Imagine an unexpected situation: a company warehouse catches fire, heavy equipment is severely damaged, or a cargo ship crashes at sea. All of these risks should be manageable with insurance coverage. However, when the claims process begins, various obstacles arise—documents are repeatedly returned, communication with the insurance company is unclear, and ultimately, the claim is rejected for technical reasons.
Cases like this often occur because many policyholders don’t understand the proper claims process—whether through an insurance agent or an insurance broker. Both parties play a role in the insurance industry, but they have different functions and interests. An agent represents the insurance company, while a broker acts solely on behalf of the insured. This difference often determines whether a claim is paid in full or denied.
In this article, Liga Asuransi will provide an in-depth review of the differences between the claims process between insurance agents and brokers, as well as why having a professional broker is crucial in ensuring the smooth and successful processing of your claim.
If your company is facing challenges in the claims process, or wants to ensure all assets and operations are optimally protected, L&G Insurance Broker is ready to assist as a professional partner who is fully committed to your interests.
Contact L&G Insurance Broker now on 08118507773 or email to halo@lngrisk.co.id for free consultation before risk.
Understanding the Role of Insurance Agents and Brokers
In the insurance industry, both agents and brokers often serve as the primary liaison between insurance companies and insured parties. However, while the two may appear similar on the surface, there are fundamental differences that significantly impact the interests and outcome of the claims process.
- Insurance Agent: An Extension of the Insurance Company
Insurance agents act as official representatives of insurance companies. They have direct contracts with insurance companies and are responsible for selling insurance products to potential customers. In other words, agents are the “face” of the insurance company to the public.
An agent’s primary role is to explain product benefits, assist potential clients in selecting an appropriate policy, and ensure premiums are paid on time. However, in the context of claims, agents are often constrained by the policies and interests of the insurance company. This means that when a claim arises, agents are limited in their ability to advocate for the insured’s interests if the claim could potentially harm the insurer.
- Insurance Broker: Advisor and Protector of the Insured’s Interests
Unlike agents, insurance brokers work solely on behalf of their clients (the insured). Brokers are not tied to a specific insurance company but act as independent advisors, helping clients obtain the best coverage based on their needs and risk profile.
In practice, brokers play a role not only during policy purchase but also in risk management, policy administration, and full assistance in the event of a claim. Brokers act as professional consultants, ensuring the entire claims process is conducted correctly and transparently. Even in disputed claims situations, brokers will assist clients in preparing technical arguments and supporting evidence to secure a claim.
- The Essence of Difference: Who to Fight For
In short, the main difference between an agent and a broker lies in who they represent. An agent represents the insurance company, while a broker represents you as the policyholder. Therefore, choosing to route claims through an insurance broker often yields more optimal results, especially for companies with high-risk exposures, such as those in the EPC, logistics, energy, or heavy manufacturing sectors.
In the insurance industry, both agents and brokers often serve as the primary liaison between insurance companies and insured parties. However, while the two may appear similar on the surface, there are fundamental differences that significantly impact the interests and outcome of the claims process.
- Insurance Agent: An Extension of the Insurance Company
Insurance agents act as official representatives of insurance companies. They have direct contracts with insurance companies and are responsible for selling insurance products to potential customers. In other words, agents are the “face” of the insurance company to the public.
An agent’s primary role is to explain product benefits, assist potential clients in selecting an appropriate policy, and ensure premiums are paid on time. However, in the context of claims, agents are often constrained by the policies and interests of the insurance company. This means that when a claim arises, agents are limited in their ability to advocate for the insured’s interests if the claim could potentially harm the insurer.
- Insurance Broker: Advisor and Protector of the Insured’s Interests
Unlike agents, insurance brokers work solely on behalf of their clients (the insured). Brokers are not tied to a specific insurance company but act as independent advisors, helping clients obtain the best coverage based on their needs and risk profile.
In practice, brokers play a role not only during policy purchase but also in risk management, policy administration, and full assistance in the event of a claim. Brokers act as professional consultants, ensuring the entire claims process is conducted correctly and transparently. Even in disputed claims situations, brokers will assist clients in preparing technical arguments and supporting evidence to secure a claim.
