CLAIMS INVESTIGATION AND ADJUSTING

Using our experience and resources we are able to make meaningful contributions in respect of:

• The Investigation of Losses
• Opining on Cover
• Resolution of disputes
• Verifying Quantum
• Negotiating Settlements

AREAS OF EXPERTISE

• Material damage losses (fire, storm, flood, etal)
• Business Interruption (loss of profit). Advice, Policy Interpretation, Formulation and Presentation of Claims.
• Fidelity Guarantee/Commercial Crime Investigation. Formulation and Presentation.
• Directors and Officers Liability.
• Public and Product liability including Defective Workmanship.
• Engineering Type Losses
• Contractors All Risks
• Plant All Risks
• Project Delay
• Marine/Goods in transit
• Mining losses
• Personal Accident
• Banking/Financial Institution special cover including Errors and Omissions.
• Personal Lines
• Motor & Heavy Commercial Vehicles.

CLAIMS HANDLING

• Investigate losses/events and determine the specific types of Insurance coverage Involved and comment on the adequacy of the portfolio of Insurance covers in respect of the losses.
• Interpret Insurance Covers, Provide advice regarding the Cover and, where required, provide advice and the like in respect of the Business Recovery Process.
• Co-Ordinate and assist with the investigation, formulation and presentation of a detailed and documented claim.
• Consult, advise and co-ordinate in the engagement of the other experts, and to effectively manage the claims process.
• Attending and providing input at all meetings/discussions as necessary with the Insured/Brokers, Insurers, Loss Adjusters, consultants and other involved parties.
• Monitor, manage and direct the activities and actions of the parties involved in the “Claims” process.
• Review insurance claim rejections and repudiations and if required reinvestigate and reformulate.

MENTORING

• Claims Management
• Claims Staff.

MANAGEMENT

• Temporary Management Assignments (Locum tenens functions)

POLICY WORDING/RISK MANAGEMENT

• Review and provide comment on Policy wordings.
• In conjunction with our associates undertake detailed Risk Identification and Risk Management Surveys.

CLAIMS AUDITING

• Review outstanding claims and reasons for settlement delays, as well as reviewing estimates.
• Review settlements and payments.
• Determine training needs.
• Review Systems and Standards.