Of course we all purchase insurance to protect us from things that can go wrong in life hoping that we never need to claim. 

But insurance exists because unforeseen events can have financial consequences which may be difficult or impossible to pay for in the aftermath or an unexpected event.

The protection afforded by insurance means that we can meet these financial obligations and, should we be injured or our property damaged by the actions or negligence of another person, we can be compensated for our pain and suffering and for any resulting financial loss.

Insurance Compensation Guide

Table of Content

Compensation pay for a insurance claim

Insurance claims come in many forms, depending on the financial loss involved. In most instances you will receive any payment directly from the insurer following settlement of your claim.

You may receive a lump sum directly from your insurer, for example in the case of life insurance or specified illness insurance. In this case, you will deal with your own insurer and your claims handler will deal with your claim. Or you may receive a monthly benefit, such as a claim for income protection where you are unable to work.

Home and buildings insurance claims

If for example, you need to make a large and complex claim on your home buildings insurance or on commercial property insurance, you may need to use your own insurance assessor, who will advise you on what will be required to put things right following an insured event. 

The assessor should be able to advise of replacement costs and timelines.

insurance policy to cover your home

Health Insurance claims

In the case of health insurance, some of the benefits you claim will be paid directly to your healthcare provider and some will be reimbursed to you after you have paid, less any applicable excess.

Health insurance claims, can be complex and take some time to complete.

What is health insurance

Motor insurance claims

If your car is damaged following a road traffic accident, the motor insurer will pay you directly for repairs to your vehicle once you have paid the relevant excess, although they may specify that you use an approved mechanic or motor repair service.

In the event that you are involved in a road traffic accident with an uninsured driver, the Motor Insurers’ Bureau of Ireland (MIBI) will be responsible for paying any award for compensation you may receive.

motor insurance ireland

Financial loss due to negligence

If it is the case that you have been injured or had a financial loss as a result of the negligence of another person, you may wish to engage the services of a solicitor and make a personal injury claim. Personal injury claims in Ireland are usually assessed and compensation awarded by the Personal Injury Assessment Board (PIAB). 

In this case, the compensation will be paid by the insurance company of the person who has caused your injury or loss. 

Average payout for compensation

There is very little information publicly available on insurance payouts made in Ireland.

The Central Bank of Ireland has published some figures on motor insurance injury claims. In the period 2015- 2021, the average compensation awarded in injury claims that were settled directly was €13,933. Where they were settled via the PIAB, the average compensation was €21,856, and where they were settled via litigation, the average compensation was €24,174.

The AA has estimated that the average insurance payout following a house fire was €15,000. However, this was published in 2012 so this figure is likely to be out of date.

Where there are figures for awards for compensation made for personal injuries in 2021, the data suggests that 48% of awards were less than €10,000 euros.

However, these figures are incomplete and do not present any kind of overall view of the insurance payouts made in Ireland, or for the amounts paid in personal injury claims. 

How to win an insurance claim

When you need to claim on your insurance, you can do several things to ensure that your claim runs smoothly, in the least time possible.

Check your full policy details. It is important to check the full details of your policy to see what you can and can’t claim for and the details of any claim limits or excess on the policy. 

You may be covered for a peril on more than one policy, for example your phone may be covered on your home insurance and a gadget insurance policy. As you can only make one claim per event, it is best to compare policies to see which offers the best cover, or where an excess applies which policy offers cover with a lower excess.

Contact your insurer promptly following a potentially insured event. Many forms of insurance will include access to an insurer’s helpline which can assist you, for example home assist helplines for a home emergency or travel helplines with travel insurance.

Many insurers request that you contact them within 48 hours of the event which may be the subject of an insurance claim.

Your insurer will ask you for details of the claim and will require you to fill in and return a claim form. Even though you may find yourself in a stressful situation, it is important to listen to and follow any advice your insurer gives you.

Your claims handler will contact you regarding your claim. It is important in making a claim to give as much information as you can. You must also send in any requested documents, receipts, or expert reports as quickly as you can. 

Keep in touch with your insurer and answer their correspondence as quickly as you can. You should also keep records of any communication between you and your insurer as well as copies of anything that you are requested to send to your insurer. 

