Claim File

1. Type of calamity (fire, water damage, storm…)
2. Contact insurance broker (if applicable)
3. Notification to the insurer
4. Appointing insurer’s expert
5. Appointing private expert
6. Taking preventive measures (as required)
7. Identifying possible liable parties
8. Contradictory assessment of the damage
9. Coordination between experts
10. Clean-up and clearing
11. Adversarial expertise
12. Damage estimation
13. Proposal for claim settlement via official report
14. Signing of the official report
15. Payment of compensation

General

• Take measures to prevent further damage
• Leave the presumed cause of damage untouched
• Take photos & list damaged contents
• Request quotes in consultation with TREX expert
• Available plans
• Lease agreement + inventory description
• Request mortgage certificate

Businesses

• Stock lists: on closing date and date of damage
• Depreciation and investment tables: on closing date and date of damage
• Trial and balance sheets (with detailed accounts 6 and 7) of the last 3 closed financial years and the most recent
• Table showing monthly turnover evolution for the last 3 years and the current year
• Inventory of (small) tools recorded directly in expenses
• Building plans with possible indication of production machinery
• Budget for current and following financial year
• Equipment on lease/rental
• Overview of costs incurred + copies of invoices
• Request certificate of business assets & mortgage certificate

Take as many photos as possible of all damage. These can later serve as evidence for your insurer or any opposing party. Preferably send the photos in jpg format via wetransfer.com.

You can already create a list of contents using a template. This template can be downloaded here. For contents, it is not necessary to provide a shortcut or link to the product

In most cases, the cause of a fire is not investigated. These investigations are very costly and are usually not conducted if there is no possibility of recourse or if no liable party is involved.

This investigation must always be conducted through a contradictory process.

In some cases, the police or fire department commissions a forensic expert to the scene. While this investigation does not necessarily focus on the cause of the fire, the expert will determine whether the fire is accidental, deliberately set, and/or if there are suspicious circumstances. If the expert establishes that the damage is accidental, they will stop their investigation and release the property or site.

If your property is sealed by the police, you may under no circumstances enter it until the seal is lifted!

Do you have supplementary legal assistance insurance? This may be a limited version (in the fire policy) or a comprehensive version (through a separate legal insurer).

They often reimburse the portion of the expert fees not covered by your fire insurance. Contact your insurance company or broker for more information.

All damages must be assessed in concert with and in the presence of all parties involved. This means that the experts present must be able to see and determine the damage themselves.

A (destructive) investigation can only be conducted once. This must also be done jointly, with all experts present and able to make any reservations which can be further investigated.

When an insurer compensates the insured party for damage, it may exercise its right of subrogation. This means the insurer steps into the rights of the insured.

The insurer can then attempt to recover the paid amount, in whole or in part, from a potentially liable party.

Troostwijk-Roux Expertises bv, in concert with the insurer’s expert, assesses the damage. This damage estimation is recorded in an official damage assessment report (PV), in which all costs incurred are listed. It follows that the estimated damage does not always equal the compensation.

Invoices for cleaning and restoration work are often reimbursed directly to the company that carries out the work. These costs are included in the estimate but are not transferred (again) to the insured party. Any advances that were disbursed will evidently be deducted from the final compensation.

Based on the official damage assessment report (PV) signed by all parties, the insurer will determine the compensation. First, the relevant policy terms are applied to the estimate; then previously disbursed amounts are deducted. The final compensation can therefore be lower than the estimated damage, taking various factors into account.

Often, a PV lists damage amounts both at replacement value and actual value at market prices. Depending on your contract terms, either the replacement value or the actual value is compensated.

If you are adequately insured, the replacement value is generally reimbursed. See the section on “compensation” for details. Compensation under common law is always based on actual value (= replacement value minus depreciation).

Contact our expert for further explanations.

The deductible is the insured party’s own share in the compensation of the damage. In every insurance file where the insurer makes a payment, a statutory deductible is applied. The amount of the deductible depends on your contract terms and may be increased. A higher share of the damage compensation usually leads to a lower premium.

In some cases, a so-called ‘English’ deductible (no deductible) may apply, or you may have a “joker” that removes the deductible. This joker can, for example, be earned by remaining claim-free for several years. If there is a liable party, you can often reclaim your deductible from them by invoicing after closure.

Payments under the “building” category are always made excluding VAT. Once you have submitted a repair invoice with VAT paid, the insurer will reimburse the VAT in following cases:

• You are not VAT liable
• You are VAT liable but cannot reclaim VAT

The total amount of remaining VAT is listed on the PV and is either 6% or 21% on the principal amount. You may offset this remaining VAT with invoices at the corresponding percentage.

