owens mccarthy

Click on the question you want to ask to see the answer.

1. Am I entitled to claim?

Generally, the cover provided by Insurance Policies is broad - however, many exclusions often apply. It will be necessary to conduct a thorough inspection of the premises [& policy in force] to provide an accurate response. Call us without obligation and we will resolve your query.

2. What does Insurance provide cover for?

Most Insurance Policies provide cover for Insured Perils. Claims are settled on an Indemnity basis subject to the Conditions of the Reinstatement Clause / Memorandum. See Glossary of Terms below.

3. What is an Assessor?

The Person who acts in the interest of the Policyholder and formulates and negotiates an Insurance claim on their behalf.

4. What is an Adjuster?

The Person who acts in the interest of Insurers in determining the course and extent of claims, and who adjusts the amount of the claim by negotiation.

5. How long will it take to settle my claim?

Owens McCarthy have an exceptional and proven track-record in achieving time-efficient settlements. Your Insurance Company are bound by the provisions of the Consumer Protection Code in matters relating to time-frames for settlements.

6. Who pays an Assessor's Fee?

Our fees are borne by you, the Policyholder, and are not allowed for under the scope of policy cover. In almost every case the added value and extra benefits we provide more than compensate for any charges that accrue.

7. How is the 'Claim Process' explained?

  • You make contact with us as soon as you have a loss - we are available 24 Hours a Day.
  • We will, at the earliest possible opportunity, arrange a site inspection by one of our experienced and appropriately qualified Claim Specialists.
  • At the time of our site visit, we will explain the claim process in detail. Any queries or questions you may have that relate to your claim will be resolved by our Specialists. We will thereafter advise your Insurance Company and have them appoint their own representative - a Loss Adjuster. We will formulate your claim and arrange for the Loss Adjuster to inspect the damaged property in conjunction with our Claim Specialist.
  • As soon as the claim has been presented, we will manage every aspect of your claim and provide you [and your Broker - if you have one] with regular updates regarding progress.
  • We will handle all negotiations with your Insurers and their Loss Adjusters and we will not finalise your claim on your behalf without your express consent. We will ensure that your settlement cheque is issued through the appropriate channels.

Glossary of Terms

Act of God

Redundant term no longer used in Insurance; an event that no human foresight can foretell.

Adjuster

Person who acts in the interest of Insurers in determining the course and extent of claims, who adjusts the amount of the claim by negotiation.

Agent

A person who acts on behalf of another.

Assessor

Person who acts in the interest of the Policyholder and formulates and negotiates an Insurance claim on their behalf.

Assurance

Insurance being cover against an event which MAY happen, Assurance is cover against an event that WILL happen. It is therefore correct to talk about Life Assurance as opposed to Life Insurance.

Average [Underinsurance]

A condition in some policies whereby the Policyholder is adjudged to be their own Insurer for the difference between the Sum Insured and Value at Risk. This makes Insurers liable only for such proportion of the loss and the Sum Insured bears to the total Value at Risk.

Broker

An Insurance Intermediary who is empowered to act on behalf of an Insurer as well as the client.

Certificate of Insurance

Evidence, in the form of a Certificate, that Insurance is in force.

Co-insurance

The sharing of a risk amongst a number of Insurance Companies - more often for large and complex subjects.

Commission

Remuneration for an Agent or Broker.

Conditions[Precedent to Liability]

The Insured is bound by the contract of Insurance to fulfil certain of its terms as a necessary prerequisite to his right of recovery against the Insurer. It is in this context that some of the terms of the Policy are described as being conditions precedent to the liability of the Insurer to provide an indemnity to the Insured.

Contribution

The right of an Insurer, who is liable under a policy, to call upon other Insurers who may also be liable for the loss, to contribute to the payment.

Days of Grace

A period of, usually, fifteen days after renewal date to allow for payment of the premium.

Declinature

Refusal of an Insurer to accept or renew a proposal for Insurance.

Endorsement

An amendment, in writing, added to the Policy of Insurance.

Excess

The first amount of each claim for which the Policyholder themselves are liable.

Ex-Gratia

A payment made where there is no legal liability.

Good Faith

Contracts of Insurance are based on the principle of utmost good faith [uberrimae fides]. The proposer and Insurer are therefore obliged not to withhold or falsify any material information. See the following Irish Case Law: http://www.bailii.org/ie/cases/IEHC/1982/1.html

Indemnity

The principle of putting the Insured back into the same financial position as he/she enjoyed immediately prior to the loss.

Insurable Interest

A policyholder has an 'insurable interest' in the property Insured when; if the property was damaged or destroyed he/she would lose out financially.

Insured

Person or Legal Entity covered by the Policy of Insurance.

Insured Perils

The perils covered by the Policy of Insurance, sometimes referred to as 'Special Perils' or 'Specified Perils' - e.g. Fire, Storm, Flood, Escape of Water etc.

Insurer

Company or group of persons covering a risk under a Contract of Insurance.

Moral Hazard

The risk arising from the character and circumstances of the policyholder or his/her employees.

Policy

The document which contains written evidence of the contract between the Insurers and the Policyholder.

Premium

The money paid by the Policyholder to Insurers for the cover given.

Proposal Form

The form on which a proposal is made to the Insurer.

Proposer

The person or company who is seeking a Contract of Insurance.

Proximate Cause

The original cause of the loss. The issue of proximate cause arises when determining whether a loss has arisen out of an Insured Peril. The proximate cause is held to be the operative cause and not necessarily the one nearest in time to the loss itself.

Reinsurance

The system in which an underwriter who has accepted a risk shares [or reinsures] a percentage of the risk with another Insurer. The underwriter is still liable to the Insured for the full amount.

Renewal Notice

The notice sent to a Policyholder to remind him/her that the contract of insurance is due for renewal.

Risk

The subject matter of insurance, or; the probability of loss, or; the peril or hazard Insured.

Subrogation

The right that the Insurer has to take over the rights and remedies of the Policyholder to reduce or make good a loss. Subrogation is a corollary of Indemnity.

Sum Insured

The extent of the Insurer's liability.

Third Party

Someone other than the Insured or the Insurer.

Underinsurance

Insurance for an amount less that the true Value at Risk.

Underwriter

The person who accepts or declines risks and who decides the terms and rates which are acceptable.

Warranty

A warranty is an undertaking by the Policyholder guaranteeing observance of certain conditions and is written into the Policy. Absolute Condition.