You discover that there is a march of humidity in the bedroom and that is the first thing you think. Warn the insurance! And then you wait for the insurance expert to come.

If you act like this, you are among the 9 out of 10 people who do. There is a general belief among policyholders, injured parties, and agents that after a claim, you have to wait for the insurance expert to intervene and assess the consequences. This way of acting is not new, and it has taken root in such a way that, in many cases, even the supervisor of the repair company is confused with the insurance expert.

There are many who, when discovering that they have been robbed at home, instead of calling the police, notify the insurance and then wait with everything mixed up for the expert to arrive. As if their presence were necessary to reorder the house or to make an inventory of what was stolen.

The same happens when a pipe breaks or we have a hit with the car. Instead of calling the plumber to fix the fault as soon as possible, we called the insurance agent and waited for the expert’s instructions.

Now I have to apologize because for years, working for an insurance company, I have nurtured this belief. It is simply the company’s way of controlling the loss from the beginning. And since there is money involved, there is always an argument with which to convince the insured to wait.

If you want to know how to repair the damage without delay, better not leave a line of the article unread.

Is the company obliged to send me to the expert to assess the damage or to the repairman to repair it?

I’m going to be direct. The insurer only has the obligation to compensate for the damages, as long as the claim is covered by the policy.

The Law 50/80 of Insurance Contract provides that the insurer shall indemnify the insured for the term of research or expert reports needed to establish the occurrence of the incident and recorded the number of damages.

At the same time, it allows the insurer, provided the insured agrees, to substitute the compensation for the repair or replacement of the damage.

But the law, as an insured, transfers several duties to you that you must fulfill:

  • Notify the insurer of the occurrence of the loss within seven days of knowing it. If you do it late or don’t do it, you expose yourself to a claim from the company for the damages that your action may have caused.
  • You must report all the circumstances and consequences of the claim. If you do not do so, you could lose the right to compensation if there is intent or gross negligence.
  • And you have to use all the means at your disposal to lessen the consequences of the accident.

As you can see, the law does not say that the insurance expert was required to intervene so do not wait for him. What’s more, for some time now, many insurers have been dispensing with the on-site expert in low-value claims.

Do I have an advantage if the insurance expert intervenes?

I have consulted OneNote to see what references I have written down and two notes appear referring to the advantages of having an insurance expert intervene after a claim.

The first is the payment commitment that the expert on behalf of the company can give to the workshop or repair service. In this way, in exchange for deciding how to repair it, you will not have to anticipate a single dollar.

The same happens with the valuation of the claim, if you agree, you will not have to wait long to collect the compensation.

As you can see, some advantage exists as long as the insurer benefits.

What problems can I have if I don’t do what the insurance expert or the company says?

You must always keep in mind that the assets are yours, they do not belong to the company and not to the expert. Therefore, the last decision you have to make because it is your interest that is at stake.

The performance of the expert must be truthful, impartial, and must put the law before the interests of each one. The insurance contract is often open to interpretation and that is where the figure of the insurance expert becomes especially relevant because the balance will fall on the side of the insurer.

Insurance experts are the ones who rule on the causes of the loss, the assessment of the damages, and the other circumstances that influence the determination of the compensation derived from an insurance contract and formulate the proposal for the liquid amount of the compensation.

Tenth additional provision Law 20/15 of Regulation, supervision, and solvency of insurance entities.

If the insurance expert is appointed by the insurer, he will make a unilateral assessment of the damages. But if this is done later, and your actions have been sensible, the expert will attest to what happened and will propose to settle the claim.

How do I act if I want to repair it immediately?

We have seen how the company has no obligation to send the expert and that if it does not do so, nothing should happen either.

The best way to act after the loss is to use common sense as if there were no insurance behind it. If you look at it, the obligations imposed by law on the insured are reasonable in all circumstances.

Then declare the claim to the insurer and provide all the documentation that supports your claim. To do this, take photographs of the circumstances and the damages, delivery estimates, invoices, and all the information that proves the repair or replacement of the goods. And if the damages are substantial or the causes are complex, my advice is that you appoint your own expert. It is preferable to do it at the beginning before the insurer designates yours.

Go to the insurer when you need urgent assistance or when the service you need is mandatory for its repairers.

conclusion

As I have already told you, it is false that the insurer is obliged to send an expert to assess the loss. It is also true that you cannot repair or replace damaged goods without the intervention of an insurance expert.

The expert will not locate the water fault, nor will he paint the car or put out the fire. So why think about insurance first?

Act as if you did not have insurance, document the loss and its consequences, and only then claim the corresponding compensation.

And remember two things:

  1. Except in certain cases,  with the compensation, you can do whatever you want. You have no obligation to use it to replace the goods.
  2. Pretending to take advantage of the insurance by increasing the consequences, falsify the causes or collect compensation more than once for the same damages,  is an illegality that can have unforeseeable consequences.

In short, it breaks with the belief that the insurance expert is mandatory and begins to act rationally.

It is not impossible, everything is a matter of starting.

What do you think, do you think the presence of the insurance expert before repairing the damage gives you an advantage?

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