- The Essence of Difference: Who to Fight For
In short, the main difference between an agent and a broker lies in who they represent. An agent represents the insurance company, while a broker represents you as the policyholder. Therefore, choosing to route claims through an insurance broker often yields more optimal results, especially for companies with high-risk exposures, such as those in the EPC, logistics, energy, or heavy manufacturing sectors.
Why Do Many Claims Fail When Filed Through an Agent?
One of the biggest challenges many companies face when experiencing losses is a flawed claims process. Numerous cases demonstrate that insurance claims submitted through agents often encounter obstacles, even resulting in rejection. So, why does this happen?
- Agents are bound to the interests of the insurance company
Agents work under contract with insurance companies. This means they are obligated to protect the interests of the insurer, not the policyholder. In the case of a major claim—for example, a factory fire, heavy equipment damage, or operational disruption to an EPC project—agents find themselves in a difficult position when clients request coverage that potentially conflicts with the insurance company’s internal policies.
- Lack of Technical and Legal Support in the Claims Process
Most agents lack technical teams or legal advisors to assist with loss analysis, verification of technical documentation, or negotiation of claims decisions. As a result, clients often lack professional support in preparing strong arguments against insurance investigations. This can lead to claims being delayed or denied due to incomplete or inaccurate documentation.
- Lack of Assistance During Claim Investigation
The claims process often involves a loss adjuster—an independent party appointed by the insurance company to assess the loss. Objective assistance is essential at this stage to ensure a fair assessment for both parties. Unfortunately, agents are generally not actively involved in the investigation process and tend to leave it entirely to the insurance company. As a result, the insured’s position in the claims process is unequal.
- Focus on Sales, Not Risk Management
Most agents focus more on policy sales than long-term risk management. Once a policy is issued, many agents no longer actively monitor risk conditions in the field. When a claim arises, their lack of understanding of the contract details and the true risks prevents them from effectively assisting.
- Lack of Understanding of Complex Policing
In some types of insurance, such as Industrial All Risk (IAR), Contractor’s All Risk (CAR), or Public Liability, the clauses and exclusions are extremely complex. Without a thorough understanding, even a small error in reporting or completing a claim form can have dire consequences. Agents without extensive experience in these areas are often unable to provide proper technical guidance.
Claims failures not only cause financial losses but can also disrupt operational stability and business confidence. This is where the role of independent insurance brokers becomes crucial, as they possess the technical expertise, negotiation experience, and professional networks that can objectively advocate for the insured’s interests.
The Advantages of Managing Claims Through an Insurance Broker
Unlike agents, insurance brokers act as official representatives of the insured (customers), ensuring the entire claims process is fair and transparent. In the risk-laden context of modern business, the presence of an insurance broker is not merely a complement but a crucial factor in the success of claims processing and the continuity of company operations. Here are some of the key advantages of handling claims through an insurance broker:
- Full Representation of the Insured’s Interests
Brokers act as independent advisors on the client’s side, not the insurance company’s. This ensures that every decision, negotiation, and argument during the claims process is focused solely on maximizing the insured’s rights. Brokers will review the policy, ensure relevant clauses are used, and advocate for optimal claim payment.
- Strong Technical and Investigation Support
When dealing with major claims such as factory fires, industrial equipment damage, or EPC project disruptions, brokers employ technical teams and risk analysts who understand the engineering, legal, and financial aspects of these losses. Brokers will assist in preparing robust and comprehensive claim documentation and assist with the investigation process with loss adjusters, ensuring objective loss assessments that benefit the insured.
- Professional Negotiations with Insurance Companies
One of a broker’s key strengths is their ability to strategically negotiate with insurance companies. Because brokers work with numerous insurance companies, they have a deep understanding of claims assessment standards, industry best practices, and the negotiation opportunities they can utilize to achieve maximum results for their clients.
- Transparent Claim Progress Monitoring
Brokers not only file claims, but alsomonitor and speed up every stage of the processThey will ensure there are no document delays, no communication breakdowns, and that every development is communicated transparently to the client. This process helps avoid administrative hurdles that often delay claim disbursement.
