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Timely Claim Reporting

While we understand that there are situations where occasionally an insured may not become aware of a loss for some time period, the descriptions of loss of each of these claims are of the type the policyholder should have been immediately aware, and should have contacted RSI immediately. We cannot stress how imperative it is to report your claims immediately. You can report claims through email, fax, or via phone.

Email - claims@rsi-ins.com
Fax – (714) 546-4457
Phone - 800-828-5273, Option 4

Some insureds may be concerned that reporting every occurrence to an insurer will result in cancellation or higher premiums. In most cases, however, notice of occurrence letters are simply filed without action unless it is clear that significant damage or injury has occurred. Adjusters are too busy to investigate every single notice. One strategy is to devise a protocol with the insurer so that incident reports are not coded into the insured's experience.
There is a danger in not reporting, however. If the insurer can demonstrate that its defense was prejudiced by lack of opportunity to investigate and settle a claim, the insurer may be able to deny coverage. This ability depends on circumstances, jurisdiction and type of policy. A look at the policy wording reveals some clues.

  • General liability policies might say something like: "You must see to it that we are notified as soon as practicable of an 'occurrence' or an offense which may result in a claim." In some jurisdictions an insurer must prove "prejudice" in order to deny coverage for late reporting. Other jurisdictions hold the view that unexplained delays in reporting justify denial of the claim outright. Besides risking no coverage, late reporting increases claim costs. One study by St. Paul Insurance Company showed a 78% cost increase for late reported bodily injury claims.
  • Property policies may say that the insured must "Give us prompt notice of the loss or damage." Obviously, it is in the insured's best interest to report property losses quickly. You want to get your money or property replaced as soon as possible. If you delay, valuable proof of loss could disappear, jeopardizing the amount of recovery. Some equipment breakdown (boiler & machinery) policies recognize the report date as the date of occurrence. This practice could seriously affect recovery of business interruption losses.
  • Professional liability and directors and officers liability policies may contain a requirement such as: "The Insured shall as a condition precedent to the obligations of the Company under this Policy, give written notice to the Company as soon as practicable …." Generally, courts will strictly interpret the reporting provisions in a claims-made policy and deny coverage to insureds reporting late. See Matador Petroleum Corp. v. St. Paul Surplus Lines Insurance Co., 174 F2 63 (5th Circ., 1999).
  • Workers compensation policies such as the National Council on Compensation Insurance (NCCI) form state that the insured's duties are to "Tell us at once if injury occurs that may be covered by this policy." Delayed claim reporting means increased cost. In one study by insurer Liberty Mutual, workers compensation claims reported in the first three days following an injury cost an average of 23% less than claims reported from 15 to 21 days after the event. In addition to the claim cost increase, many states impose fines for late compensation claim reporting.

Obviously all insurers want notice of loss sooner, rather than later. Prompt reporting is in the best interest of all parties. Late reporting can be costly, especially to the insured. Please feel free to contact with any questions or comments you have regarding claims.