Briefly About The Claim

Making a claim, especially those who have never experienced an incident that they are used to (most commonly insured people have only experienced in motor vehicle claims), often the insured experiences confusion and it is not even impossible to actually take actions that can lead to disappointment because it can result in the claim being partially deducted and even being rejected by the insurer.

When you want to make a claim against your loss and/ or incident, it can be a daunting process (not mentioned horror like in the haunted house) if you don’t know where to start, but we wish that our brief explanation will help you find your way around it and provide you with all the necessary information to processing your claim.

However, big or small your claim, our Specialist Claims Solutions Team dedicated is on hand to walk you through any claims processes you need to undertake.

Often the insured feels that the settlement of their claims will be the same as the treatment of their experience in motor vehicle insurance claims, even though the facts are very different in practice.

This is because in partial loss claims on Motor Vehicle insurance all loss recovery is carried out by the insurance and the insured only provides documents with information related to the incident event, then the insured controls the final result of the repair or recondition work carried out by the insurance team, except in certain special circumstances such as the insured as owner of the vehicle lives in a remote location and the insurer does not have the nearest repair workshop partner located in the insured area.

Meanwhile, for loss claims on NON Motor Vehicle insurance all loss recovery is carried out by the insured himself, including providing of technicians, mechanics, engineers, repairers, as well as the availability of spare parts and/or materials for the recovery and reconditioning of damage or loss, including the quality and process of carrying out repairs supervised by the insured himself.

The insurance company team only checks the suitability of the quantity, quality and price with the related events/causes of loss and then compares their findings with the provisions of the insurance policy.

There is also an insurance policy product where in the claim settlement process the insurer will focus on seeing the time spent between the date of the accident, submission of claims, supporting documents, repair estimates and until the implementation of repairs or replacements carried out and time frame will finish by the insured, because this will affect the amount of claim value which they will pay to you.

If based on the view of insurance that the amount of a claim is considered large and/or has the possibility of being disputed, they will appoint other parties to involve as their teamwork in an effort to facilitate and convince their reinsurers, including if possible to reject or minimize the loss amount of claims that they have will to pay to the Insured, i.e : surveyor and/or adjuster, and/or solicitor, and/or salvor, and/or salvage buyer, etc.

We wish our brief explanation will help you find your way around it and provide you with all the necessary information to processing your claim.

HOW DO YOU MAKE AN INSURANCE CLAIM WITH BMJ INSURANCE BROKERS.?
You don’t need to worry about facing various kinds of obstacles, because we are here to help resolve your claim, so as a first step if an incident occurs and you want to file a claim to the Insurance, you can take the following steps:

Step 1.
PREVENT & SECURE (as if how if)

The first thing to do in the event of any claim is to prevent any further damage or loss “as if how if” your property/ assets are not protected by the insurance.

This is more relevant for material/ property/ asset related claims, but the majority of most outlines have something in common as your first step.

Read what to do

BREAK-IN AND THEFT
(including attempted break-in)

This may mean closing a broken window or door. Authorities officer area i.e : police / local security / emergency services must know the situation and conditions, but then you still have to ensure that the building is safe.

This includes boarding up broken windows and doors, and might mean emergency repairs, or covering of the roof if damaged. The fire brigade or police may have even already boarded the property up for you or then seal by police line for couple days.

Never remove any damaged contents as you may need evidence of these for your claim, unless you have official permission from the police and/or insurance you have notified.

FIRE ACCIDENT
Emergency services should take care of the situation but then you should make sure the building is safe, secure and watertight.

STORM DAMAGE
Once the storm event has passed you should make sure the building is safe, secure and watertight by boarding up any windows and doors and covering any damage to the roof if necessary.

FLOOD DUE TO INCLEMENT WEATHER
The most important thing is that you do not throw any damaged items away and that you take pictures of the damage where you can.

These will all serve as evidence to help with your claim. In the event of major floods, it might be impossible to keep water out of your buildings, but where possible you should try and sweep or mop the water out and turn any water, gas and electricity services off.

Once cleared, it might also be an idea to place sandbags in external doorways to prevent further flooding if appropriate.

REMEMBER

Never remove any damaged contents and/or documents related as you may need evidence of these for your claim, except for security reasons from other possible loss amount/ risk that might arise.

If possible, immediately make documentary evidence of the event or loss that occurred i.e. take some photos and/or videos, because this will make it easier for the implementation of the next stages your claim settlement process.

in the event of an accident that causes losses to other parties and is suspected to be due to your negligence, do not provide confirmation to them regarding the amount or value of compensation, even though you are convinced that the accident occurred and the loss result that befell the other party was the result of your negligence.

In the event of a lawsuit for legal liability as a result of your business activities/products or professional work, be patient, don’t panic and tell them that you need time to examine and analyze their lawsuit in more detail and will contact them shortly.

In the event of a loss, it is clear that you are the one who is negligent resulting in physical material damage and/or bodily injury to third party as motor vehicles case (collision), be patient and tell them that you have insurance coverage against TPL risks and convince the victim (Third Party) that you are responsible and will compensate the loss as soon as the insurance finds out (survey). (TPL = Third Party Liability).

Do not provide confirmation to them regarding the amount or value of compensation, even though you really believe that the cause of the accident was due to your negligence.

If there is negligence from other parties that results in losses to you, immediately take action to obtain evidence of their negligence, i.e: confiscation of ID card (if caused by a personal), proof of your official report to their party (corporate), and documents related to the existence of their involvement and then inconsistent with what they had agreed at first the initial outset.

