Getting claim information from your insurance company

In our area a few of us have been getting together to sort out insurance problems with a particular company. Standard story: rebuilds have become repairs, or high value repairs have turned into low value repairs. Invariably the amount of information provided by the insurance company has been conflicting and inadequate.

The key to our being satisfied about what is going on is to get all the information the insurance company holds. There are two ways of doing this: paying a lawyer to get it for you, or trying a DIY approach. This post is for the DIY people.

What has the insurance company been doing and what is it up to?

To come to grips with the way your insurance company is treating your case, it is important to have all the insurance company documentation in front of you: to see what has changed over time, what has been factored in, what has been left out, what is contradictory, and what is plain wrong. Insurance companies are reluctant to give this information out, and sometimes refuse. Clearly this serves their purposes as many assessments have been of doubtful quality, or skewed towards a lower cost solution, and won’t stand up to scrutiny.

In understanding why they behave like this it is important to appreciate that insurance companies often don’t operate with the values we feel are important: decency, fairness, honesty, integrity or openness. Their only functioning corporate value is to not get caught doing anything unlawful. If this seems harsh, remember insurance companies (where there is a high value at stake) have a tendency to take an untrusting and sometimes suspicious approach to claimants, fearing there may be dishonest motives behind the claim.There is no reason why this approach cannot be reciprocated.

Using your legal rights (click the link to continue)

Although the operation and cost of the legal system often favours big corporates, and those with deep pockets, there are tools we can use to push our insurers in a direction that helps our respective situations.

The Privacy Act allows anyone to find out what information is held about them by a government or private sector agency. This means you have a legal right to know, and have a copy of, all material the insurance company has about your claim. Not just now, but for each of the assessments they have done (if more than one) and all the details, costings, reports, comments, observations, letters, e-mails and recommendations that arose from the assessment(s).

You can exercise this right to have the information simply by sending a short letter (see below). See here for information on the Privacy Commission’s website. Principle 6 (here) covers access to personal information.

Under the Privacy Act the insurance company has 20 working days from the day after they receive your request to send you the information you have asked for. If they refuse to give you the information you request, or don’t bother to respond, a complaint can be made to the Privacy Commissioner who will investigate to see if your rights have been abused. More about that in a few weeks, or earlier if a problem arises.

The letter
When asking for information, be brief. Maybe something along these lines:

The Manager XYZ Insurance

Dear Manager

Insurance claim xxxxxxxx in the name of ab & cd of  XX Cowlishaw Street, Avonside

This is a request under the Privacy Act.

Please send to me at the address above a copy of all papers, reports, assessments (complete with full costings), and all other information recorded with respect to the insurance claim on our/my property.

The letter may seem a bit short however, when dealing with people who are employed to minimise the cost of your claim and discourage you from challenging their assessment, a short letter means there is less opportunity for “mistakes” or “misunderstandings” to arise or be invented.

You don’t have to explain why you want the information, and to do so could be unwise. The insurance company doesn’t need to know your business, what you intend to do with the information, or who you will be showing it to. Should the insurance company offer to explain what you need to know over the phone, insist that everything be put in writing.

The letter is addressed to “The Manager” for a few reasons. Starting at the top is a good idea, your claims officer may not understand how the Privacy Act works, whereas the manager is paid to know these things. Also, if your claims officer is away, the request may be left until he/she gets back.  Big organisations, including insurance companies, are supposed to have people designated as Privacy Officers (see here). Sending the letter to management is more likely to ensure your request ends up with these people.

If possible send the letter in a way that there is a record of the day it was posted and the day it was delivered. Try a  Ready to Go envelope from NZ post. It costs about $6 and you can track when it was delivered. A small cost to have proof that it was posted and delivered. Knowing the day it was delivered allows you to calculate when you should receive an answer.

Once you have the paperwork, there are people who can help you work your way through it and check whether everything is as it should be, or what next if there is something improper.

Good luck.

ADDED 02/06/2012  There is a small update here.