Experience > Forensic Accounting > Insurance Claims
Natural disasters and other unforeseen business interruptions require qualified professionals to prepare and defend complex insurance claims. Our insurance experience includes both carriers and claimants. We determine business interruption damages, and compile related documentation needed to achieve a fair insurance settlement.
Most commercial insurance policies provide coverage for (i) lost profits which occur in connection with a covered physical loss, (ii) the added costs of getting the business reopened, and (iii) losses in connection with closures from actions of a civil authority. Some business policies also provide protection from “contingent” business interruption losses caused when key suppliers or customers experience a disaster that also affects your business, even when the physically-damaged property is NOT owned, operated or controlled by the insured. Often, the policy provides coverage for the cost of preparing these difficult-to-understand claims.
- On numerous occasions, our experts prepared business interruption insurance claims, or critiqued the claims prepared by others.
- On numerous occasions, our experts defended insurance carriers against claims of bad faith denial of coverage (or related similar claims) brought by an insured. Our analyses focused on both the claim preparation/review process, the amount of the allowed claim, and the impact on the insured of not having insurance recoveries earlier.
- On several occasions, our experts assembled accounting and/or computerized records to demonstrate the amount of inventory or other physical assets that were destroyed by an insured event. Prepared the related successful insurance claim.
The following representative engagements provide additional description of the sort of projects described above:
- Prepared the claim for both physical loss and business interruption for a major destination resort. The claim was complicated because the insured was significantly expanding the business prior to the loss, and continued to do so afterwards at the same time that the insured repairs and business interruption were occurring. The loss was sufficiently large to attract national attention.
- Prepared and negotiated a claim for business interruption for a publicly traded casino that was severely damaged by a natural disaster.
- Determined the value of a New York City mall in connection with a business interruption claim arising from the attacks on 9/11/2001.
- Using computerized records, prepared an inventory valuation for a hospital after a hurricane flooded the facility. We valued over 10,000 individual inventory items, many of which were severely damaged in the flood, making physical identification difficult. In addition, we calculated business interruption damages when the hospital was closed and reopening.
- Examined the business interruption claim of an insured on behalf of a carrier after the carrier had been accused of bad faith denial of a claim. We reviewed the original claim and the work performed by the carrier’s first accountant. We discovered that the original accountant had made unreasonable assumptions and calculations. We then examined the insured’s claim from scratch and learned that the loss of business was entirely due to new competition that had nothing to do with the insured event. The dispute was successfully resolved at an amount considerably lower than the insured’s original claim, with nothing paid for the bad faith claim.