THE HURRICANES ABCs OF CLAIMS & FLOODS ADVOCACY
The ABCs Of Claims Advocacy
BY: KEANE MURANAKA ATLAS INSURANCE
Do you know what a claims advocate is or why it’ s great to have one in your corner? When it comes to defending your rights against an enormous insurance carrier, your claims advocate has your back. As Atlas claims advocates, our job is to help you get a fair and reasonable settlement on your claim. This is especially true if your case is the subject of an incorrect analysis of coverage / liability or an outright denial of coverage / liability due to an unfair assessment or a misinterpretation of policy language.
For example, we handled a recent case on behalf of a notable nonprofit organization that experienced roof tile breakage after a wind storm impacted its Honolulu offices. Since the roofing material had once been the subject of a class action claim— in which the nonprofit had not participated— the insurer refused to cover our client’ s losses. After some serious due diligence by us on the case, we helped our client recover damages, arguing that although the insured did not originally participate in suing the material’ s manufacturer, the product had been installed to correct building standards at the time yet still had been considerably damaged. Based on the analysis we presented, the insurer agreed to provide a sizeable settlement to this client.
In another case, we helped a small business owner whose carrier anticipated the insured being sued by an injured employee following an auto accident involving a vehicle operated by a company driver. The case had been assessed a large reserve by the carrier— over $ 280,000— which we disputed based on the governing statute that disallowed such lawsuits based on simple negligence. The carrier then reviewed the case, including the precise statute wording that excluded liability for this type of incident. As a result, the carrier sharply lowered our client’ s reserve requirement, allowing them to obtain far more competitive rates for the coming insurance year.
When working with an agency, it’ s worth finding out whether it employs claims advocates to work on your behalf in the event of a dispute. Qualified advocates will fight strongly in favor of an agency’ s client, often meeting in person with the client in order to fully gather important details. Once the advocacy team has a solid understanding of the situation, they can draw from their own experience to determine how to best frame the client’ s arguments, instructing the client on what to ask for and how to present the case. In complex situations where litigation is involved, claims advocates can help iron out reporting details and step in to assist if the case is headed in the wrong direction. Under this scenario, help can come from all sides— before, during, and after the case— depending on the specific circumstance.
Your claims advocates’ backgrounds can greatly influence the quality and degree of representation you receive. At Atlas, for example, our claims advocacy team has decades of experience working from various perspectives— with insurance carriers, litigation attorneys and, of course, agencies. These diverse backgrounds allow us to help our clients submit their claims and appeals in the best possible light to achieve a positive outcome. If you are searching for new coverage and would like to meet our claims advocacy team, please be sure to let your broker know. We would be happy to answer your questions. +
Keane Muranaka has 25 years of claims management experience and has held various claims positions in the local property and casualty industry. Prior to joining Atlas, he was Assistant Vice President, Claims Supervisor – Field Unit for Island Insurance Company, Ltd. His previous claims experience also includes past President of the Hawaii Insurance Claim Managers Association and is a member of the Hawaii Claims Association.
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