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ELEMENTS OF CLAIM
SETTLEMENTS
Duncan Webb
How is the claim settled?
• When you reinstate the insurer will pay
• The insurer will manage the reinstatement
• The insurer will pay the cash equivalent of the
cost to reinstate
• Usually the insurer’s choice
• No policy requires a final settlement
• Insurers may require a clear settlement agreement
which is consistent with the policy
When you reinstate we will
pay…
• Most common settlement clause
• No right to cash settlement (other than indemnity
value)
• Needs insurer’s consent to incur costs
• Query who is in control of reinstatement project
• Insurer will often seek to dictate reinstatement
method / professionals / contractors
The Repair Contract
• Whose Contract?
• Insurer - builder / homeowner – builder / homeowner – insurer –
builder.
• Check the Policy
• If there are additional works then you may need to be a party.
• Contract terms are negotiable. Look out for:
• Variations
• Completion dates
• Penalties
• Unforeseen conditions
• Insurer can be liable for increases in cost (where no final cash
settlement).
• Get the contract reviewed.
Some Legal Niceties
• Insured has obligation to prove loss / damage
• Insurer cannot equivocate forever
• Reinstatement may require disproportionate
repair
• Damage is any adverse change (amenity /
aesthetic / structure / durability)
• No policy allows payment of the “best estimate”
of the cost of reinstatement.
• Windfalls possible
Cash- can my insurer insist?
• In some policies the insurer
has a right to pay the cash
equivalent of repair or rebuild
but:
• Did the insurer make an election
to repair themselves?
• Has the insurer represented that
they would manage?
• Good faith…
• Rebuff threats in respect of repair
/ rebuild contract timelines.
Full and Final?
• Insurer cannot insist that
your settlement is “full
and final”
• Beware of full and final
agreements if you are
going to repair.
• May be advantages to full
and final agreements
where you intend an
outside of policy solution
When should I agree to a full
and final settlement?
• When risks are low
• When you are wanting to depart
from policy
• Different house
• Waiting before undertaking
repair
• Buying two properties
• Note the terms of the settlement
agreement
• “intend to…”
• Repair / rebuild / reinstate /
replace?
• In general must spend on
reinstatement.
Can I ask for more cash
later…?
• Not if the agreement was
full and final:
• Limited exceptions
(such as fraud)
• Partial settlements are
possible. Insurers may
agree to pay more for:
• Variations
• Increased foundation
costs
LAND…
Duncan Webb
Land Damage
• the land on underneath the building; and
• all land within 8 metres of the building;
and
• the land holding—
• within 60 metres, in a horizontal line,
of the building; and
• Which is the main access way; and
• all bridges and culverts situated within
the land; and
• all retaining walls and their support
systems within 60 metres, in a
horizontal line, of the building which are
necessary for the support or protection
of the building or of the land.
• Must form part of the “land holding”
(not just legal title).
Damage
• Adverse change affecting usability.
• EQC categories:
• Flat land: Land cracking (spread and shaking);
undulation; ponding; settlement based drainage
issues; groundwater springs; ejecta; increased
vulnerability (flooding and liquifaction);
• Hill: mass land movement; rock fall / cliff collapse;
localised movement (small slips / retaining wall
failure).
• Must be change to the land in question.
• Kraal v Earthquake Commission [2014] NZHC 919, [2014] 3
NZLR 42.
The Amount of Land
Insurance
• For land the lesser of:
• (a) the value, at the site of the damage, of an area of
land being:
• the minimum area allowable to be used under the District
Plan for residential land; or
• 4 000 square metres; or
• The land that is actually lost or damaged—
• For retaining walls , bridges & culverts - indemnity value.
Land Damage: Fix or Pay?
• Sometimes that will be the cost of repair
• Will never be more than the value of the insured
land at the time of the loss
• May be the “diminution of value” (EQC v ICNZ
[2014] NZHC 3138
• Value of land lost where total loss.
