In reviewing a policy in general, for a policy renewal, or for considering an optional new policy, both the goal and the activity are an exercise in “pro-active claim review”.
Obviously, a policy review during an ongoing claim is not proactive but rather reactive. At this point, there is little that can be accomplished other than making the best out of what already exists.
By analyzing the policy in advance of a claim and from the perspective of a hypothetical claim, light is shed on obstacles to claims, reductions of claims, denials of claims, and missunderstandings of or misrepresentations of the policy, before there is a claim. By using several different claims scenarios, a broad-based picture of the potential claim coverage is obtained.
This allows the policyholder to make better decisions about what policy they really want, what policy exclusions, sub-limits, deductibles, and coverages, they want. They can then determine their coverage, wants and needs, and in relationship to the cost.
Now, when there is a claim, the expectations are clear. Nobody likes adverse surprises.
Unfortunately, all too many insurance agents, and all too often, may not properly or adequately represent and coordinate the policy with the client’s wants, needs, and budget. This is the scenario and practice that is at the root of a great many shortcomings and adverse surprises when claims occur. Had the policyholder been aware, perhaps they would have made some changes in the policy or considered a different policy completely.