Payments for contents are generally made inclusive of VAT. If a lump sum is specified, no additional VAT is payable. For all other items, excluding VAT, you can reclaim VAT after submitting an invoice. For VAT reimbursement, bundle the invoices and send them along with the PV and a cover letter to your broker or directly to your insurer.

Before the disbursement of compensation for your home or property, the insurer must verify that no mortgage exists on this property.
While it is possible that no mortgage exists or ever existed, the mortgage certificate request is necessary.

The document then serves as proof. Click here for more information.

The claimant may always hire their own expert to assess the damage. This must be an independent professional expert who performs claims assessments exclusively for the claimant. This is called a private expert or opposing expert.
The insurer’s expert and the private expert jointly assess the damage amount. If the two experts agree, they set the damage amount together. If they do not agree, the claimant has two options:

1. Appoint a third expert. The insurer’s expert and the private expert appoint a third expert. The three experts determine the final damage amount by majority vote.
2. Proceed to court with the appointment of a legal expert.

If the parties disagree on the cause of damage and/or its assessment, a legal damage assessment can be requested. One party submits a claim to the court. The court then appoints a domain expert or legal expert.

This expert will hear both parties, conduct an investigation into the cause, and prepare a damage assessment. The judge will issue a ruling based on this report.

If there is a dispute between certain parties, a subpoena may follow after a prior notice of default. One party submits the summons to the court, which initiates a procedure.

If the judge requires explanation, framework, or any investigation, especially in the fields where the judge lacks the necessary expertise, they may order a legal expert. This expert acts as the judge’s eyes on site and reports directly to the judge.

Typically, an insurance file is closed with the preparation of an Official Report (PV). This is an official document recording all details of the various parties and the damage estimate. Each party must sign this PV.

Note: The damage estimate does not always exactly match the compensation. The experts assess the damage and prepare an estimate; consecutively, the insurer makes payment based on the estimate and your policy terms.

• Building
• Contents
• Equipment
• Goods

Additional Coverages

• Demolition and clearance (D&C)
• Salvage and preservation (R&P)
• Temporary unavailality (TU)
• Expert fees

Underinsurance occurs when the insured value, as stated in the special conditions of your insurance policy, does not match the (actual) value that should have been insured. In this case, the insurer will usually apply the clause for underinsurance and you will most likely only be partially compensated.

Be sure to consult our expert for more explanations if this applies.

Insurance law requires the insurer to pay at least 80% of the determined damage estimate for the building excluding VAT within 30 days after agreement on the damage amount. Initially, 80% of the damage estimate is reimbursed, excluding VAT. After submitting repair/reinvestment invoices, the insurer will first pay the non-recoverable VAT. When the total invoice amount exceeds 80% of the estimated damage, this difference will also be paid.

Exact conditions of this procedure can vary according to your insurance contract. Consult your broker or insurance company for precise details.

Under normal circumstances, insurance law provides a maximum payment period of 30 days after receipt of the signed Official Report (PV) at the insurer’s head office.

The usual practice is 14 days.

Compensation for contents and additional coverages can usually be made immediately and directly. Compensation for the building will, in most cases, be paid directly to the policyholder.

If a mortgage exists on the damaged property, the compensation is often first deposited into a blocked account, since the mortgage holder wants to ensure that the compensation is used to restore the mortgage collateral. Barring this, the bank would be left with the burned property as collateral for the mortgage.

In principle, you can use the received compensation freely. In the case you want to comply with the 80% rule or VAT, conditions are attached.

To meet 80% of the damage amount, you normally have no reinvestment or repair obligation. This means the invoices do not need to cover repair of the damage must apply to an investment in a property of the insured in Belgium.

However, some insurers apply stricter conditions. Some insurance companies do not apply this 80% rule and pay the full compensation immediately. Consult your broker or insurance company for the exact conditions.

Troostwijk-Roux Expertises bv always contracts with its own client and never works directly for a fire insurer. This means we always issue an invoice to you as the client (and contracting party). Fortunately, most of this invoice is usually reimbursed by your insurer. In exceptional cases (e.g., no coverage), the services provided by Troostwijk-Roux Expertises bv are still to be compensated.
The formula and standard for calculation of your reimbursement can be found in the general terms of your (fire) insurance policy. Make sure you use the correct version and apply necessary indexations.

Our invoice is calculated based on the agreed percentage of the total damage estimate, with a minimum based on the amount of hours spent. For private individuals, this total amount is increased by the legally applicable 21% VAT.
In a covered claim and acquired supplementary coverage, the insurer will disburse the amount based on your policy terms. Upon receipt of our invoice, you can submit it to your insurer, directly or via your broker.

You may also opt for a payment mandate. Download the relevant document, complete it, and send it to Trex at dossier@trex.be with your file number. We will then submit your invoice directly to your insurer. Please note however, that you remain responsible for paying the invoice if direct reimbursement is not approved or paid by your insurer.