• May be by reference to cost of ancillary works to
house (lifting / foundation enhancement).

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Elements of Claims Settlement (Kaikoura Meeting)

  • 2. How is the claim settled? • When you reinstate the insurer will pay • The insurer will manage the reinstatement • The insurer will pay the cash equivalent of the cost to reinstate • Usually the insurer’s choice • No policy requires a final settlement • Insurers may require a clear settlement agreement which is consistent with the policy
  • 3. When you reinstate we will pay… • Most common settlement clause • No right to cash settlement (other than indemnity value) • Needs insurer’s consent to incur costs • Query who is in control of reinstatement project • Insurer will often seek to dictate reinstatement method / professionals / contractors
  • 4. The Repair Contract • Whose Contract? • Insurer - builder / homeowner – builder / homeowner – insurer – builder. • Check the Policy • If there are additional works then you may need to be a party. • Contract terms are negotiable. Look out for: • Variations • Completion dates • Penalties • Unforeseen conditions • Insurer can be liable for increases in cost (where no final cash settlement). • Get the contract reviewed.
  • 5. Some Legal Niceties • Insured has obligation to prove loss / damage • Insurer cannot equivocate forever • Reinstatement may require disproportionate repair • Damage is any adverse change (amenity / aesthetic / structure / durability) • No policy allows payment of the “best estimate” of the cost of reinstatement. • Windfalls possible
  • 6. Cash- can my insurer insist? • In some policies the insurer has a right to pay the cash equivalent of repair or rebuild but: • Did the insurer make an election to repair themselves? • Has the insurer represented that they would manage? • Good faith… • Rebuff threats in respect of repair / rebuild contract timelines.
  • 7. Full and Final? • Insurer cannot insist that your settlement is “full and final” • Beware of full and final agreements if you are going to repair. • May be advantages to full and final agreements where you intend an outside of policy solution
  • 8. When should I agree to a full and final settlement? • When risks are low • When you are wanting to depart from policy • Different house • Waiting before undertaking repair • Buying two properties • Note the terms of the settlement agreement • “intend to…” • Repair / rebuild / reinstate / replace? • In general must spend on reinstatement.
  • 9. Can I ask for more cash later…? • Not if the agreement was full and final: • Limited exceptions (such as fraud) • Partial settlements are possible. Insurers may agree to pay more for: • Variations • Increased foundation costs
  • 11. Land Damage • the land on underneath the building; and • all land within 8 metres of the building; and • the land holding— • within 60 metres, in a horizontal line, of the building; and • Which is the main access way; and • all bridges and culverts situated within the land; and • all retaining walls and their support systems within 60 metres, in a horizontal line, of the building which are necessary for the support or protection of the building or of the land. • Must form part of the “land holding” (not just legal title).
  • 12. Damage • Adverse change affecting usability. • EQC categories: • Flat land: Land cracking (spread and shaking); undulation; ponding; settlement based drainage issues; groundwater springs; ejecta; increased vulnerability (flooding and liquifaction); • Hill: mass land movement; rock fall / cliff collapse; localised movement (small slips / retaining wall failure). • Must be change to the land in question. • Kraal v Earthquake Commission [2014] NZHC 919, [2014] 3 NZLR 42.
  • 13. The Amount of Land Insurance • For land the lesser of: • (a) the value, at the site of the damage, of an area of land being: • the minimum area allowable to be used under the District Plan for residential land; or • 4 000 square metres; or • The land that is actually lost or damaged— • For retaining walls , bridges & culverts - indemnity value.
  • 14. Land Damage: Fix or Pay? • Sometimes that will be the cost of repair • Will never be more than the value of the insured land at the time of the loss • May be the “diminution of value” (EQC v ICNZ [2014] NZHC 3138 • Value of land lost where total loss. • May be by reference to cost of ancillary works to house (lifting / foundation enhancement).