Report to the police in the nearest area if the accident or loss is due to elements of a criminal motive, i.e : Theft, Burglary, Robbery, Vandalism, etc.

Step 2.
CALL BMJ

Once you have confirmed that you have prevented further loss or damage then you will need to speak with a BMJ officer, we will then be able to take the necessary details and information about your claim to forward it to insurer and advise you of the best plan of action for you.

Read what to do

Keep calm and inform the BMJ officer in chronological detail from the beginning of the activities carried out by the witness and/ or youself until the loss incident occurred.

Mention the names of witnesses and/ or yourself who directly saw, heard and/or were involved in the loss incident event and also are known to have been involved at the scene, including the precautions and security measures taken to prevent the loss becoming large.

Step 3.
Fill Out a Claim Form

After you have spoken to us and you have decided that you want to make a claim, we will ask you to fill in a claims form.

Read what to do

All of our different insurers have their own claims form, so it is important you fill in the right one.

Don’t worry, we will tell you know exactly which one you need to fill in, and help you with any parts that you might find difficult.

Please don’t fill in a claims form until we has advised you to do so.

With you having carried out all the steps above, you have finished making a claim or the first stage of the claim settlement process has been completed and you will be guided by our team to proceed to the next stage in preparing your claim supporting documents according to the loss event that occurred and the type of coverage your insurance policy.

FREQUENTLY ASKED QUESTIONS

Do I need to tell BMJ if any incidents, even if we do not claim?

Yes. All incidents should be notified to us even if you do not want to make a claim, so we can inform insurer accordingly.

Where can I get a claim form from.?

Please contact us so we can send you one by post or email.

We have suffered a break-in what should we do?

Inform the police and obtain an officialy crime reference number report from them. Make sure the property is safe, secure and watertight, then obtain two estimates (if possible) for repairs/replacement, dont forget to take some pictures (photos) of damage.

Is wear and tear covered?

No, General maintenance and wear and tear is not covered under the policy. Neither is gradually operating cause.

Water is coming in through the roof

If this is rain water it may be roof tiles have slipped or perhaps lead has been stolen by unknown person. Ask a roofer to investigate and make it watertight and secure. Estimate should state the cause of the damage i.e. stolen lead, stormy conditions etc.

How long does it take to complete the stages of claim?

Sooner or later the settlement of the claim depends on how quickly the supporting documents you provide.

Insurance does not replace your damaged assets or lost items, because the insurance liability is only for the value amount of your assets and/or the compensation limit amount as mentioned in the policy provisions, except for motor vehicle insurance.

So, the sooner you provide claim supporting documents and related information required to your claim, the faster the process for settlement of claims will be completed

How long it will take to receive payment of claim for such losses?

In accordance with OJK-RI regulations that insurance must have made payments to you no later than 30 calendar days since you and insurer agreed on the amount replacement/ compensation for losses.

How long do I have tolerance period to report a claim?

Soonest, as soon as possible after you have an incident and/or lawsuit because the insurer also needs time to review and find out (i.e : surveys, seeing the condition of the incident location, interview, etc.) and also each insurance policy has different requirements regarding notification of losses that result in your claim being accepted or rejected by the insurer due to delays in claim reporting, therefore our advice if possible is less than 1×24 hours after you find out the accident information or it happens to yourself.

What Is UNDERINSURED Average?

Your claim payments will be subject to an average underinsured calculation, if it is proven that your Sum Insured is lower (inadequate) than the price required by the terms of the insurance policy.

Example : Terms of the Insurers’ policy Coverage is subject to the New Replacement Value (NRV) for Sum Insured.

It means, the Price of a new good item is required as the Sum Insured of the insurer’s policy, so that if a loss occurs, the insurer can provides you with loss replacement money at a NEW Price, even though the goods covered by the insurer are for OLD goods condition.

This is because the insurance company assumes you pay a premium based on a new price calculation in order to get a new price item replaced when the accident event occur.

However, when your claim is known that the sum insured is Not based on the new price, of course the insurance will Not replace to you with the new price, because you are paying the premium also Not based on the new price calculation.

Let’s say the new price is USD 100 million, but your sum insured is only USD 75 million (the percentage between the new price and the sum insured is 75%, so the value of the premium paid is also 75% only), considering the insurer covered is not in the full amount of new price (only 75%), of course insurance pays you as claim settlement also 75% only, or in other words the payment for your claim will be deducted 25% by the insurance.

However, the above conditions (new for old payment) are subject to the New Price of the replacement item having the same level of quality and quantity as the claimed to old damaged item, otherwise they will deduct as a “Bettement Factor” to your claim payment.

What is Betterment factor?

Insurance will makes deduction as a “Betterment Factor” for payment of your claim settlement if you replace the damaged goods with Better Quality.

This is because the NEW price for the type and quality level of the damaged goods is available on the market, therefore the insurer will Pay you the New Price Available on the market for the Same Quality as the damaged goods, so the difference value between the two prices is your responsibility and not covered by the insurance.

Deduction due to the “betterment factor” are carried out by insurance because the premium you pay is equal to the price with the quality of the goods covered by the policy since the beginning of the policy period, of course the replacement cannot exceed/ better than the quality of the goods that have suffered losses and covered by the insurer.

Still curious.? do you want to know how to prevent insurance deducting against your claim amount.?

Contact us immediately, become our client and get rid of your confusion, especially if you are currently having problems with your insurance claim settlement process.

Let’s feel comfortable to move forward confidently with us standing by your side.

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