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Insurance Claims Services

Is your company facing a major insurance claim or product recall?

Insurance of property, products, people and profits is a key component of corporate risk management. PwC provides policyholders and insurers with independent advice and assistance in managing insurance claims. If you require a quantum expert, we can assist you. Our dedicated team can support you by helping to reduce disruption to your business, customers and management time when faced with a major incident.

More about this service

Isurance of property, products, people and profits is a key component of corporate risk management.

With the increasing instances of major disasters such as flood or fire, combined with the common use of personal or family trusts, there has never been a greater requirement for investigative accounting expertise in relation to insurance claims or disputes.

Despite statistics showing the very high proportion of all claims are paid, the perception amongst the general public and business owners remains that insurance companies resist paying out claims. As a result, claimants may inflate claims so that when only a percentage is paid out, their full loses are covered. In turn, insurance companies are required to investigate more claims, incur more costs, identify more issues and challenge more items within claims. In turn, this all leads to increased premiums.

One way to potentially avoid this downward spiral that costs all parties more money, is to engage an independent forensic accountant at the start of the process to work with both parties to quantify the claim. Whilst this may not be cost effective for material loss, house or car claims, it is repeatedly a successful approach for other claims such as for business interruption or income protection.

Furthermore, given the skills of the wider team, we are very well placed to investigate claims under fidelity guarantee insurance, or to review the investigations or your team and either give comfort that all lines of enquiry have been followed, or suggest alternative avenues.

Finally, we can also provide “whole book” reviews of claims, carrying out transaction analysis over the entire claims book to identify suspicious items. Whilst this work is carried out internally by many insurance companies, a periodic third-party review often highlights issues not previously considered.

Our insurance claim/dispute analysis services include:

  • Income protection claim review
  • Business interruption claim analysis and calculation
  • Risk assessment reviews
  • Litigated claims support
  • Forensic analysis of suspicious claims
  • Fidelity guarantee investigations, or investigation reviews.

Potential issues

  • You have a major insurance claim to deal with
  • Your lawyers say you need a quantum expert
  • One of your products has been recalled
  • You want to know if your directors' and officers' insurance cover is effective
  • You would like an independent review of your insurance arrangements
  • You want to know if you are fully covered under your insurance policies
  • You require an insurance due diligence review for a merger or acquisition
  • You want a second opinion on a claim.

How we can support you

  • Effective management of claims
  • By offering professional, independent and practical advice
  • Reduced disruption to your business, customers and management time when faced with a major incident
  • Technical skills, industry knowledge and geographical cover from one source
  • Ensuring your business has effective, value for money insurance policies
  • Speedy and robust resolution of insurance issues.

Contact us

Jovana Zelic

Jovana Zelic

Senior Manager, Forensic Services

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