Submitting a Claim

Persistence is key when submitting claims — as a risk manager, be aggressive in pursuing every penny to which your company is entitled, Robert Horkovich, managing partner at Anderson Kill & Olick, told delegates of the 2008 RIMS conference in San Diego, Calif.

Horkovich, John Lambdin, assistant treasurer and director of insurance at Weyerhaeuser Company, and Linda Wikstrom, risk management administrator with the San Diego Unified Port District, hosted the seminar, “Ethics in Claims Management,” at the conference.

The hosts provided a David Letter-man- style Top 10 list to ethically handling and making good management practices in claims submissions.

The Top 10

10. Your policies aren’t worth their weight in gold. They are worth far more — Even before the claim arises, right now, make sure that you put your policies in order and your claims documentation in order to make sure that if an insurance company has a shredding machine you will not be affected by it, Horkovich said.

9. It’s not a good idea to lie on an insurance policy application — Disclose all known losses requested, because once a negative claim comes up there is going to be a number of people investigating. You do not want your claim denied on the basis that you did not disclose, he added.

8. It’s not a good idea to sleep on providing notice — It’s better to provide notice of occurrence faster than a speeding bullet. There is a difference between notice of occurrence — telling the company of a circumstance, which might give rise to a claim — and notice of claim — telling the insurance company you want defense and identification. Most CGL policies require the policyholder to provide the insurance company with written notice of an occurrence or claim under the policy as soon as possible, Horkovich pointed out.

7. It’s not a good idea to inflate your claim — “You should aggressively seek every penny to which you might be entitled under the policy, but don’t puff your figures,” Horkovich warned. “It’s really not a good idea.” Not only is it a crime, but it will likely destroy the relationship you have with the insurance company, he added.

6. Don’t treat your records of loss like trash — Make sure you keep good records of your losses — keep them and keep them organized. It’s really important when asked for the back up of expenses that a company is able to substantiate the expenses. “It helps you move your claim through the claims handling process,” he added.

5. It’s not a good idea to miss the boat on deadlines — Calendar your deadlines — these are unforgiving — meet the deadlines no matter what.

4. It’s not a good idea to keep the insurance company in the dark — Keep the insurance company informed about what’s going on, especially about the types of settlements your company is involved in, Horkovich said. Give insurers the opportunity to be involved.

3. Don’t wrestle with insurance companies over reasonable requests — Policyholders have a duty to cooperate with the insurance company, which is guided by a standard of reasonableness. Photocopy, photograph or videotape any documents provided to insurance companies.

2. Always try to have the last word — Respond to all insurance company correspondence. “Every single time they send you a letter, you send them a letter,” Horkovich said.

1. Never give in — Don’t take no for an answer.