Project Managed Claim Handling Process

Project Managed Procurement

The Project Managed claim handling process is typically administered under a delegated authority where the service provider (loss adjusting firm) does not refer to the Insurer except under specified circumstances. Project managed procurement seeks to speed up the claim process and typically reduces the amount of paperwork involved. The Insurer instructs the service provider (loss adjuster) how their claim protocol and processes are to be implemented and also which preferred suppliers are to be used in undertaking repairs. The process is generally quicker than the traditional approach.

Claim Triage

Claim information provided by the Insurer is reviewed and the policyholder contacted by telephone. If a valid claim is not indicated, the claim is repudiated. If a valid claim is indicated then a preliminary inspection is made.

(The triage process is not necessarily implemented by all Insurers.)

Preliminary Inspection

This inspection is carried out to gather information such as description and condition of your property, the circumstances relating to discovery of the damage exhibited, extent of damage, likely cause and scope of repair. All this information is acquired to enable us to determine liability and confirm the proposed course of action. A letter will be sent after the first visit either repudiating the claim or confirming liability.

Repudiation Of Claim

In some instances, your claim may not be covered by your policy in which case we will write and confirm this. Usually, you will be told at the time we visit if your claim is valid or not and the reason why.

On-site Investigations

Site investigations are not necessarily undertaken in a project managed claim handling system. Typically, any probable influences are identified and mitigation work is undertaken as quickly as possible. If site investigation is needed, then trial holes will be excavated and soil samples obtained and tested.

Mitigation

After the first visit, there will be recommendations to carry out some initial measures such as investigating and repairing leaking drains or removing nearby trees or other vegetation. After this, monitoring may be used to see if building movement has stopped.

Monitoring

Crack monitoring might be used depending upon the circumstances. If drains have been repaired, 6 months monitoring is likely before repair. If trees have been removed monitoring is likely for 12 months after the tree is felled.

In some cases, building repairs are carried out immediately and the repair then acts as the monitor.

If monitoring indicates movement has not been stopped by mitigation work, then a ground investigation is likely to be undertaken.

Stabilisation and Repair

Outline details for repair are gathered at the first visit. A schedule is prepared and issued for tendering at or just before completion of monitoring (if undertaken). You will receive a copy of the schedule just before tenders are invited. A contractor will be appointed on the basis of the estimates received.

Once the contractor starts repairs, you will be required to pay your policy excess As the work proceeds, you may decide to off set some or all of the policy excess against certain elements of the work. With your Insurers agreement, cash settlement can be agreed for some of the repairs or in some circumstances, all of the repairs.

When the repairs are finished and have been appropriately certified as being satisfactorily complete, you will be provided with the closing paperwork. The information you receive will vary depending upon the requirements of your Insurer and the scope of our instructions.

Typical project managed claim process

Typical project managed claim process