How it Works:
Insurance Claim Tips for Business Owners
by Ron Reitz, President of San Diego-based Quality Claims Management Corp www.qualityclaims.com
Most business owners don’t necessarily think about their insurance coverage until a loss occurs and
they need to file a claim. However, the time to analyze your insurance is before you need to file a
claim: Preview is always nicer than review.
If you do suffer an insured loss, you need to be very familiar with certain aspects of your claim.
Here are the three areas that cause the biggest business insurance disputes with insurers.
Period of Restoration – This is the duration of time your loss will be based upon.
The period of restoration begins 72 hours after the physical loss or damage occurs. This is s
ometimes referred to as a time deductible since coverage does not start until after the 72 hours
expire. This period can be reduced or eliminated with various endorsements.
The end of the period of restoration can be difficult to calculate because it’s subjective.
The date theoretically ends at the earlier of when the property should reasonably be repaired or
replaced, or when the business is resumed at a new permanent location.
The insured may be given additional time to replace stock or supplies, or for a manufacturer, time
is given to bring production back to the pre-loss point. But what’s a reasonable period of time to
repair or replace the property? With no hard date for when the period ends, disputes arise. If
you’re a tenant and your lease requires the landlord to repair the property, then you’re at the
landlord’s mercy. Your claim can be adversely affected if the landlord is slow. These days, it’s
quite possible the landlord doesn’t have the financial ability to make those repairs. In this case,
it may be best to relocate, fast.
After the property is repaired, it’s very likely to take months before you return to your pre-loss
sales volumes. Unfortunately, this is outside the period of restoration and your coverage may be
history. That’s why we recommend adding an “Extended Period of Restoration” endorsement to your
policy to provide coverage in 30-day increments.
Extra Expense Coverage – Any expense incurred to mitigate your loss is considered
an extra expense. If your business had to relocate to resume operations in order to retain your
customers, then the costs of doing so would be considered extra expenses. Be sure your policy
provides an adequate amount of extra expense coverage.
Proving the expenses incurred relate to mitigating your loss can be another area of contention.
Be sure to keep the insurer aware of all expenses you are incurring. Get written confirmation
from the insurer that it will pay for those extra expenses.
Calculating the Amount of Loss – Your policy should provide coverage for the
amount of net profit you would have earned had no loss occurred, as well as continuing normal
expenses. Determining the profit you would have earned can be challenging. No wishful thinking
allowed.
Two key components in determining what you would have earned are your sales forecast and your
previous year’s results. If you happen to suffer a loss during a seasonal peak period of time
but your business was not meeting its current year sales projections, then you may find
yourself in the middle of a dispute.
Will you be able to prove you would have met your sales forecasts during your period of restoration
even though you had not met them prior to the loss? If your business is seasonal in nature, you
will need to work diligently to keep from losing your key customers as you may not have another
opportunity to get them back until the following year. Can you prove you lost them as a result of
the insured event?
If you suffer an insured loss, you should focus all of your attention on mitigating your loss and
returning to normal operations as quickly as possible. It may be prudent to hire a professional
public insurance adjuster – a third party expert so you’re not forced to rely on your insurance
claims agent – to assist you in the preparation and calculation of your loss. That way you can
focus on your business.
Ron Reitz is president of San Diego-based Quality Claims Management Corp., a nationally licensed
public insurance adjuster, providing hazard claim recovery services to investors, mortgage servicers,
homeowners and businesses. Earlier, he pioneered the national hazard insurance claims business of
GMAC-RFC (now GMAC-ResCap).
He is the past president of the California Association of Public Insurance Adjusters and currently
serves on the board of the National Association of Public Insurance Adjusters. Contact Quality
Claims Management at (866) 450-1183 or www.qualityclaims.com.