Illinois Casualty Company (ICC) has been insuring the Food and Beverage Industry for 75 years and recognizes that claims must be handled quickly and carefully to allow the business to resume operations as soon as possible. The claims process is a critical aspect of the insurance industry, ensuring that policyholders receive the support they need when an incident occurs.
The Occurrence
Every claim begins with an event that triggers it, such as an accident, damage, or loss. For our purposes, we call this an occurrence. The date of the occurrence is crucial as it starts the clock ticking from a statute of limitations perspective. The facts surrounding the event will drive all subsequent claim decisions.
Reporting the Claim
The reporting phase involves notifying the insurance company about the occurrence. This can be done by various parties, including the agent, insured, claimant, or other parties, through different channels such as email, phone, fax, or website. The timing of the report is also important and can be immediate or late, justified or non-justified. Once an incident is reported, the claims team will review the claim immediately and assign it to an adjuster for handling.
From Investigation to Resolution
Upon receipt of the claim, the assigned adjustor begins the investigation phase, which is a thorough process involving a three-pronged attack to evaluate: coverage, liability, and damages. Various tools are used during the investigation, including recorded statements, affidavits, official reports, media searches, and more.
Once the adjuster has developed sufficient information through the investigation, they can begin the process of evaluating the claim. During the evaluation phase, they must determine the following: Is the loss covered? Are damages owed, either by statute or by contract (i.e. the policy)? If so, how much?
The resolution phase involves moving the claim to completion either through settlement, denial, or other alternative means (i.e. arbitration, mediation, appraisal, litigation, etc.).
Recovery
Recovery refers to the process by which an insurance company seeks to regain money it has paid on a claim. This could be through reimbursement from a third party that is legally responsible for the loss or damage, a process known as subrogation.
In property insurance, when an insurer pays its policyholder for damage to covered property, the insurer assumes ownership of the damaged property and can then sell it for salvage. Money recovered through subrogation and salvage helps reduce the overall cost of the claim to both the insurer and the policyholder, which best serves the public interest.
The claims process is a complex and multifaceted journey that requires careful attention to detail and collaboration between various parties. By understanding each phase of the process, from occurrence to resolution, insurance professionals can ensure that claims are handled efficiently and effectively, providing the best possible outcome for policyholders.
For more information about insuring your business with ICC, use our Find an Agent search and locate an agent in your area.
