Insurables — Australian business risk, sourced and dated

Notifying a claim: what to send and when

In short

  • Notify as soon as you know something has happened, before you know whether it will become a claim. Late notification is a reason claims get declined.
  • On claims-made cover such as professional indemnity, notifying a circumstance that might become a claim is what preserves cover under the current policy.
  • Do not admit liability, agree a settlement, or start paying to fix third-party damage before speaking to the insurer.

Most claim disputes trace back to the first week. Notification was late, an admission was made, evidence was lost, or repairs went ahead before the insurer saw anything.

This page is the sequence for the first few days, and what to keep.

Notify early, even when it might come to nothing

Policies require notification as soon as the insured becomes aware of an event, and claims-made policies also require notification of circumstances that might give rise to a claim. Neither obligation waits for a formal demand to arrive.

Notifying something that never becomes a claim costs nothing. Failing to notify something that does can put the whole claim at risk, and on a claims-made policy it can move the claim into a period where no policy responds.

What to send with the notification

Send the facts you have, without speculation about fault. The insurer needs to know what happened, when, where, who was involved and what has been said so far.

Attach whatever already exists instead of writing a narrative: photographs, the incident record, the relevant contract, the correspondence, and any letter or demand received.

  • What happened and when, in plain sequence
  • Who was involved and how to contact them
  • Photographs and any site or incident records made at the time
  • The contract or purchase order the work was done under
  • Any demand, letter or message received from the other party
  • Whether anyone has been told anything about fault, and by whom

What not to do before the insurer responds

Do not admit liability or agree to pay. Policies commonly exclude liability the insured assumed voluntarily, and an admission made to be helpful can remove cover for the very claim it was meant to resolve.

Do not repair or dispose of damaged property beyond what is needed to make the site safe, and keep the damaged items. An insurer that cannot inspect what was damaged is being asked to accept a claim it cannot verify.

Keep your own file from day one

Keep a dated record of every conversation with the insurer and the assessor, including who said what. When a claim is straightforward this is wasted effort; when it is not, this file is the whole basis of a complaint.

Keep the policy schedule and wording that applied on the date of the event, not the current one. Cover is decided under the policy in force at the relevant time.

Questions

Will notifying a claim increase my premium even if nothing comes of it?
Notifications form part of the claims history an insurer sees at renewal, and that history is one input into pricing. The alternative — not notifying and losing cover for a claim that does arrive — is a much larger exposure.
Who do I notify, the broker or the insurer?
If a broker arranged the policy, notify the broker and ask them to confirm the notification has been lodged with the insurer. Ask for that confirmation in writing, because the notification date can matter.
What is the difference between a claim and a circumstance?
A claim is a demand made against you. A circumstance is something that has happened which might lead to one. Claims-made policies want to hear about both, and notifying a circumstance is what keeps it attached to the current policy period.
The other party says they will not claim. Do I still notify?
Yes. An informal assurance is not a release, and positions change once a repair quote arrives. Notification is cheap and reversible; a late notification is neither.

Sources

  • Moneysmart (ASIC) — Regulator guidance on making insurance claims and what insurers require.
  • AFCA — External dispute resolution scheme; its published approaches explain how claim disputes are decided.

Related

Clauses this page relies on