The key to claims success: Q&A with Bellrock Claims Director, Mat Holland
The past few years have been anything but dull for Mat Holland. Since 2019 Bellrock’s Claims Director has secured $24 Million, in payouts on behalf of our clients in NSW alone. An impressive figure, particularly amidst hardened market conditions and at a time when strategic claims denials and delayed claim response times from insurers have frustrated many policyholders.
Here we discuss current market trends in claims management with Mat and how strong client/broker relationships have been a key driver to successful claims outcomes for his clients.
Mat: First and foremost our client’s risks are comprehensively placed with insurers and underwriters that truly understand their businesses, so that risks and claims are resolved in the best interests of our clients. At Bellrock, we are fortunate to have a vastly experienced team across all business lines, which in turn enable our clients to receive the best possible level of advice and covers available and assurances for their respective business.
In terms of the claims process itself, we believe that “Claims” is our shop window at Bellrock, and this approach sets us aside from other intermediaries within the industry. In essence this means we are true advocates of our clients throughout the claims process.
When preparing loss reports and claims submissions on behalf of our clients we gather the relevant key facts and make observations on liability, quantum, indemnity and resolution strategies. In addition, before we present to insurers we discuss claim strategy and outcomes with our clients. We do this to ensure the insurance strategy aligns with our clients’ commercial objectives.
Bellrock has made a significant investment in people and technological resources, so that we can provide leading claims services to our clients. Our team comprises insurance and legal professionals who have extensive expertise and experience in all general insurance products. Lastly, we also pride ourselves on adopting a conclusion driven approach to all notifications and claims, recognising that prolonged disputes rarely benefit our clients or insurers.
Mat: Without question the industry has evolved exponentially over the last 25 years. When I first entered the insurance industry the age of email and internet were relatively unknown quantities and new claim notifications were either mailed, faxed or sent by Telex!
The advancements made from a technology perspective have been truly mindboggling from that perspective, impacting all aspects of the insurance industry. I have been fortunate enough to work with some true legends and dare I say pioneers of an industry I hold very dear.
In terms of current notable trends (and staying on the theme of technology advancements), following a number of significant well publicised events, there has been a significant increase and awareness in terms of Cyber Liability Insurance (see our guide to Cyber Liability Insurance here). In our Market update back in June 2021, it was estimated that Australian businesses will have spent in excess of $7.5 billion on cyber security in 2021. From our perspective, there has certainly been an uplift in claim notifications in this space.
Another area where increased activity has been observed is Strata related claims. Aside from claims arising from some significant storm events throughout 2020/2021 we have also seen a notable increase in disputes and claims arising from renovations to Strata Buildings. See our recent article on this topic here.
Mat: The impact and effects of the COVID-19 pandemic on businesses and individuals across Australia and globally has been truly devastating.
As far as Bellrock’s clients are concerned, at the outset of the COVID-19 pandemic, there was a significant influx of claims primarily in relation to Corporate Travel, the bulk of which have been fully resolved by Insurers.
There however remains a significant and wider impact on the insurance industry across all insurance products. The most notable and well publicised being the two “test cases” litigated in the High Court, the second of which is likely to be unresolved until the end of 2021.
However, there are also implications such as potential claims against Directors & Officers and Company Liability in terms of responses to COVID-19, mismanagement of company finances, continuous disclosure, insolvency, unfair dismissal and claims brought by regulatory authorities by way of some examples.
There is also a heightened risk in terms of Cyber, which we predict will continue to increase, with many companies still lacking adequate risk management, governance or response plans.
In summary, the aftereffects of COVID-19 will likely continue for some time to come.
Mat: Our existing relationships with Insurers obviously assists significantly in ensuring that claims, once submitted, are actioned and resolved as expediently as possible and with as little negative impact as possible to our clients.
As noted previously, our combined extensive experience in claims management also enables us to be proactive in obtaining all relevant information ahead of providing detailed submissions to Insurers, which significantly decreases the life cycle of claims.
By way of an example, we recently dealt with a mechanical breakdown and spoilage of goods claim, whereby detailed information regarding the circumstances and quantum was sought at the outset from the client. Once this was received, a detailed claim submission was made and the insurer confirmed payment in full within 3 hours.
Mat: Inevitably, there are always circumstances where cover may be disputed. It is also important to highlight that no one insurance policy is without some limitations.
That said, there are circumstances whereby challenges can be made and a decision to deny cover by Insurers can be overturned, where appropriate and valid.
Below are examples of where we have successfully overturned decisions to decline coverage:
- Where there is clear obvious ambiguity under the Policy
- A misunderstanding of the factual matrix of the claim
- Misinterpretation and application of a Standard Exclusion
- Alleged “material non-disclosure” where either such matters were incapable of being disclosed, or, were in the public domain, or, were not material to the risk being underwritten, or, where a reasonable person in the circumstances of the insured could never have anticipated disclosure of those matters.
There is also an obligation that both insurers and the insured alike act in utmost good faith throughout the claims process. This means that insurers are obligated to professionally and competently work through claims issues with the insured and their broker, including the articulation of a coverage position clearly and on a well-reasoned basis.
We do not suggest all claims are paid, but insurers must ensure that claims positions are thorough.
Mat: In the event of an incident which will or may give rise to a claim, it is imperative that procedures are implemented and adopted, so as to ensure that the impact on your business operations, and thus trading results are minimised.
The Bellrock claims team are here to assist you in getting your business back on track within a reasonable timeframe. Below is a brief guide to assist you in the event of a claim and provides a number of recommended steps which must be taken immediately:
Report the incident to your Bellrock Broking contact by telephone, email or facsimile whenever practical and within 24 hours of the incident. Regardless of whether or not the claim has been reported or a loss adjuster appointed, you must immediately do whatever is necessary to prevent further injury or damage.
- Call the Fire Brigade, Police Department, Ambulance or other appropriate Emergency Service.
- If during business hours, ensure safe evacuation, if necessary, of staff and neighbours.
- If critical machinery fails, commence investigations to locate replacement plant and/or services.
- If your premises are uninhabitable, investigate the availability of alternative premises.
- Remove property that is exposed to further damage to a more secure place, if possible.
- Providing there is no imminent danger to staff or anyone else, ensure the safe removal and storage of vital business records.
- Professional Indemnity Insurance
- Directors & Officers Liability/ Management Liability Insurance
- Employment Practices Liability Insurance
- Fidelity Insurance.
You should notify in writing any circumstances that you become aware of during the period of insurance, which could give rise to a future or potential claim, as soon as practical, within the period of insurance. Failure to notify claims may breach the terms and conditions of your policy coverage.
Whatever the circumstances of the incident, do not admit liability even if you think you were at fault. Your insurer may be entitled to deny a claim, or pay a reduced claim, if a statement made by you or your employees prejudices the Insurers’ position.
For more information on general insurance or advice in the event of a claim please contact us via the form below.