Making an insurance claim
This section has information to help you if you need to make an insurance claim:
The first thing you need to do is check your full policy (not just the summary) to see whether you are covered. Remember, you may be covered for the same loss under more than one policy. For example, if your money is stolen while you are on holiday, this may be covered by your all-risks household policy and also by your travel insurance. You cannot claim under more than one policy for any loss, so carefully consider which policy to claim against, bearing in mind the excess on each policy.
There are three steps to help you make a claim:
- Call your insurer or broker as soon as you discover a problem. They often have a free emergency helpline
- Give brief details of the claim and request a claim form
- Depending on the type of claim, your insurer or broker will give you advice on what to do next. For example, if your home has been damaged, they may suggest you get some emergency repairs done. Always check that your insurer will cover the cost of any repairs
For larger claims, such as a buildings claim on your home, you may want to hire an assessor. An assessor works on your behalf and will negotiate with your insurance company to settle your claim. Assessors’ fees are not covered by your policy, so you will have to pay for this service yourself. An assessor is not the same as a loss adjuster, who is employed by the insurance company and works on their behalf.
Things to consider before making a claim
- Before making a claim, check the excess you have to pay yourself on your policy. The amount varies but is generally between €100 and €300. You will not be able to claim for amounts less than the excess.
- If the amount of a claim is small, consider whether it is worth making a claim. If you make a claim, you may lose your no-claims discount with certain insurers and you may find it more difficult to shop around for certain types of cover the next time you renew your policy.
How an insurer must deal with your claim
Although there is some paperwork involved in making a claim, you should remember that under the Central Bank’s Consumer Protection Code regulated companies are required to:
- Have a written procedure in place for dealing with claims.
- Help you if you need to make a claim and let you know about new developments which affect the outcome of your claim within 10 business days of knowing about them.
- Let you know their decision on your claim within 10 business days of making the decision. When a claim is not settled in your favour, they should explain the reasons why in writing, and provide you with details of how you can appeal the decision.
When you applied for insurance your insurer will have told you, under the Central Bank’s Consumer Protection Code, that any cover or claim you make could be affected if you give inaccurate or incomplete information when you apply for cover.
Your insurance company will consider your claim and decide whether your policy covers you for the costs or damage. It is your choice to accept their settlement. You can negotiate with your insurance company or broker if you are unhappy with their offer.
Insurers normally settle claims by cheque, payable to you. If you have arranged home insurance through your mortgage lender, the insurance company may pay the money to your lender who will then pass it on to you.
How long should it take to settle a claim?
There is no definite length of time to settle an insurance claim and it will depend on the type of claim. Some claims may need expert opinions or the input of several people before the claim can be agreed.
Personal injury claims – what to do if you have an accident
In cases that involve another party, such as a traffic accident, you should:
- Report the matter to the Gardaí immediately
- Advise your insurance company straight away
- Contact the Injuries Board (an independent statutory body set up by the Government) and/or get legal advice
In the case of a claim for personal injury, you don’t have to accept the amount an insurance company offers. You can decide to reject their offer and refer your claim to the Injuries Board, to decide the amount of compensation you should get for personal injuries. This helps to make the claims process less expensive, as you are under no obligation to use a solicitor.
The Injuries Board website will let you see how much you could receive for certain injuries. You can take a claim and apply directly on http://www.piab.ie or use the Injuries Board Smartphone app.
However, if you decide to reject the Injuries Board assessment, you may take your claim to court. In these circumstances, you may prefer to get legal advice as soon as possible.
Some policies contain a ‘legal expenses clause’, where you would be offered the use of legal services if you were making a claim. Check if you have this cover on your policy so that you do not pay for any services you are already covered for.
If someone is claiming against you
Insurance companies do not have an obligation to inform you of the outcome of a claim made against you and can agree a settlement without your knowledge or consent. Keep in contact with your insurance company, in particular the claims manager appointed to the claim.
If you disagree with the finding, you can make your feelings known to the claims manager and the customer complaints department at the insurance company. If you need to make a complaint, follow our complaints procedures.
If you have an accident with an uninsured driver
Follow the above procedures, but you may also wish to contact the Motor Insurance Bureau of Ireland (MIBI). The MIBI was set up to compensate victims of uninsured and untraced drivers in Ireland.
It also makes sure claims against foreign registered vehicles in Ireland, or Irish motorists abroad, are properly handled and settled.
Who can I use to repair my car?
If you are getting repairs made to your car, you might want to make a claim on your policy to cover the cost. You can choose to use a business from your insurance company’s panel of “approved repairers” or you can use a repairer that is not on that list, for example, a local mechanic you have used before.
If you decide to use your own repairer, you may need to have the repair costs authorised by your insurance company before you have the work done. Be aware that many insurance companies have limits on the amounts that you can claim for work carried out, for example, on windscreen repairs.
Before you decide who repairs your car, always check the terms and conditions of your insurance policy, or contact your insurance provider, to see if the work needed to repair the damage is covered by your policy and if there are any limits on the amount you can claim.
Can my claim be refused?
Your claim can be refused for a number of reasons.
Could I get less money then I claimed for?
In some cases, your claim may be reduced. For example, if you have underestimated the cost of rebuilding your home and replacing your belongings when taking out home insurance, you could get less money than you claimed for. This is due to an ‘average clause‘, which is included in some policies.
For example, if the contents of your home are worth €40,000 but you insure them for just €20,000 and they get completely destroyed by fire, the most you will get from your insurance company is €20,000.
Even if you claim €10,000, the insurance company will look at the overall amount you insured your contents for and will consider that you are only half insured. So they may pay out only €5,000 or half of the total damage.