A policy is a promise about a day you hope never comes. What decides whether that promise is kept in full, in part, or not at all is rarely the wording alone — it is how the first two weeks after the loss are handled. This is what happens during a claim, and where a broker changes the outcome.
The shape of a claim
Most claims follow the same path. You notify the insurer. The insurer acknowledges and opens a file. It verifies cover against the policy and sets a reserve — its internal estimate of what the claim will finally cost. On anything substantial it appoints a loss adjuster to inspect and report. You produce documentation. The insurer evaluates what is owed, sometimes makes an interim payment on the undisputed part, then settles against a signed discharge. Afterwards it may pursue recovery from whoever caused the loss.
Two of those steps are invisible to most policyholders and both matter. The reserve, because it follows you into your renewal terms long after the claim closes. And the discharge, because signing one closes heads of claim you may not have finished quantifying.
Who is who — and who is paid by whom
A loss adjuster is appointed and paid by the insurer. A good one is even-handed and their report is the evidential backbone of the settlement, but they are not your representative and their duty is not to maximise your recovery.
A loss assessor is the mirror image: appointed by you, acting for you, and typically paid a percentage of what they recover — around ten per cent is the usual market figure.
Your broker occupies the same advocacy role as the assessor, without the deduction. We are already remunerated through the placement, so the claims work carries no separate fee to you.
The adjuster who visits your premises works for the insurer. If nobody is advocating for you, the only professional in the room is being paid by the other side.
What changes when a broker is involved
- Notification. We notify in the form the policy requires, to the correct handler, the same day — and record that we did. Notification clauses are frequently conditions precedent, and a notice sent to the wrong place may not count as notice at all.
- The adjuster’s visit. We attend, and we prepare you for it. What an adjuster is testing on a first inspection is not always what it appears to be.
- Documentation. We give you the full schedule up front and submit it as one package, rather than the piecemeal drip that stretches a claim over months.
- Cash flow. We ask for interim payments on the undisputed portion. After a cyclone, the gap between the loss and the settlement is often what actually closes a business.
- Negotiation. Disputes about quantum are argued on wording, precedent and market practice. That is a professional conversation, and you should have a professional in it.
- Discharge. We check what the release actually closes before you sign.
What to do in the first hours
Before anything is moved or cleaned up, photograph and film everything — wide shots that establish location, then close-ups. Report to the police where there is theft, malicious damage, riot or a motor incident, and keep the reference. Assemble proof of ownership and value: invoices, purchase orders, the asset register, delivery notes, bank and card statements.
Then take reasonable steps to prevent further loss. Board up, sheet over, move stock to dry storage, pump out. This is a positive duty under the policy, and the reasonable cost of doing it is normally recoverable — so keep every receipt and code them separately in the ledger.
Finally, and this is the one most often got wrong: do not throw anything away until the adjuster has inspected and released it. Disposing of damaged property is among the fastest routes to a reduced settlement. Keep a contemporaneous log too — dates, times, who said what. Memory degrades quickly and a claim can run for a year.
Why claims get reduced or declined
Very few claims fail because an insurer behaved badly. They fail for a short and predictable list of reasons: late notification where the clause was a condition precedent; non-disclosure or misstatement at inception or renewal; underinsurance, where the sum insured is below the true value and average cuts the settlement in proportion; breach of a policy condition or warranty, such as an alarm not set or a warranted security control not actually in place; an excluded peril; or, on a business interruption claim, the failure of the underlying property claim on which it depends.
Every item on that list is addressable before the loss. None is addressable after it.
Timeframes in Mauritius
It is worth being precise here, because the two are often confused. The Insurance Act 2005 does not prescribe a period within which a claim must be settled. What is set out, in the Financial Services Commission’s guidance on complaints handling for insurance companies, is that a complaint should be acknowledged within three working days and normally settled within thirty working days.
So if a claim stalls, the route forward is to raise it as a formal complaint, at which point those service standards engage — and if it remains unresolved, the Office of Ombudsperson for Financial Services can consider complaints against insurers and insurance intermediaries licensed by the Commission. Our complaints procedure sets out the steps.
The work that decides a claim is mostly done before it happens: the right sum insured, the right wording, and the discipline to notify properly.
How we help
We manage claims from first notification to settlement — notifying the insurer, briefing you before the adjuster attends, assembling the documentation, pressing for interim payments and negotiating the final figure. If you need to report a loss, call us on 5256 5688 or email info@globalequity.mu. Our claims support page sets out what we need from you at each stage.
