Gulfshore Insurance > Gulfshore Blog > Claims Management

When it comes to insuring your vehicles, it’s appropriate to feel slightly confused and unsure of which company really is the correct fit for you and your family. Selecting the right carrier is not always as simple as it seems. Many companies spend millions of dollars per year in advertising, making claims of premium savings, customer service, ease of doing business and the amount of years their company has been in business. For many families across the country these companies might meet their needs in the event of a claim. However, with these advertisements, very rarely do these companies make it clear what ‘coverage’ they are actually offering, and if you are in an accident, how will they satisfy or exceed your expectations.

Market Value vs. Agreed Value

Market Value: This is the term we hear most often, and it is the most common coverage offered by insurance companies. But what is it? The insurance term “Market Value” simply means – The value of your car in its current state, condition, mileage and age.  A depreciated value. This value is suitable for older cars in ‘fair’ condition. In the event of a total loss, the guidelines used by the insurance company are similar to the guidelines you would use to sell your car privately. Sources like, Kelly Blue Book are commonly used. This value is constantly changing and fluctuating each year.

Agreed Value: This term is used by the insurance company in making a declaration that a fixed value has been agreed upon by the insured and insurance company. This coverage should be strongly considered when you own a new, high value, custom, antique, or modified vehicle. The coverage will be based on the price you paid, recent appraisals, or invoices from the modifications. In the event of a total loss, the insured will be paid the agreed value which is stated on the policy declaration page.

Liability vs. UM/UIM

Liability: This coverage will pay “others” that you have caused injury to. The liability value on your declaration page is the amount of coverage you have purchased from the insurance company to protect your assets if you were to be held responsible for bodily injury, physical damage, and financial loss caused to another individual.

UM/UIM: (UM) Uninsured Motorist / Under Insured Motorist Coverage. This coverage will pay “you” for the bodily injury, physical damage, and financial loss someone else has caused you and did not have the proper liability coverage to pay for those damages.

Personal Injury Protection (PIP)
This coverage will change depending on the state where the policy is written. In Florida, the PIP coverage is your first line of defense in an accident, and is paid to “you” regardless of fault. The state required minimum is $10,000 for your PIP coverage.

Rental Reimbursement
Experiencing a car accident is a stressful situation. You contact your agent, you submit the claim, and have your vehicle towed to the body shop… now what? You need to secure another vehicle to continue your daily life. Do you know what rental reimbursement coverage you have purchased from your insurance carrier? If you drive a Mercedes, Audi, BMW, Jaguar, Lexus, Maserati, Land Rover, Bentley, Porsche, or luxury vehicle from GM, GMC, Ford or Acura will you be reimbursed to rent a similar kind of quality vehicle? Purchasing adequate rental reimbursement coverage will eliminate another stress in the event of a claim.

Claims Scenario:
The below scenario is to illustrate the aforementioned coverage, and how they would help or hinder the claims experience.

Mr. Insured and his Wife drive home from dinner, and during their drive home they were interrupted by a car traveling at 80 mph, running a red light into the driver side door of their luxury vehicle.

The driver of the other vehicle was fleeing the scene of a police call against him.  As he was running from the police, he ran a red light and caused the accident with Mr. & Mrs. Insured.  The at fault driver, was not only engaging in a criminal act, but did not have active insurance  at the time of the accident, leaving Mr. & Mrs. Insured vulnerable to pay their own medical expenses and suffer loss of income. Mr. Insured was a working physician at the time, and suffered severe headaches which left him unable to effectively work with the same precession as he was previously.

Since the at-fault driver did not have an active policy, there was no coverage available for Mr. & Mrs. Insured. They had to use their personal auto and umbrella policy. The auto insurance paid first with the personal injury protection, which was limited to $10,000, and then the uninsured motorist coverage at a limit of $500,000. Due to the extent of damages that Mr. Insured suffered, the uninsured motorist coverage on the underlying auto policy was insufficient. This lead to the umbrella’s uninsured coverage paying the remaining balance of the claim.

Mr. and Mrs. Insured did have rental reimbursement. However, their insurance carrier only allowed $50 per day reimbursement. The $50 was only enough to rent a mid-sized sedan, not a luxury vehicle. The insurance company did not offer an “agreed value”, which resulted in Mr. Insured only receiving a depreciated valuation to replace the vehicle. That led to Mr. Insured having to pay even more out of pocket to replace the totaled vehicle.

injured hand and work injury claim form

Promptly reporting workers’ compensation claims is a best practice, and now there’s evidence that a delay in reporting injuries can raise claims costs up to 51%.

Promptly reporting workers’ compensation claims is a best practice, and now there’s evidence that a delay in reporting injuries can raise claims costs. A new study from the National Council on Compensation Insurance, Inc. (NCCI) reports that a delayed injury report can increase compensation claim costs up to 51 percent as the condition worsens. The simple strategy of reporting claims promptly can significantly reduce claims costs.

NCCI researchers found that claims costs can climb after a delay of only seven days. A report more than 29 days after an incident may result in costs nearly 49 percent higher. One reason for the increase is that attorneys are more likely to become involved in comp cases the longer a claim is delayed. Employers are encouraged to help employees understand that prompt reporting of an accidental injury decreases the likelihood of an attorney’s involvement, according to J. Bradley Young, a partner with Harris, Dowell, Fisher & Harris, who works on compensation cases.

“I still deal with employers every day who feel that if they educate their workforce about comp laws, they’re simply telling their employees how to get more money out of comp claims, which isn’t the case,” Young told researchers.

Other obstacles to early reporting in the workplace are the perceptions that the employee who reports an injury will be doubted or considered lazy and not wanting to work. By not coming forward, some injuries can worsen, making costly measures such as surgery more likely. Employers can boost employee morale by communicating that injuries are a serious matter, and that employee well-being is a priority.

Based on the NCCI survey, employers who educate their workforce about early reporting and who demonstrate concern for all workplace injuries can significantly help create positive benefits for their employees while minimizing claims costs.

Contact the Gulfshore Insurance Risk Management Team with questions concerning claims reporting processes, as well as tools available to help mitigat workplace risks.

Tim Spear is a Client Advisor and Partner at Gulfshore Insurance. Tim works with a wide range of business clients to deliver strategic risk management and commercial property and casualty insurance guidance.

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With the holidays quickly approaching it is important to be sensitive to all employees’ cultural and religious beliefs. Many employees will decorate their office spaces with trinkets and ornaments revealing their religious beliefs during the holidays. With employee claims of religious discrimination on the rise in the U.S. and workers’ expressions of faith growing more diverse, companies are dealing with the complexities of managing religion on the job.

Religious discrimination is a serious matter, according to the Equal Employment Opportunity Commission religion-based complaints have more than doubled in the past 15 years, and are growing at an even faster pace. While the act is non-physical, religious discrimination can cause serious emotional harm.

Companies big and small are being affected by the complex intermixing of work and faith. Read more

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Although employers rightfully appreciate the efficiency and responsiveness of employees who use cell phones (and smart phones) to get their work done, they must also be aware of the financial and safety risks created by the use of these devices while driving. Employers are facing increased liability exposures from employee use of mobile phones to text, make calls, etc. while on the road. Read more

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Gravity–what’s it costing you?
According to recent data, the total annual cost of slip and fall injuries in the United States in over $60 billion annually. There is more involved in preventing a slip and fall accident than just placing the proper signage at a slippery entrance. Property Managers and Board Members should always prepare for the worst and hope for the best. Below is an action plan to help you manage slips, trips and falls at your association.  Click here to download a Slip & Fall Checklist to use at your association. Read more

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