Angela Lee
Senior Vice President, National Claims Director
Essential principles of claims reporting
As insurance policies become increasingly complex, understanding the basics of claims reporting is essential for effectively navigating any claims that may arise. Proper claims reporting not only helps you maximize your insurance policies but also protects your business from potential coverage gaps and complications.
To manage the claims process successfully, businesses should keep these best practices in mind:
- Understand the claims notice requirements: Stay updated about the specifics of your insurance coverage, including what counts as a “claim,” coverage limits, exclusions, and notice requirements. Be aware of any deadlines for notifying insurers about claims and the steps for filing a Notice of Circumstance. This knowledge is crucial to ensure compliance, protect your coverage, and document potential claims effectively before they arise.
- When in doubt, report it: Contact your local MMA team if you’re unsure about reporting something.
- Set up claims reporting protocols: Create clear steps for reporting claims to make sure notifications are timely and accurate.
- Mandatory reporting considerations: Claims from serious incidents, like loss of limbs, burns, fatalities, and other critical injuries, usually need to be reported right away because of their serious nature and the potential impact on safety, compliance, preserving evidence, and legal responsibilities.
- Keep communication open: Encourage regular conversations with your insurance carrier's team members to clarify any questions you have about claims reporting and processing.
- Document everything: Keep a record of all communications about claims reporting, including the date and how you notified each insurer.
- Follow up: After submitting the claim, check in with your insurance carrier to confirm its status and make sure it’s being processed quickly.
Key considerations for effective claims notification
When reporting claims, keep the following points in mind:
- Timely notice of claims: Reporting claims quickly is essential. Delayed reporting can lead to various issues, including denial of coverage.
- Layered insurance programs: Insurance programs often have multiple layers of coverage from different insurance carriers, each with distinct reporting requirements.
- Potential for multiple policies: A claim may involve different types of coverage. It’s important to assess which policies may provide coverage for the claim and make sure to notify all relevant insurers.
- Claims-made policies: A “claims-made” policy is triggered when a claim is first made against an insured during the policy period, no matter when the wrongful act happened. These policies usually have strict timeframes for notice, so it’s important to notify all relevant parties quickly to ensure coverage.
- Involvement of defense counsel: If you have a liability claim that requires an urgent response, or if you want to get approval to hire a lawyer (and your policy allows it), make sure to communicate this clearly during the claims notification process.
Importance of notifying excess and umbrella policies
Excess insurance carriers are increasingly involved earlier in the process. Notifying excess and umbrella carriers about a claim is a key step in claims management. If the excess or umbrella coverage is on a claims-made policy, you must give timely notice to all relevant layers at the same time you notify the primary carrier. Maintaining communication with excess carriers is important to protect your interests.
Effective claims reporting isn’t just a necessary step; it’s crucial for protecting your interests and maximizing the value of your insurance coverage. By understanding your policy details, following best practices, and maintaining open communication with your insurance team, you can navigate the claims process more effectively and reduce the risk of complications.
At MMA, we provide you with the support and resources you need to manage your claims confidently. Whether you’re facing a claim now or preparing for future possibilities, remember that we’re here to help you through this process.
