Government says insurance firms should be more open

| 15/12/2008

(CNS): While those on Grand Cayman are already only too familiar with the term ‘under-insured’ Brackers hit by Hurricane Paloma last month are now also discovering how the insurance industry’s averaging can work against their home insurance claim. Speaking at last week’s media briefing, government explained on behalf of the industry what it means but also noted that the sector needed to be more open about it and explain averaging to customers before selling them policies.

Government Ministers said there were concerns about the impact this issue was having yet again on people who have suffered in the face of a major hurricane. Kurt Tibbetts, Leader of Government Business, read a statement from the industry and emphasised it had nothing to do with government but the sector had submitted it to him by way of explanation.  He said the written submission explained the logic behind the averaging clause and it would allow people to at least know what the position was and the industry rationale when the claims were in question.

After the LoGB read the statement Minister Alden McLaughlin acknowledge that the procedure was common throughout world but he was concerned that insurance companies are not transparent about this issue when selling policies. “We need to insist that insurance providers explain the average law and if the insurance companies cannot demonstrate that they explained it at the time of sale, when it comes tothe claim it should be paid,” McLaughlin said. “It can’t be applied if it has not been explained.”

He suggested policy holders should be required to sign a document written in plain English that says the issue of averaging has been thoroughly explained, and then if after that people chose to under-insure then that is a fair choice. They’ll know to only expect a certain percentage of a claim if their house is damaged.

The LoGB said he did not want to make across the board judgments about all insurance firms but there are issues about the averaging. “We need to find a way to make sure the insurance companies have an obligation to inform people of the conditions,” he said, adding that the insurance industry explanation was logical enough, but if people were unaware then it could not be seen as fair. “I think it’s fair to say that not all insurance companies are doing this and we can’t legislate as the logic behind the policy is not one we can refute. What we can make happen is to make sure people make decisions with full knowledge,” said Tibbetts.

McLaughlin said that insurance firms were always by their nature seeking to pay as little as possible on claims and that the under-insurance was always going to be a negotiation.  The policy holders could dispute the insurance company’s assessment of how much it would cost to rebuild a given property, and claimants that could demonstrate that the cost to rebuild their home was less than the insurance company claimed should fight the assessment. “I would advise people never to agree to the first proposal from the insurance company and argue with them about replacement costs. You are entitled to rely on your own valuations over how much it costs to re-build,” the Minister said.

McLaughlin noted that attempts to establish new regulations regarding the insurance industry and address some of the problems that arose in the wake of Hurricane Ivan more than four years ago have proved very frustrating. “We have not got to where we think we need to be with insurance regulation and the industry as a whole. You have to sit where we sit to see where this has gone. It is frustrating and I hope this might be the impetus we need in the sector to try and get some agreement.”

The issue of averaging in the insurance industry and the subsequent situation of underinsurance was a huge issue in the wake of Ivan, when policy holders found that when the actual cost of rebuilding their homes was, according to the insurance firms, higher than the sum insured, so people were only given a percentage of their claim even when their house was completely destroyed.

In the statement issued to government, the industry said collectively that averaging was a fair way to ensure there would always be funds to pay claims. They explained that if it costs $150,000 to rebuild a house but a policy holder has only insured the house up to 100,000, then the holder is a third under insured and will only receive two thirds of any claim. The policy has angered many as people believe if they insure their property for $100,000 and the property is destroyed they should receive the $100,000 regardless. They said it was the only fair way because if other policy holders were putting the full value into the pool, then they would be unfairly treated if everyone got full claims regardless of their policy contribution.

The issue is contentious, however, as it depends very heavily on what sort of price the insurance company says a rebuild will be per square foot for materials and labour because many home owners will do a lot of the work themselves or have family members that can help them and would only see the re-build costs in terms of materials and limited labour.

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