ROUX AFRIQUEGROUP
ROUX AFRIQUE CLAIMS · AFRICA & THE MIDDLE EAST
CLAIMS ADJUSTER · CLAIMS ADVOCACY · TPA
MOBILISE · QUANTIFY · NEGOTIATE · SETTLE
A major loss cannot be managed as a routine administrative file.
Roux Afrique Claims supports insured companies, industrial groups, institutions and investors facing major or complex losses.
We organise facts, evidence, property damage, business interruption and negotiations through to a documented settlement. Any TPA authority remains strictly governed by the mandate, jurisdiction and authority matrix.
FROM THE FIRST HOURS
After a major event, the company must act quickly without weakening its future claim.
A technically justified expense can become difficult to recover if it is not documented, linked to the loss and submitted in accordance with the policy.
Roux Afrique Claims balances operational urgency, evidential discipline, policy analysis and financial control.
THREE DELIVERY MODELS
Appointed by the insured to build and advocate a documented claim.
Operational management from notification through settlement.
Delegated administration within a valid legal, contractual and regulatory framework.
The TPA designation grants no implied authority; every power remains subject to the mandate.
CLAIM GOVERNANCE
Loss team, decision-makers, approval paths, emergency measures, decision log and initial strategy.
Policies, periods, insured interests, deductibles, limits, extensions, coinsurance, fronting, reinsurance and documentary duties.
Locations, photographs, exhibits, witnesses, logs, maintenance, analyses, chain of custody and established-fact register.
Buildings, machinery, stocks, safeguarding costs, debris removal, transport, erection, testing, salvage, depreciation and betterment.
Lost capacity, trends, seasonality, gross profit, savings, ICOW/AICOW, mitigation, repair and ramp-up.
Repair or replacement, temporary solutions, outsourcing, long-lead items, permits, commissioning and critical path.
Statement of Claim, quantum, evidence reconciliation, memoranda, issue register, interim payments and executive decisions.
Allocation by section of cover, agreement and payment tracking, reserved items, recovery, archiving and prevention recommendations.
METHODOLOGY
Assemble the team, secure the mandate and establish governance.
Identify policies and record communications.
Protect people, facilities and evidence while limiting deterioration.
Build a sourced chronology and separate facts, statements and assumptions.
Assess PD, BI, costs and mitigation on explicit bases.
Link each item to evidence, calculations, responsibilities and assumptions.
Test technical, contractual, financial and documentary consistency.
Present positions, address gaps and seek a documented agreement.
Track approvals and payments, close the file and capture lessons learned.
Every material amount must link to a fact, damage, calculation basis, supporting document and documented coverage position.
GOVERNANCE BY EXCEPTION
Registers structure amounts, positions, decisions and uncertainties.
Initial, updated, agreed, disputed and paid amounts; evidence, owner, status and next action.
Party positions, factual and policy basis, financial impact, expected decision and deadline.
Safeguarding measures, approvals, commitments, communications, reservations and provisional agreements.
Missing or conflicting information, assumptions, sensitivity and remediation action.
RECOVERY CASH FLOW
An interim payment request can be prepared when part of the loss is sufficiently evidenced and undisputed.
The payment decision remains with the insurer or authorised party.
CONTROLLED DELEGATION
The matrix defines what may be executed, recommended, authorised or escalated.
No authority is presumed; anything beyond delegation is referred to the principal.
DATA ROOM
Depending on the loss, the team assembles operational, technical, financial and policy records.
Access is governed by data sensitivity, confidentiality and party rights.
INDEPENDENT QA/QC
The review tests factual, technical, financial, policy and documentary coherence.
A claim is not presented as final while material investigations or decisions remain open.
DIGITAL EVIDENCE
Technology organises evidence and provides spatial context without determining coverage.
Structures the claim file and its progress.
Creates a spatial record of the loss.
VRA3D does not replace testing, causation analysis or specialist inspection.
DELIVERABLES
Depending on the mandate:
DECISIVE MOMENTS
Late mobilisation may remain possible but cannot recreate evidence that was not preserved.
SECTOR EXPERTISE
Teams are assembled around damage type, technology, coverage, financial stakes and jurisdiction.
Technical and financial depth is calibrated to the actual significance of the claim.
DISTINCT EXPERTISE
Structures facts, evidence, damage, loss, claim submissions and post-loss negotiations.
Provides reconstruction or replacement bases when appointed; a pre-loss value does not automatically determine indemnity.
Establishes pre-loss BI values, dependencies and periods; Claims quantifies the loss actually sustained after the event.
Assesses hazards and protections before loss; post-loss investigation requires a separate mandate.
Addresses programme architecture, Risk Financing and governance; Claims manages the event once it has occurred.
Roux Cyber acts as a Cyber Claims Adjuster on behalf of the insured and coordinates specialist digital investigation; legal opinions, litigation and arbitration remain with authorised counsel.
FRAMEWORKS
The policy, endorsements, applicable law, facts and authorised decisions remain decisive.
Reference to a market standard does not imply accreditation or regulatory authority.
An advisory mandate creates no regulated decision or payment authority.
FREQUENTLY ASKED QUESTIONS
The former supports the insured in preparing and advocating the claim; the latter acts under the insurer's mandate.
No, except under an explicit and valid delegation. Under an insured-side mandate, the insurer decides coverage.
Yes. It may include quantification, negotiation, agreement tracking and payment reconciliation; payment authority remains with the authorised party.
It may support technical presentations where the programme and mandates permit, without presuming a direct right of the insured.
Claims Management governs the file; TPA requires a delegation defining authority, limits and oversight.
As soon as the policy, law and circumstances reasonably allow; missing details may be supplemented later.
Urgent safety measures should not be delayed, but must be documented and notified under the policy.
Yes, when part of the loss is evidenced, subject to approval by the authorised party.
It is isolated and assessed against policy terms, technical necessity, depreciation and regulatory requirements.
From the actual loss, financial data, trends, savings, mitigation and policy wording.
No. It addresses technical, financial and insurance matters; legal opinions remain with authorised counsel.
Yes, subject to the evidence available, by reconstructing the facts, amounts, parties’ positions and causes of delay.
CLAIMS MANAGEMENT & TPA
Share the event, policies, first actions, apparent damage and operational impact. We will define the appropriate governance, expertise, evidence strategy and negotiation framework.
Speak with Roux Afrique Claims