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Claims Handling Process
Insurer's Rights: To be granted significant access to the property to complete their
assessment, adjustment, and estimate of the damages. They do not have the right to
control the claims process or make final determination on the value of the loss.
Insured's Responsibilities: To prove their claim including causation, extent of
damages, method of remedy and costing. The insured has the right to use a third
party to control the claims process to determine the value of the loss.
1 - Assessment Phase
Insurer Insured
Investigate if the cause is a covered loss Don't surrender your rights and responsibilities
To provide a written coverage position to your insurer
shortly after the loss Hire the experts at MPRC to determine
causation and prove your claim
2 - Adjustment Phase
Insurer Insured
Adjust and estimate damages to Appraise and estimate damages to
contents/stock and dwelling/buildings contents/stock and dwelling/buildings
Takes a position on ALE/LOI indemnity period Document timelines to accurately reflect the
Use their PVs estimate to establish their value restoration period
position only Submit POL based on the value of the amount of
loss
3 - Appraisal Phase
Insurer Insured
Insurer triggers appraisal when the insured will Insured triggers appraisal when the insurer wil
not pay the value stated in the POL
not accept their value position
Appraisal determines the value of the loss ONLY - Best evidence wins - that is why you need
MPRC
it is independent of all other questions
4 - Litigation Phase
Disagreements over coverage and non-value disagreements are determined
in the courts, not by PAs