Everything New Zealand business owners need to know about making insurance claims, from notification to settlement.
To make an insurance claim in New Zealand, contact your insurer or broker as soon as possible after the incident occurs. Most insurers have a 24/7 claims hotline. You'll need to provide details of the incident, including when and where it happened, a description of the loss or damage, and any relevant documentation. Your broker at BizSure NZ can guide you through the entire process and help ensure your claim is properly documented.
The first step is to notify your insurer immediately. Contact your insurance broker or the insurer's claims department as soon as possible. Take photos or videos of the damage if safe to do so, and document everything related to the incident. If there's a risk of further damage, take reasonable steps to prevent it (such as covering a broken window). Keep all receipts for any emergency repairs or temporary measures.
While there's no strict legal deadline, you should notify your insurer as soon as reasonably possible after an incident. Most policies require 'prompt' or 'reasonable' notification. Delaying your claim can sometimes result in the insurer refusing to pay, especially if the delay prejudices their ability to investigate. It's best to lodge your claim within days of the incident occurring.
Material facts are anything that would influence an insurer's decision to cover you or the premium they charge. Examples include previous claims, criminal convictions, building defects, or known hazards. You have a duty of disclosure when taking out insurance. Failing to disclose material facts can result in your claim being denied.
Yes, you must notify your insurer of any material changes to your business. Changes in activities, location, revenue, or risk profile can affect your coverage. Failing to notify can invalidate your policy or result in claim denial. Always inform your broker before making significant changes to your business operations.
Required documents vary by claim type but commonly include: your policy documents, incident report or claim form, photos/video of damage, police report (if applicable), repair quotes or invoices, receipts for damaged stock or equipment, financial records showing loss of income (for business interruption), witness statements, and any correspondence related to the incident. Your broker can advise on exactly what's needed for your specific claim.
The excess is the amount you pay towards each claim. For example, if you have a $1,000 excess and claim $10,000, you pay $1,000 and the insurer pays $9,000. Excesses vary by policy type and can often be adjusted when you take out or renew your insurance - a higher excess usually means lower premiums. Some policies have different excesses for different types of claims.
Processing times vary depending on the complexity of the claim. Simple claims with clear liability and documentation can be resolved within a few weeks. More complex claims involving disputes, multiple parties, or large amounts can take several months. Your insurer should keep you informed of progress. If your claim is urgent (e.g., you need funds to continue operations), let your insurer know.
A loss adjuster is a professional who investigates insurance claims on behalf of the insurer to assess the cause and extent of loss. For larger or more complex claims, your insurer will appoint one. You can also engage your own loss assessor to advocate for your interests. While not mandatory for smaller claims, having professional help can ensure you receive fair compensation, especially for significant business interruption losses.
Common reasons for claim denials include: late notification (failing to notify the insurer promptly), lack of proof or documentation, policy exclusions (damage not covered by your specific policy), excess not paid, fraudulent or exaggerated claims, breach of policy conditions (e.g., not maintaining security systems), and incidents occurring before the policy start date. Understanding your policy exclusions is crucial.
Yes, if your claim is denied, you can appeal. First, request a written explanation for the denial. If you believe the decision is wrong, complain to the insurer's internal disputes resolution process. If unresolved, you can take your complaint to the Insurance Financial Services Tribunal (IFST) or the courts. Having an experienced insurance broker advocate for you can significantly improve your chances of a successful appeal.
If you're dissatisfied, first put your concerns in writing to the insurer. Ask for their complaints procedure and timeline for response. If unresolved, escalate to their internal dispute resolution department. Should you still be unhappy, you can contact the Insurance Financial Services Tribunal (IFST) for free dispute resolution. As your broker, BizSure NZ can also advocate on your behalf throughout this process.
If you're under-insured, you may face penalties when claiming. Many policies apply the 'average clause', which means if you insure for less than the full value, any claim payment is reduced proportionally. For example, if you insure for 50% of the true value, you may only receive 50% of any claim. Regularly review your sums insured with your broker to ensure adequate coverage.
Most standard business interruption policies exclude pandemic-related losses. Following COVID-19, many insurers have added specific exclusions for pandemics, epidemics, and government-ordered closures. However, some specialized policies or extensions may offer limited pandemic coverage. It's important to review your policy carefully and discuss your specific needs with your insurance broker.
New Zealand's Earthquake Commission (EQC) provides automatic cover for residential properties, but businesses must rely on private insurance. Most commercial property policies cover natural disasters including earthquakes, floods, and storms, though specific terms vary. Some policies have separate excess amounts for natural disaster claims. Given NZ's earthquake risk, ensure your policy specifically includes seismic events and understand any waiting periods.
This depends on your policy terms and whose negligence caused the damage. If the contractor caused damage through their own negligence, their liability insurance should respond. If the damage falls under your policy (e.g., fire damage to your building), you would claim on your policy. Ensure contractors have their own public liability insurance and get certificates of currency confirming their coverage before work begins.
Co-insurance is when you agree to carry a percentage of the insurance yourself. For example, with 20% co-insurance, you would pay 20% of any claim and the insurer pays 80%. This is different from an excess and is often used for risks the insurer considers higher than average. Your broker can explain how this affects your coverage and premiums.
Our experienced insurance brokers can guide you through the claims process and help ensure you receive fair compensation.