Claims and client service

Hail, flood, storm: running a claims surge without losing the book

When a storm puts a month of claims into two days, a brokerage needs triage, document packs and a communication cadence. A practical plan for short-term brokers.

Published on 8 min readFCB.ai
Contents
  1. Why a surge breaks an ordinary claims desk
  2. Triage: three lanes, not one queue
  3. The document pack decides the speed
  4. What the rules put on the insurer, and what falls on you
  5. Talking to two hundred waiting clients at once
  6. The six weeks after
  7. Frequently asked questions

A hailstorm crosses the East Rand on a Wednesday afternoon. By seven that evening the brokerage has forty messages: cracked windscreens, holed roofs, a panel shop already quoting, two commercial clients with water through a warehouse ceiling. By Friday it is closer to two hundred, the insurer's claims line is answering in twenty minutes rather than two, and every loss adjuster in the province is booked into next week.

Nothing about the individual claims is unusual. What is unusual is the arrival rate, and that is a capacity problem rather than a technical one. Brokerages that come out of a catastrophe with their book intact are almost never the ones with the cleverest wordings; they are the ones that had a plan for the forty-eight hours after the sky cleared.

Why a surge breaks an ordinary claims desk

A short-term desk that comfortably handles a handful of notifications a day is not a smaller version of one handling two hundred. Three things break at once.

Intake fragments: clients message the adviser they know, on whatever number they have, and half the notifications never reach the person who is supposed to log them. Visibility disappears, because with the queue growing hourly nobody can say who has been answered — so the loudest client gets three replies and the quiet one with the worst damage gets none. And proactive communication becomes impossible: there is no approved template to send a status update to three hundred people, so the firm goes silent exactly when silence is read as incompetence.

Each of those is fixable in advance, and only in advance. In the middle of a surge you will not get a new template approved, restructure your inbox, or teach a team a triage rule they have never used.

Triage: three lanes, not one queue

Sort every inbound message into one of three lanes before anyone starts drafting a reply.

  1. Emergency and mitigation. The property is uninhabitable, water is still coming in, a business cannot trade, a vehicle is unsafe. These move the same day: point the client to the insurer's emergency assistance line, confirm the duty to prevent further loss, tell them to keep every invoice and to photograph everything before anything is moved or repaired.
  2. Standard damage. The bulk of the surge. These get a structured intake and a complete document pack before submission, because a half-complete claim submitted quickly is slower than a complete one submitted an hour later.
  3. Questions that are not claims. Excess amounts, whether something is covered at all, whether to claim on a small loss. These deserve a considered answer and a note on file, but they must not sit in the same queue as a family without a roof.

Two practical rules make the lanes work. Acknowledge everything within the working day, even if the acknowledgement only says who owns the file and when the client will hear next — an unanswered message is what turns a claim into a complaint. And take the notification wherever the client sends it, then move it into the brokerage's system immediately; our claim notification on WhatsApp walkthrough sets out the intake questions worth asking at first contact.

The document pack decides the speed

Assessment time is rarely lost at the insurer. It is lost in the days a client spends hunting for something nobody asked for clearly at the start.

Claim typeCollect at first contactUsual cause of delay
Motor (hail, flood, storm debris)Policy number, registration, licence and driver details, photographs of all panels and the interior, location and time, whether the vehicle is drivableVehicle already at a panel shop before the insurer authorised an assessment
Home buildingsDated photographs from outside and inside, extent of water ingress, whether the roof is temporarily secured, contractor quotes if anyEmergency repairs done and the evidence destroyed
Home contentsRoom-by-room list with makes and models, purchase proof where it exists, photographs before disposalDamaged goods thrown out before assessment
Commercial property and business interruptionSchedule and sums insured, stock affected, trading records, mitigation steps taken, the dates the business could not tradeNo contemporaneous record of the trading impact

Send the relevant list as one message rather than five, and confirm receipt of each document as it arrives so the client can stop worrying about it. Underinsurance surfaces during a surge more than at any other time; where average applies, say so early and in writing, and move the conversation to the account handler rather than arguing it in a chat thread.

