your Insurer
Time is Critical
Most insurance policies require you to notify your insurer “as soon as reasonably practicable” after an incident. This typically means within 48-72 hours, but check your specific policy terms.
How to Make Initial Contact
- Phone: Usually the fastest option, available 24/7 with most major insurers
- Online: Many insurers now offer online claim lodgement
- Mobile Apps: Increasingly popular for quick, photo-enabled claims
Information You’ll Need
- Policy number
- Date, time, and location of the incident
- Description of what happened
- Details of any other parties involved
- Police report number (if applicable)
- Photos and documentation
Step 3: The Claims Assessment Process
What Happens Next
Once you’ve lodged your claim, your insurer will:
- Assign a claim number for tracking
- Appoint a claims assessor or investigator
- Begin their investigation process
- Arrange inspections if needed
Working with Assessors
Be Honest and Thorough: Provide all requested information promptly and accurately. Withholding information or being dishonest can void your claim.
Ask Questions: Don’t hesitate to ask about the process, timelines, or anything you don’t understand.
Keep Records: Document all communications with your insurer, including dates, times, and the names of people you speak with.
Common Challenges and How to Overcome Them
Claim Delays
Causes: Missing documentation, complex investigations, or high claim volumes Solutions: Respond quickly to requests for information, follow up regularly, and keep detailed records
Disputes Over Coverage
Causes: Policy interpretation differences or exclusion disputes Solutions: Review your policy carefully, seek clarification in writing, and consider getting independent advice
Settlement Disagreements
Causes: Differences in valuation or repair costs Solutions: Get independent quotes, provide evidence of value, and understand your right to dispute resolution
Your Rights as a Policyholder
Right to Information
You have the right to understand why decisions are made about your claim and to receive clear explanations of the claims process.
Right to Fair Treatment
Insurance companies must handle your claim fairly and in good faith, following industry codes of practice.
Right to Dispute Resolution
If you’re unhappy with how your claim is handled, you can escalate through:
- Internal complaints process
- Insurance & Financial Services Ombudsman (IFSO)
- Legal action (as a last resort)
Tips for a Successful Claim
Prevention is Better Than Cure
- Maintain your property well
- Follow safety guidelines
- Keep your insurance up to date
- Review your coverage annually
During the Claims Process
- Be patient but persistent
- Keep detailed records
- Communicate clearly and promptly
- Don’t accept the first offer if you believe it’s inadequate
Working with Professionals
Consider engaging:
- Loss Adjusters: Independent professionals who can advocate for you
- Lawyers: For complex or disputed claims
- Repair Specialists: For accurate damage assessments
Conclusion
While making an insurance claim can be stressful, understanding the process and your rights can make it much more manageable. Remember, insurance is there to help you recover from unexpected events – don’t hesitate to use it when you need it.
The key to a successful claim is preparation, documentation, and clear communication with your insurer. By following this guide and staying organized throughout the process, you’ll be well-equipped to navigate the claims process and get the outcome you deserve.
Need help with an insurance claim or want to review your current coverage? Contact Cornerstone Insurance today for expert advice and support.
Phone: +64 211 280 727
Email: amy.tao@cornerstonefs.co.nz
WeChat: Amytaoingrace
This article is for informational purposes only and should not be considered personal financial or legal advice. Please consult with qualified professionals to discuss your specific situation and needs.