Let's set out the division of roles honestly: in a routine claim, the insurer's claims line and online portal are the fastest route – that's where you report it, and that's where the case moves forward. The broker's role begins when the case gets stuck or becomes disputed. But then, very much so.
- Routine case = the insurer's channel: report it via the claims line, follow the normal process – I'm happy to help you get started if asked.
- Stuck or disputed case = help from the broker: liaising on the basis of the terms, on the company's instructions.
- The strength of that help lies in the documents – which is why it pays to document properly from day one.
What counts as a stuck or disputed case?
Typical signs: the calculation differs materially from a reasonable expectation, and the justification doesn't explain the gap; repeated, off-target rounds of document requests; reference to an exclusion or requirement that, in the company's reading, doesn't hold up; or simply: weeks go by with no meaningful step forward. None of these automatically means the insurer is wrong – it means the case calls for professional argument.
What does the broker do at that point?
First, I review the case: the policy, the terms, the calculation, the correspondence – to find the real reason for the gap. Then I help the company liaise with the insurer: pointing to the terms, the documents, and claims-settlement practice – speaking the insurer's professional language. If needed, I also help prepare the complaints procedure, and show what further avenues of redress exist – for those (an arbitration board, court), a legal representative already takes over. So the role isn't magic, it's professional help: I help with the company's case, where I can, and the right to decide stays with the client throughout.
What can the company do in advance?
The outcome of disputed cases is largely decided well before the claim: good documentation (the checklist), an up-to-date inventory, and well-maintained sum-insured values are what make the case stronger. And one important framing sentence: helping in a stalled or disputed claim, where I can, is part of the broker service – I charge the client no fee for advice, and the insurer pays the broker's remuneration. On preventing reasons for rejection: the honest list.
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