Claims
At Housing Authority Insurance Group, we strongly believe that
the most effective way to deal with claims is to avoid them.
Effective implementation of the five risk control techniques -
avoidance, loss prevention, loss control, risk transfer, and
exposure segregation - are the first actions to reduce or eliminate
any risk of loss to a PHA. These techniques are classified as
pre-event loss control activities. They are actions or procedures
that can reduce risk before an accident occurs.
Unfortunately, no matter how many precautions are taken,
accidents happen. In these cases, PHAs must be prepared to defend
themselves when claims and lawsuits are filed. These defensive
techniques are classified as post-event loss control activities;
they are actions or procedures that are carried out after an
accident happens.
Claims Process
Nobody wants to file a claim. When an unfortunate event takes
place, HAI Group wants to make the claims process as simple and
manageable as possible for you and your PHA. This section provides
information to assist you in the claims handling and filing process.
Please click any of the links below for claims process information
from pre-event documentation and claims reporting to recordkeeping.
- +Pre-Event Documentation
The most important procedure in the pre-event phase of risk control
is establishing and maintaining a solid base of accurate
documentation of PHA risk control activities. This documentation not
only establishes policies and procedures to help prevent unwanted
accidents, but it also provides a measure of proof that can help
defend the PHA against a later claim.
Take, for example, accidents involving smoke detectors. Many PHAs
require maintenance staff to test and inspect living unit smoke
detectors during a work order visit for another reason. The smoke
detector test should be documented on the work order or separately
on an inspection form.
- +Reporting a Claim
Your first priority, whether a claim is for property or liability,
is to report the loss as quickly as possible after an incident has
taken place.
Investigating a claim as soon as possible allows the investigating
team to collect hard facts while they are still fresh in the minds
of involved parties. Immediate assessment also allows investigators
to view the location, if needed, before changes are made to the
site.
If you have a log in user name and password, click here
to access the Claims forms. If you do not, please click here
to request login access. (If a claim is reported late, or not reported at all,
coverage could be restricted or even denied.)
- +After a Claim is Filed
The insurer designates a claims examiner to investigate, detail,
document and appraise every aspect of the claim.
A determination is made as to whether the claim is covered by your
insurance policy.
Deductibles and other individual PHA policy provisions are taken
into consideration.
Legal counsel, experienced claims adjusters, or appraisers are used
to help settle claims as quickly as possible.
Insured PHAs can receive regular reports that indicate the
status of their outstanding claims reserves as well as claims paid.
Loss reports are available in 8 different formats. Insured PHAs may
print their loss information from our website at housingcenter.com
in the Member's section at their convenience. Contact Nancy Swistak
at 800-873-0242, ext. 259 to sign up for online claims reports.
- +After a Property Loss
Post-event loss control (or action taken after an incident takes
place) is needed to prevent further property loss or accidents
beyond what has already taken place. Post-event loss control can
also prevent an event from happening again. Depending upon the type
of loss, post-event loss control could include:
Boarding up openings in a damaged structure;
Locking doors;
Covering openings in a roof;
Draining heating systems;
Turning off electricity; |
If a loss has taken place as a result of a “hazard”, it is important
to remove the hazard or secure the area as quickly as possible to
prevent further or additional losses.
- +Factual Investigations
PHAs must establish formal procedures that will be carried out after
an accident or loss on PHA property. These procedures, if conducted
properly and promptly, will help reduce the cost of a claim against
a PHA, or may even become a factor in eliminating the claim
altogether.
PHA staff should be trained adequately in post-event loss control.
Following are the basic questions that need to be answered if an
accident or endangering incident occurs on PHA property:
Who?
The name, address, date of birth, social security number,
occupation, name of guardian (if minor), and gender of the person(s)
involved, and whether he/she is a resident, visitor, or contractor.
What?
The nature of the accident or incident and the injury(ies). Approach
witnesses for an accurate statement and record witness(es) name,
address and phone number. Document the exact sequence of events that
led to the circumstances of the incident. Use a step-by-step
approach to determine what happened, including every person and
every object that contributed to the occurrence. Select words
judiciously, stating the facts, but leaving out opinions. Include
estimated property damage costs, even though actual costs will be
determined later.
When?
The date and time of the event, as well as weather and lighting
conditions. Be aware that incidents are sometimes alleged to have
occurred days and even weeks prior to the date they are reported.
The "when" data have tremendous value in legal actions and in court
decisions, and they are a key indicator of the need for additional
investigation.
Where?
The exact location of the accident or incident, with notes on
details that may have caused the event or been a factor. Take photos
whenever possible.
Why?
Review the facts surrounding the accident or incident to find
probable cause. Determine a course of action. |
- +Recordkeeping
Following a factual investigation as described above, the details
should be documented and the appropriate claim forms completed and
forwarded to the insurance company for resolution. Despite
negligence, injuries occurring on PHA property have the potential to
become claims. It is critical that full documentation is on file to
prove any valid defense if a claim is later filed against a PHA.
The key to all recordkeeping is good file maintenance. Organized,
accurate files are especially important when claims are made against
a PHA. Timely accessibility to these files will improve the
efficiency of the legal defense process. Computer tracking programs
that are designed to improve record keeping are recommended. This
way, the defense team will have access to critical documentation
that has an audit trail. Examples of PHA activities that would
benefit from having computer audit trails are: maintenance work
order systems; housing unit modernization and improvement programs;
and accident investigation records.
- +Professionals Standing by Ready to Help You
A full team of professionals is ready to help you through your
insurance process. Each step of the way we are available to answer
questions, research your needs and help you enjoy the best possible
protection. Our computer technology allows us to provide speedy
answers to your inquiries regarding coverage(s) and options
available. That’s the kind of service you would expect from a
company that is in partnership with PHAs
Reporting a Claim
Report Property, Liability, or Auto Direct Claims:
800-873-0242 ext. 288
Fax: 203-250-8377
Housing Authority Insurance Group
Attn. Claims Department
P.O. Box 189
Cheshire, CT 06410
Report Travelers Auto Claims to their 24/7 Claims Hotline:
800-238-6225 or 800-832-7839
If you have a log in user name and password, access
the Claims forms
by logging in to our Members site. If you do not, please to
request login
access.
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Reporting a Claim
Housing Authority Insurance Group Claims forms are available on the Member
site. You can now fill out and submit the forms online or print the forms, fill them out, and fax
or mail
them for processing.
Login to our members site to
access the forms
. If
you do not have a login, you can
request login access.
HADA
HADA, an organization of attorneys who perform defense work for HAI
Group, hosts an annual seminar on various subjects of interest to
our members and defense attorneys giving them the opportunity to
network.
Get information on the next
HADA seminar.
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