- Risk Consultation and Future Claim Prevention
In addition to assisting when a claim arises, brokers also play a role in providing risk mitigation recommendations. Based on their experience handling previous claims, brokers can help companies improve protection systems, update policy clauses, and avoid potential future disputes.
With these advantages, it’s clear that insurance brokers are more than just intermediaries, but also strategic partners in corporate risk management. In today’s uncertain business climate, having a professional broker like L&G Insurance Brokers means comprehensive protection and support from start to finish in the claims process.
Claim Submission Procedure Through an Insurance Broker
One of the main advantages of using the services of an insurance broker isa much more systematic and efficient claims procedureBrokers not only assist with document preparation but also oversee each stage to ensure claims are processed according to international standards and protect the insured’s interests. The following are the general stages of the claims process managed by an insurance broker:
- Initial Notification (Notice of Loss)
The first step the insured must take is to immediately notify the broker after a loss or incident occurs. The broker will then assist in preparing an initial report to be forwarded to the insurance company within the policy deadline—usually within 7 to 14 days of the incident.
At this stage, the broker will ensure that all important information is recorded correctly: chronology of events, time, location, estimated loss amount, and initial evidence such as photos or internal reports.
- Initial Analysis and Policy Review
After receiving the report, the broker will do a comprehensive review of the policy insuranceTo ensure the type of risk involved is covered by the insurance contract, the broker also assesses any relevant exclusion clauses and prepares a defense strategy if clarification from the insurer is needed.
This analysis is crucial because many claims go unpaid due to misinterpretation of policy clauses. With a broker’s expertise, the risk of such errors can be minimized.
- Coordination with Loss Adjuster and Insurance Company
Insurance companies usually appoint loss adjusters to objectively assess losses. The broker will be an active partner throughout this process—ensuring smooth communication, accurate data submissions, and consistent investigation results.
If there is a difference in assessment, the broker acts as a professional negotiator who submits technical justification in order to fight for a fair claim value for the insured.
- Claim Documentation and Compilation
The broker will help the client prepare all the necessary documents such as:
- Complete loss report
- Proof of ownership or employment contract
- Photos or videos of the incident
- Bill for repair or replacement costs
- Company internal investigation report
With neat and complete documentation, the chances of a claim being approved increase significantly, while also speeding up the disbursement time.
- Negotiation and Finalization of Claim Payment
The final stage is negotiating the claim amount and settling the payment. The broker will ensure the final result reflects the actual loss and meets the policy coverage limits. Once agreed, the insurance company will transfer the claim funds directly to the insured’s account.
Through structured steps and professional support, insurance brokers act as guardians of your financial interests and business reputation. The typically complex claims process can be streamlined, streamlined, and streamlined, allowing your company to quickly and easily resume operations without disruption.
Conclusion
In today’s uncertain business world, insurance is more than just an administrative obligation, but a key foundation for maintaining a company’s financial and operational stability. However, the success of this protection depends not only on the policy you have, but also on who assists you through the claims process.
From the previous discussion, it’s clear that insurance agents and brokers have very different roles. Agents represent insurance companies and sell their products, while brokers work solely on behalf of the insured—helping them select the best policy, managing risks, and even fighting for fair claims payments.
Handling claims through a broker offers a variety of strategic advantages: from technical assistance, clear communication, process efficiency, and assurance that every decision is made in the client’s best interests. In the corporate context, particularly in high-risk sectors such as EPC, energy, logistics, and heavy manufacturing, a broker is not simply a complement but a strategic partner in long-term risk management.
With over two decades of experience in handling various types of corporate and industrial insurance, L&G Insurance Brokers has been trusted by many national and multinational companies as a professional partner in claims management and risk management.
Ensure your business isn’t harmed by inaccurate claims processing. Consult your company’s insurance and claims needs with L&G Insurance Brokers—a trusted partner who fully supports your interests.
📞 Contact L&G Insurance Brokers at +62 811-8507-773 or visit www.lg-insurance.co.id for more information.
