Assessment and repairs process

When you make a claim against an insurance policy for a loss or damage, your insurer’s primary goal is to either repair, rebuild or replace your property as quickly as possible and to the best quality possible under the policy’s terms and conditions. In some circumstances you may be offered a cash settlement.

Many insurers have preferred suppliers of repair and building services. Others will allow you to choose your own.

 

Contractors

Many insurance companies build strategic relationships with building firms, motor vehicle repairers, specialist suppliers and project managers. These contractors are selected because they meet the insurers’ requirements for capacity, quality and performance.

If your insurer selects a contractor to repair or rebuild your property, that firm will have signed a contract with the insurer promising that the work that the insurer has approved, is carried out quickly and to the standards that the contractor has agreed to deliver.

Sometimes firms subcontract work to a local company and will guarantee the work is done to the required standard and usually within very tight timeframes.

Once your job has been approved and has been allocated to the insurer’s contracted company, that business will often use local tradespeople and suppliers. These subcontractors will need to meet the insurer’s standards and requirements for quality, capacity, cost and availability.

If repairs are performed by a company that was authorised by the insurer, then under the General Insurance Code of Practice, the insurer is responsible for the quality of the workmanship and materials.

So, if the repairs are faulty or incomplete then the insurer is responsible for fixing this.

If you have a complaint about whether the work has been timely or whether the repairer or builder has conducted itself appropriately, you can also tell your insurer. This can be addressed through the insurer’s complaints handling process.

If your insurer allows you to choose your own repairer, be aware the insurer may not be prepared to guarantee the work or service performed by that provider.

 

Assessors (claims adjusters)

Unless you have a simple claim, your insurer is likely to arrange for a specialist assessor (also known as a claims adjuster) to investigate the extent of the loss or damage (in some cases the insurer may send a builder or tradesperson) and recommend repairs, building works, replacement of items, or a cash settlement.

The assessor will have a good knowledge of what situations are covered by your policy, and the maximum amount your insurance covers. Sometimes the claims adjustment is done over the phone or an assessor may assess the damage in person before arranging for repair quotes.

In a complex claim, an assessor might speak to you about the claim and might follow up on police, emergency services or other records. The assessor might also call in an architect, engineer or builder to make sure that the repairs are appropriate.

Though assessors are responsible for making sure that your claim is covered under the policy, their job involves interpreting the wording of the policy and then organising for appropriate action to take place.

Sometimes that might involve negotiating a lump sum settlement with you – which is a single payment of money – rather than a repair or replacement. You may wish to consult a lawyer or a trusted advisor before accepting any lump sum settlement.

If you are not happy with this process you can seek to resolve your issue through the insurer’s internal dispute resolution process.

 

Being alert to scams

Opportunistic con-artists often set their sights on disaster victims who are waiting for insurance payments.

Most repair scams have one common characteristic – they are unsolicited. If a seemingly concerned repair worker approaches you offering to fast track your repairs, be on guard and ask to see identification.

Your insurer will be able to tell you if it has sent workers to your property.

How to protect yourself from scams:

  • Contact your insurance company and seek advice about the repairs process under your policy
  • Contractors and assessors authorised by insurers will normally notify customers in advance before repairs or inspections are scheduled to take place. If a contractor or assessor approaches you unexpectedly, ask to see credentials, and if you are not satisfied contact your insurance company to make sure they are appointed by your insurer
  • If you remain suspicious, ask to see the contractor or assessors’ driver's licence and write down the licence number and their vehicle's licence plate number
  • Before hiring anyone, get all the details of a job in writing and only work with contractors who are licensed and insured
  • Pay with a credit card or a cheque rather than cash. Don’t hand over any form of payment directly to a contractor or assessor requesting cash, unless authorised by your insurer to do so
  • If you’re unsure, contact the police