Computation of Fire Insurance Claims

Calculating a fire insurance claim involves several steps to ensure that the policyholder is compensated fairly for the loss or damage caused by fire. The process includes assessing the loss, verifying policy coverage, applying relevant clauses, and finally calculating the claim amount.

Notification of Fire Incident

The first step after a fire occurs is for the insured to notify the insurer about the fire incident. Prompt notification is crucial as it initiates the claim process and allows the insurer to assess the damage as early as possible. Most insurance policies specify a timeline within which the fire incident must be reported.

Assessment of Loss

After the insurer has been notified, a loss assessor or surveyor is appointed to inspect the property and estimate the extent of damage caused by the fire. The surveyor assesses:

• The condition of the property before the fire.
• The extent of damage to stock, machinery, and other assets.
• The salvage value of any damaged goods or property. The assessment forms the basis of the claim, determining how much of the property has been destroyed or damaged.

Calculation of the Value of Stock or Assets Lost:

In the case of businesses, the value of the stock lost in the fire is calculated. The insured needs to provide details of the stock on hand before the fire occurred. This can be derived from:

• Stock registers or accounts.
• Invoices and purchase records.
• Valuation of finished goods and raw materials.

The valuation of assets or stock is often done at cost price or market value, depending on the terms of the policy. If the stock was insured at invoice price, any profit margin already added is also considered.

Application of Policy Coverage Limits:

Every fire insurance policy has a maximum coverage limit or sum insured, which is the maximum amount the insurer is liable to pay. If the loss exceeds this limit, the policyholder will not be compensated for the excess. In such cases, the claim amount will be restricted to the sum insured.

Deduction of Salvage Value:

Salvage value refers to the residual value of any goods, property, or assets that can still be used or sold after the fire. The insurer reduces the claim amount by the salvage value, as the policyholder can recover some amount by selling or reusing salvageable items. This is essential for fair compensation as the insured should not be paid for goods that still retain some value.

Formula:

Net Loss = Total Loss − Salvage Value

Application of the Average Clause (if applicable)

Average clause is a provision in fire insurance that applies if the insured sum is less than the actual value of the property. In such cases, the policyholder is considered to have underinsured the property, and the insurer reduces the claim payout proportionally.

Formula for Average Clause:

Claim Amount = (Sum Insured / Actual Value of Property) × Net Loss

For example, if a property worth ₹10,00,000 is insured for ₹6,00,000 and suffers a loss of ₹4,00,000, the claim is reduced as follows:

Claim Amount = (₹6,00,000 / ₹10,00,000) × ₹4,00,000 = ₹2,40,000

The policyholder will only receive ₹2,40,000, instead of the full ₹4,00,000, because of underinsurance.

Consideration of Deductibles

Fire insurance policies often include deductibles or excess clauses, which are amounts the policyholder must bear out of pocket before the insurance coverage kicks in. For example, if the deductible is ₹50,000, and the total loss is ₹3,00,000, the insurer will pay only ₹2,50,000. Deductibles encourage policyholders to avoid making small claims and to take preventive measures.

Calculation of Business Interruption Loss (if applicable)

In cases where the policy covers loss of profit due to business interruption, the insurer compensates for the reduction in gross profit caused by the fire. To calculate business interruption loss, the following factors are considered:

• Historical profit trends.
• Fixed operating expenses (e.g., rent, salaries).
• The duration of business disruption. The amount paid for business interruption is based on the financial data provided by the insured, and it helps maintain financial stability while the business recovers from the fire.

Claim Settlement by Insurer

After assessing all the factors value of the loss, salvage, deductibles, and the average clause the insurer arrives at the final claim amount. Once agreed upon, the insurer pays the policyholder the claim, restoring them to their pre-loss financial position as closely as possible.

Example: Calculation of Fire Insurance Claim

• Value of stock before the fire: ₹15,00,000
• Loss of stock due to fire: ₹5,00,000
• Salvage value of remaining stock: ₹50,000
• Sum insured: ₹12,00,000
• Deductible: ₹25,000
• Actual value of stock: ₹15,00,000

Steps:

1. Calculate the Net Loss:

Net Loss = ₹5,00,000 − ₹50,000 = ₹4,50,000

2. Apply the Average Clause:

Since the sum insured (₹12,00,000) is less than the actual value (₹15,00,000), the average clause applies:

Claim Amount = (₹12,00,000 / ₹15,00,000) × ₹4,50,000 = ₹3,60,000

3. Apply the Deductible:

The final claim amount after deducting the policy deductible (₹25,000):

Final Claim = ₹3,60,000 − ₹25,000 = ₹3,35,000

The final payout by the insurer would be ₹3,35,000.