Insurance Claims

Typically clients will appoint Pragmaticum when there is an expectation of a large of complex loss.

Pragmaticum will lead on the claim for business interruption but is also able to assist in other (typically simpler) areas as well as providing a coordinating role to prevent omission or duplication.

Our values are to support and guide the business in suffering the smallest possible loss but then to accurately quantify it and seek full recovery. Immediately after the incident we are able to advise and run scenarios of recovery strategies so that in agreement with the Insurer the one that is then chosen means that the business interruption loss that unfolds is kept to a minimum.

We are able to support the client through the typical phases of an insured loss:

  • From the day one feelings of worry and numbness,
  • Through the investigative stage whilst insurers accept liability
  • To the planning and implementation of recovery strategy
  • The assessment of loss and submission of the various claims including,
  • The monitoring of the recovery strategy and management of interim payments
  • The negotiation of settlement.
  • Recovery of any third party liability

Here are some basic tips

  1. Tell your broker or insurer (in writing) that there has been an incident and that you will be making a claim against your insurance policy and give the policy number as a reference.
  2. Get professional assistance and set out the outline of what has happened and the impact you think it will have on your business. Be mindful that this may be referred back to sometime in the future. If you have an insurance broker being them into the communication.
  3. Start the process by getting details from your insurer as to who its loss adjuster will be (if they are not pre-assigned) and when they will meet you (asap).
  4. The loss adjuster, who represents the insurer, will consider what has happened, the extent of the loss and whether it is covered under the insurance policy. It is important that there is an early meeting with you and your advisors so that agreement can be reached on the next stages of the process.
  5. From as early as possible get a record of everything (dated and timed). You will never be able to take too many photos or videos of the scene, but also of subsequent activity of debris removal and reinstatement. This material is not only useful in the proof of loss but also in marketing the recovery of the business and the journey it has undergone
  6. Before liability is accepted by the insurer it may well be necessary for forensic scientists to be appointed to establish the cause of any loss. You may also want to appoint your own if liability is in any doubt.
  7. Mitigate your loss by protecting the residual value of the business
  8. Communicate; not just with your broker and insurer but also with:
    • Your staff, as they will need reassurance. You don’t want to lose key personnel because they think the business is finished.
    • Your customers, to enable them to change their plans. It is better for them to use an alternative supplier temporarily than to be let down badly by you. Honesty and what you do in adversity are often what build stronger future relationships.
    • Your bank, to arrange the necessary finance to tide you over until the insurer can make an interim payment. Be aware to approach this with caution as the bank will have relied on the asset as security that may no longer exist.

How Pragmaticum can help

We have been here many times before and can offer sound advice on every step you and your business makes on the road to recovery.

In order for you to receive interim payments your insurer needs to be comfortable with the information you have provided. This will not only involve the expected value of the loss but you may also need to resolve any policy cover issues that may have been raised by the loss adjuster.

At a time when many claims are being made, the best presented claims have the greatest chance of being paid in full and quickly.

Pragmaticum will take the lead on the preparation and presentation of your business interruption claims and other heads of loss if required. We can provide support and advice in your communication with all parties to get the most appropriate messages across with the least amount of management effort.

Pragmaticum becomes part of the senior management team to take away the problem of claim preparation to allow business recovery to be the main focus. In being an experienced sounding board we are able to give confidence to management activity as well as direction.

Business Interruption claims

These are complex. With Material Damage claims you know you had a desk, how much it cost and where it came from. With Business Interruption claims, in effect, you have to look into the future and estimate as accurately as possible what would have happened if the damage had not occurred.

With these “What would have happened” scenarios no claim is 100% provable. The policy sets out a formula and provides a good deal of flexibility to allow you to calculate your loss BUT there could be pitfalls, e.g:

  • How adequate is the cover of the policy?
  • How long a period of loss is included? (indemnity period)
  • Do you continue to pay staff or lay them off?
  • Intervening causes – i.e unrelated to the loss such as a new competitor in the market.
  • Limits on the increased cost of working – you need to rent new offices, but not in Mayfair!
  • Are the overheads included in a stock and work in progress claim also being claimed as part of the business interruption?

Pragmaticum’s charges

  • Pragmaticum can be instructed on a time and disbursements basis or on a contingency fee (percentage of the settlement) basis, the choice will depend on the circumstances but always with the intention it best meets the needs of our client and represents excellent value for money.

Pragmaticum Limited is authorised and regulated by the Financial Conduct Authority. Ref: 501527