What the rules put on the insurer, and what falls on you

Under the Policyholder Protection Rules made under the Short-term Insurance Act and supervised by the FSCA, an insurer must operate a claims management framework: claims assessed after reasonable steps to gather the relevant information, claimants kept informed of progress, an escalation and review process for disputed outcomes, and records kept of all claims. Once a decision is taken to accept, repudiate or dispute a claim, the claimant must be told in writing, with reasons, within ten days of that decision. What the rules do not do is fix a single legal deadline for finishing an assessment — which is why "the insurer is taking too long" is a conversation about the framework and its timeframes, not about a date in a statute.

Two consequences follow for a brokerage. If your firm holds a binder for claims you are performing the insurer's function, and the same expectations follow the function into your office. And whether or not you hold a binder, the messages in which you advised, instructed and reported are your own record under the FAIS General Code of Conduct — which means they cannot live on a departing employee's handset. Our guide to FAIS record-keeping for WhatsApp conversations covers what that requires in practice.

One distinction is worth stating out loud during any event with a political or civil dimension: Sasria covers riot, strike, public disorder and terrorism, not weather. Storm, hail and flood damage is a conventional policy question, and confusing the two in front of a client is an expensive way to be wrong. The Sasria checks a commercial broker should run at renewal are a separate exercise entirely.

Talking to two hundred waiting clients at once

During a surge, cadence beats precision. A short, honest update every second day — what stage the claim is at, what is still outstanding, when the next update comes — keeps a claim out of the complaints queue far more reliably than a perfect answer that arrives a week late.

Mechanically, batch updates to clients who are not currently in conversation with you require an approved utility template, so that template has to exist before the storm. Replies land in an open service window where free-form messages are unrestricted and cost nothing, which is the billing shape described in our note on what a brokerage pays to message on WhatsApp. Pause marketing and cross-sell campaigns to the affected areas as well: a cover-review offer landing in the same week as a flooded lounge reads as tone-deaf, and the blocks and complaints it attracts damage the number you now depend on.

This is where a shared inbox stops being an administrative preference. In ORIS, a segment for the affected area drives status updates built from approved templates, incoming replies are classified so that urgent and unhappy messages surface instead of queueing behind routine ones, and drafted replies can be reviewed before they go out, with escalation to a human where the situation calls for it. What matters is not the automation but the fact that every thread sits at brokerage level, assignable to whoever is on shift.

The six weeks after

Surges end unevenly. A fortnight in, most files are settled and a stubborn minority — the disputed quantum, the underinsured warehouse, the repudiation nobody expected — take another month. Book two pieces of work now. The first is a complaints review, since disputed outcomes are exactly what reaches the National Financial Ombud, as set out in our piece on handling declined-claim complaints and the records to keep. The second is a renewal conversation about sums insured, excess structures and the mitigation clients have just understood for the first time. A catastrophe is the one moment when a client will genuinely read a letter about their sums insured. Use it.

Frequently asked questions

Can we accept claim notifications on WhatsApp at all?

Yes, provided the conversation is recorded at brokerage level and can be retrieved later, and provided you follow the insurer's own notification requirements. Nothing in the rules privileges a phone call over a message; what matters is that the notification, the documents and your advice are on file and attributable to a named representative.

Who authorises emergency repairs after a storm?

The policy wording and the insurer do. Clients have a duty to prevent further loss and should take reasonable steps immediately, but permanent repairs carried out before an assessment can compromise the claim. The safe message is: make it safe, photograph everything first, keep the invoices, and do not start permanent work until we confirm.

Should we message every client in the affected area, or only those who claim?

Message the segment. A short utility message telling clients how to notify a claim and what to photograph reduces the number of incomplete notifications you will spend the week chasing, and it reaches the clients who would otherwise assume their damage is not worth reporting.

How long may an insurer take to decide a claim?

There is no single statutory deadline for completing an assessment. The insurer must run a claims management framework with reasonable timeframes and must keep the claimant informed, and once a decision is taken it must be communicated in writing with reasons within ten days. Persistent silence is a service failure to escalate, not something to accept quietly.

What do we do when the damage exceeds the sum insured?

Say so early, in writing, and explain how average works before the assessor does. Clients cope far better with bad news delivered by their own broker on day two than with the same news delivered by a stranger on day thirty, and the file will show that you raised it.

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