LOSS CONSULTING

An insurance policy is a very dynamic instrument: and when a loss occurs, it reacts by imposing innate obligations and duties on an Insured while providing conditional benefits and coverage. In the commercial insurance arena, there is a diverse universe of policy forms and endorsements with varying language and terms that will be interpreted and applied to determine the final resolution of a claim. A thorough and competent understanding of the insurance contract is critical for an effective presentation and adjustment of a claim to recover the maximum benefits available. PGA’s team of seasoned professionals can fill this void and assist with:

  • Documenting the correct and proximate cause of damage to ensure all of the appropriate coverages and/or exclusions are applied.
  • Accurately quantifying the extent of damages so that the optimal amount of benefits can be recovered and unnecessary financial losses can be avoided.
  • The compliance of policy obligations and duties that maybe required of the Insured including, but not limited to, providing inventories of damaged property, executing Sworn Statements in Proof of Loss, and preparing for an Examinations Under Oath.
  • Communicating with clients’ contractors and vendors so that repair strategies coincide with policy benefits and do not conflict with coverages.

LITIGATION & ALTERNATIVE DISPUTE RESOLUTION SUPPORT

With every insurance claim, the possibility of a disagreement between the policyholder and the insurance carrier over coverage or the amount of damages naturally exists. Typically, these disputes are resolved through litigation or some alternative dispute resolution process such as mediation or a form of binding arbitration. Regardless of which resolution method, it is imperative that a systematic and tactical approach is used in the presentation and adjustment process of each claim to increase the probability of a prevailing outcome. PGA’s practical and conceptual claims experience enables us to assist our clients’ legal team through all facets of the litigation and resolution process, despite the forum.

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