Expectation vs reality: claims handling after catastrophes

People buy insurance so that they’re looked after when disaster strikes – but how prepared are they for the realities of the claims process after a major natural catastrophe?

Insurers are currently battling through 230,000 claims from the east coast floods in February and March, which is Australia’s worst flood on record, plus many more from a myriad of other events.

And, as has been well reported, there is a shortage of building materials and tradespeople – as well as a high employment environment which makes it harder for insurers to “scale up” as they usually would following a major claims event.

None of this is the fault of insurers – but it adds up to delays, in building work but also in communication. And by all accounts, frustration is growing. For direct customers who don’t have a broker to assist, it can all get too much.

Insurers have done well to close 36.3% of flood catastrophe claims already, according to Insurance Council of Australia (ICA) figures, but that still leaves 145,000 outstanding.

Customers threatening to go to the media is becoming commonplace, and some are boiling over. Anecdotal reports suggest that insurer call centre staff are increasingly being verbally abused.

While insurers are doing their best under difficult circumstances, they don’t deny they’re stretched.

The General Insurance Code of Practice says that insurers “will tell you about the progress of your claim at least every 20 business days”. It adds that “we will respond to your routine enquiries about your claim’s progress within 10 business days”.

But one industry source predicts these clauses will have been breached “tens of thousands of times” in recent months.

There are just too many claims and not enough staff, and not enough time to update people on claims that have not progressed anyway.

“It’s not some sort of systemic issue, it’s just inevitable with events of this scale,” the source said.

“It’s not possible to have hundreds of people twiddling their thumbs and waiting for a catastrophe to strike.”

For those without flood cover, there can be long waits for hydrologists to assess their claims, and temporary accommodation allowances may well run out.

Typical policies allow 12 months’ temporary accommodation, or 10% of the sum insured – and this might not be enough under the current circumstances.

Of course, underinsurance or going without insurance altogether leaves consumers at risk of losing everything. Having the right cover in place is vital – and valid claims will be paid.

But still, after catastrophes the size of the recent floods, some claimants will need to be patient.

How good is the industry at making this known in advance? Every insurer promises to look after its customers at claims time, and slick marketing videos often show claimants returning to repaired homes just months after an event.

For the people in these clips, everything went perfectly. But how does this make others feel?

A team of academics recently turned the spotlight on insurer claims handling after natural disasters, arguing that the customer experience can fall far short of expectations.

As insuranceNEWS.com.au has reported, Melbourne Law School researchers interviewed 30 insureds who had put in claims following catastrophes, and their comments make for tough reading – with some saying dealing with the insurer was more traumatic than the disaster itself.

The claimants talk about being bounced from person-to-person, and a feeling of helplessness as their claims got bogged down in complications and delays.

“One participant rang her insurer 44 times and was allocated eight different case managers; another made around 30 phone calls over several months while attempting to contact any of the four case managers appointed to her claim,” the report said.

“At one point, she spent six hours on the phone, speaking to seven different people but ‘not being able to get any information from anyone’.”

Shortages of experts and tradespeople also caused long delays, and repairs did not always go to plan.

“One participant had eight unsuccessful make-safe jobs performed on her roof. Another said, ‘I lost count at the number of so-called experts coming through my house at 25’.”

The 30 interviewees had already contacted the Financial Rights Legal Centre to seek help with their claims, so the study cannot be considered representative of the broader claims experience.

But the researchers say the findings show a gap between “public expectations and what insurance can deliver in the wake of disaster”.

While insurers deny very few claims, the study says the “promise” of insurance can still fall “far short” of expectations of protection and peace of mind.

ICA, in response to the Melbourne researchers’ study, says recovery after a disaster “can take time”.

“Understandably waiting for a decision to be made on an insurance claim can add to an already stressful period in someone’s life,” a spokesperson said.

“Insurers make every effort to support customers when they need it, scaling up resources and prioritising those who have been impacted the most.”

While insurers say they will learn from this event, there is a sense that the “perfect storm” of challenges currently faced means that repair delays and communication issues are an inevitability.

But the researchers question whether this is acceptable.

Research Fellow Evgenia Bourova told insuranceNEWS.com.au that while the issues facing insurers cannot be denied, there is still an “adequate standard” of claims handling that customers should be able to expect.

“They just want to know that their claim hasn’t fallen into a black hole,” she said. “People who did have a consistent person to talk to – it made a big difference to them.

“Maybe insurers do need to employ more staff so that an adequate standard can be maintained even after major catastrophes.”

For obvious reasons the claims experience can be quite different in the midst of a major catastrophe, compared with a claim where just one person in an area has been affected by a random event.

And maybe that does need to be made clearer in advance.

People would be better prepared for what’s to come, and less likely to lose patience when expectations are not met.