HAI Group Claims and Loss Control Guide
At HAI Group, we’ve made the property and liability claim filing process as simple as possible for you and your organization. This guide provides a detailed explanation of the entire process, from pre-event documentation and post-event loss control to investigations and recordkeeping. Accidents happen–HAI Group is here to help.
Preparation is crucial, as the claim filing process begins before an incident happens. The pre-event phase consists of establishing and maintaining accurate documentation of your risk control activities. This documentation sets policies and procedures to help prevent accidents and provides a measure of proof that can help defend your organization against future claims. For instance, consider accidents involving smoke detectors. Many organizations require that their maintenance employees test and inspect living unit smoke detectors during every work order visit. The smoke detector test should be documented on the work order or separately on an inspection form to prove it happened.
Report your claim
Whether a claim is for a property or liability incident, your priority is to report the loss as quickly as possible. This allows for a prompt investigation while facts are still fresh in the minds of involved parties. An immediate assessment also allows investigators to view the location of the incident before changes are made to the site. Please note that coverage could be restricted or even denied if a claim is reported late or not reported at all.
After your claim is filed
Our team will designate a claims examiner to investigate, detail, document, and appraise every aspect of the claim. A determination is then made as to whether or not your insurance policy covers the claim. During this process, deductibles and other individual policy provisions are taken into consideration. Legal counsel, experienced claims adjusters, or appraisers are used to help settle claims as quickly as possible. Insured organizations can receive regular reports that indicate the status of their outstanding claims reserves, as well as claims paid. Loss reports are available in your Account Dashboard, which you can access by logging into your HAI Group member account.
Prevent further losses
Post-event loss control activities are defensive techniques to help prevent further property loss or accidents after an incident. Depending upon the type of loss, post-event loss control can include:
Boarding up openings in a damaged structure
Covering openings in a roof
Draining heating systems
Turning off electricity
If you have a loss due to a hazard, you must remove the hazard or secure the area as quickly as safely possible to prevent additional incidents.
Establish formal investigative procedures to be carried out by your organization after an accident or loss on your property. If conducted properly and promptly, these procedures may help reduce the cost of a claim against your organization or become a factor in eliminating the claim. We suggest training your entire staff in post-event loss control. Detailed below are basic questions that need to be answered if an incident occurs on your property:
Who? The name, address, date of birth, Social Security number, occupation, name of guardian (if minor), and gender of those involved, and whether he/she is a resident, visitor, or contractor.
What? The nature of the accident or incident and any injuries. Approach witnesses for an accurate statement and record the name, address, and phone number of any witnesses. Document the exact sequence of events that led to the circumstances of the incident. Use a step-by-step approach to determine what happened, including every person and every object that contributed to the occurrence. Select words judiciously, stating the facts but leaving out opinions. Include estimated property damage costs (actual expenses will be determined later).
When? The date and time of the event, as well as weather and lighting conditions. Be aware that incidents are sometimes alleged to have occurred days and even weeks before the date they are reported. Information around the timing of the alleged incident has tremendous value in legal actions and court decisions and can be a key indicator of the need for additional investigation.
Where? The exact location of the accident or incident, with notes on details that may have factored into the incident. Take photos whenever possible.
Following a factual investigation as described above, all details should be documented, and the appropriate ACORD form should be completed and submitted to our Claims Department for resolution (member login required). Injuries occurring on your organization’s property have the potential to become claims despite alleged negligence by the injured. It is critical that complete documentation is on file to prove any valid defense if a claim is later filed against your organization.
The key to all recordkeeping is diligent file maintenance. Organized and accurate files are critical when claims are made against your organization, and timely accessibility to these files will improve the efficiency of the legal defense process. Computer tracking programs designed to improve recordkeeping are recommended so that the defense team will have access to critical documentation with an audit trail. Examples of activities that would benefit from having computer audit trails are maintenance work order systems, housing unit modernization and improvement programs, and accident investigation records.
Professionals standing by, ready to help
Don’t hesitate to reach out to us for assistance. We have a full team of professionals ready to help you through the entire process.
Call 800-873-0242 to speak with a Claims Department representative. For after-hours questions, call 800-873-0242, ext. 288.
Includes copyrighted material from a company under the HAI Group family, with its permission. This post is for informational purposes only and is not intended to provide legal advice, and shall not be relied on as such. We strongly recommend consulting with legal counsel or an appropriate subject matter expert.