If your claim involves a third party, any correspondence that you receive from them should be forwarded immediately to your insurer.

If your claim involves an injury to you and subsequent financial loss due to the negligence of a third party, you may wish to pursue a personal injury claim. In this case, you may wish to engage a personal injury solicitor and pursue your claim through the PIAB.

Insurance compensation claim rejection

It may be the case that your insurance claim is fully or partially rejected by your insurer. This may be for a number of reasons:

It may be that the specifics of your insurance policy do not include protection for the events that led to your claim. 

For example, your illness is not on your insurer’s list of specified illness or the consultant or hospital that treated you is not covered by your health insurer. Your home insurance may not include cover for flooding or subsidence due to the geographical area in which it is situated.

It is really important to read the small print when taking out insurance so as to ensure that the insurance offers the best cover for your needs. 

It is also important to look at the cover limits for your policy. If you take out, for example, pet insurance, ensure that the maximum cover limit will be sufficient to pay the vets’ bills that your pet’s treatment may need.

Again, look at the cover that you are getting when you are purchasing insurance. With the current cost of living crisis, underinsurance can easily occur. 

With home insurance, for example, it is best to be as accurate as you can in calculating, for example, home rebuild costs or contents values. 

Trying to save a small amount of money on an insurance premium can be a false economy. Always look carefully at the cover limits in your policy. Taking a higher voluntary excess at the point of purchasing insurance can also mean that you have to make a higher out of pocket payment when you need to make a claim.

If you deliberately give your insurance company false information, either at the point of purchasing a policy or when making a claim, you may find that your policy is cancelled and you receive no pay out. 

It is really important to be as accurate as you can and to be truthful in giving information in purchasing insurance and in making a claim.

It is essential that you inform your insurer as soon as you can following an insured event, whether or not you intend to make a claim. 

You must also follow any advice that your insurer gives you, as well as forward any evidence of your claim or expert reports that your insurer requires. Respond promptly to any communication from your insurer during the claims process especially.

It is essential that you continue to pay your premiums in order to continue to be protected by your insurance. 

You may not be aware that you have missed a premium payment, but you should always check any correspondence from your insurers in case it needs attention.

Insurance compensation claim rejection

How long does it take to receive insurance payouts?

This can vary widely, depending on the size, nature, and complexity of the claim. Where expert reports such as medical reports are required it can take time to gather all of the information required for the claim to proceed. 

When an application is made to the PIAB, generally once the application has been submitted, assessment of the claim can take 9 months. You will then have 28 days to decide whether to accept the assessment and offer of compensation of the PIAB.

Consumer Protection Code guidelines for insurance companies

The Consumers’ Protection Code of the Central Bank outlines some guidelines for insurance companies in dealing with claims.

Insurance companies are required to have a written procedure in dealing with claims. They are obliged to help you when you need to make a claim. If any development which affects your claim occurs, they are obliged to inform you of the development within 10 days.

Likewise, once a decision is made regarding your claim, they must inform you within 10 days. If the claim is not settled in your favour, you are entitled to the reasons for the decision in writing. The insurance company must also outline their appeals procedure to you at this point.

 It is worth noting that if someone makes a claim against you, the insurance company can settle this claim without your knowledge or consent. You can make a complaint in writing if you are unhappy with the outcome of a claim against you.

Conclusion

To ensure your insurance claim goes as smoothly as possible, and to give yourself the best chance of your claim being successful, some tips are common to all insurance claims.Following this advice will help you to get the insurance compensation that you deserve.

  • Understand your policy and what is and is not included before making any claim.
  • Record the event which will be the subject of the claim as fully as possible and try to ensure you have the contact details of any other party involved in the claim. Be as accurate as you can and truthful in any information that you give.
  • Gather any evidence, documents or receipts that your insurer requires and keep copies of everything.
  • Follow any advice that your insurer gives you eg. securing your home following a break- in.
  • Reply promptly to any correspondence from your insurer and send them any information that they ask for.
  • Consider engaging a professional in complex cases involving larger payouts, such as an insurance assessor in home insurance claims, or a solicitor to advise you in a personal injury claim.

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