Insurance Claim Preparation
WHAT WE DO

Forensic Accounting 
Claim Preparation

Sigma7 RWH Myers is a forensic accounting firm that specializes in the assessment, quantification and presentation of losses to insurers. Insurance policies have become increasingly complicated and are challenging for all involved especially the policyholder. It’s more and more common to see overlapping perils, overlapping coverage extensions and overlapping interruptions, such as direct, contingent and/or service interruptions. Our objective is to relieve the time and resource burden on our clients while providing the expertise needed to achieve an equitable settlement creating a smoother process for all involved. We utilize our proprietary tools to enable forensic accounting efficiency and accuracy, while connecting multiple parties around the globe to help expedite claim settlement.

We are RWH Myers—a team of experienced, independent and specialized forensic accounting professionals armed with powerful tools, delivering BIG results.

Our Process
Loss adjustment is a process, not an event. The process we envision is collaborative and goal-oriented. Upon engagement, we meet with our client to establish a scope of loss and review loss estimates for conceptual and factual accuracy, and consistency with policy terms. Using Sigma7 RWH Myers claim formats, we assemble a comprehensive loss estimate for reserve and advance purposes. We also create a firm timetable outlining our responsibilities and the responsibilities of our client’s personnel with respect to data and document gathering. We prepare interim reports over our letterhead as soon as practical, and coordinate the work of auditors and other experts engaged by your insurer. We provide continuous consulting services to answer additional requests, advise management on the status of the claim, and assist in settlement negotiations. And, we always strive to ensure that your overall objectives are met.

The most common types of claims we prepare include:

Business Interruption & Extra Expense

Business Interruption coverage is intended to reimburse the policyholder for the income lost or incremental increase of expenses experienced during the loss period. This coverage is typically triggered by physical damage as a result of a covered peril or another trigger defined in the property policy such as Civil Authority, Ingress/Egress or Service Interruption. Contingent Business Interruption claims typically involve property damage or other covered peril at a supplier or customer location.

Though the application of this coverage may appear simple on the surface, measuring a time element claim is far from black and white. There are various methods of calculating business interruption and associated source material to substantiate your claim. Here is an overview of what you should expect when measuring your BI loss.
  • Most records will be available when/if needed later, but certain “live” documents, such as forecasts, that dynamically change, must be saved offline before they do. Be prepared to discuss the sources of information in the monthly operating statistics and financial statements
  • Be prepared to discuss the specifics of your operations – production process, location and capabilities of other facilities, etc.
  • Organize documentation and calculations under the terms of the policy so that a claim can be submitted in a timely manner; for larger losses, regular interim claims may be submitted to ensure cash flow
Request Our BI Claim Check List

Property Damage 

When a property claim occurs, with or without business interruption, it is very common to assume that it will be straightforward. Just submit your invoices and your insurer sends you a check. There are many potential issues when preparing a property claim that are commonly overlooked or misunderstood. The challenge is even greater if there is a business interruption component to your claim. Here is an overview of what we do for you during a property damage claim: 
  • Prepare estimate of overall claim so that adjuster can set reserves 
  • Assign a claim coordinator – an internal person who will be responsible for centralizing information related to the claim
  • Create cost centers to capture vendor charges, internal labor and internal material charges – do not charge operations related expenses to these cost centers
  • Files for the following documentation should be maintained: vendor charges, labor distribution, materials distribution, journal entries, monthly operating statements, justification of major repair / replace decisions, notes and miscellaneous information
  • Organize documentation and calculations so that a claim can be submitted in a timely manner; for larger losses, regular interim claims might be required
  • Prepare for audit of claim by adjuster accountants – work expeditiously to answer questions
  • Settle pieces of the property claim when completed – i.e. building, equipment, clean up, etc.
All claim submissions are subject to adjustment and audit, so having a skilled claim team on your side will minimize insurer resistance leading to a fast and fair insurance recovery. We are here to serve you as both an expert resource and service provider. 
Request Our CAT Claim Guide

Cyber Claims

Insurance claims arising from a cyber related peril have become more complex as a result on the various coverages that may apply. From a claim preparation perspective, cyber exposures falls into two categories: business interruption and restoration, and they are interrelated. 
  • Business interruption is a time element loss similar to that from a property trigger. When an incident occurs that affects operations and production, the loss of earnings earnings that results may be covered. The time element considers the time of restoration i.e. time it takes to get back to pre-loss levels. This includes the extra expenses needed to keep the operation running. In addition to lost sales, there may be a loss of customers or contracts that should also be assessed.
  • The restoration involves both the costs and steps needed to repair and replace damaged hardware and software systems necessary to restore operations back to pre-loss levels. How long that takes is your period of restoration. Restoring critical systems may involve various outside consultants to implement the restoration plan and these costs should be included in your claim.
Choosing the right firm for your cyber loss can be difficult especially given the unfamiliarity most have with these claims. In our experience the claims process is similar to a property claim as far as documentation and calculations. However, getting access to the documentation and aligning it with the policy can be challenging. In the end, a well thought out and well prepared claim will make all the difference. 

Request PDF Cyber BI

Product Recall Claims

Product recalls can be costly and logistically complex, as well as damaging to a company’s reputation. When insurance coverage is in place may to help defray these costs, preparing a product recall claim will add another layer of complexity and an increased workload that should not be underestimated. Having knowledgeable experts on your side will lessen the time burden on your organization while providing much-needed expertise related to the quantification and documentation required throughout the insurance recovery process. 

Sigma7 RWH Myers has decades of experience with all aspects of product recall claim preparation. The business interruption or “loss of gross profits” must be carefully quantified and supported by historical performance considering multiple factors such as seasonality and special events projected during the loss period. Concurrently, all of the response costs must be captured and documented in accordance with the terms of the policy. These costs may include: 
  • Additional labor and third-party costs
  • Advertising and promotional costs to launch the recall
  • Shipping costs to collect recalled products
  • Product destruction and disposal costs
  • Product replacement, repair and distribution costs
  • Fees to wholesalers, distributors and retailers
  • Reputation repair and management costs
All claim submissions are subject to adjustment and audit, so having a skilled claim team on your side will minimize insurer resistance leading to a fast and fair insurance recovery

Event Cancellation

Event cancellation claims recovery protect policyholders from budgeted costs, expenses and income should an event be cancelled or disrupted due to unfortunate circumstances beyond the insured’s control, including: 
  • Adverse weather
  • Non-appearance
  • Communicable disease
  • Extra expense to mitigate loss 
  • Property damage and money
Though the coverage may vary from policy to policy, our experts will help you through the claim process step by step, efficiently and effectively, to settlement. Our clients leave their claim preparation to the professionals at Sigma7 RWH Myers so they can focus on their next event. 

Contact us!

For a no-obligation consultation with a Sigma7 RWH Myers Partner please complete this form and we will contact you to arrange an introductory web meeting or feel free to contact one of our offices directly. Thank you for your interest in Sigma7 RWH Myers.
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