Claims, the moment of truth
Keep it Simple
Edition only available in Portuguese

Claims, the moment of truth

By: Paulo Pereira e Pedro Pinhal

In the fourth book of the series, Paulo Pereira and Pedro Pinhal demystify and decode the claims management process, sharing practical insights into some of the key general principles whilst focusing on the settlement of property damage claims around fire and multi-risk. They also review some history-making claims that are still remembered today.


Claims and insurance are inseparable. After all, insurance arose from, and is justified by the need to eliminate or mitigate damage from an adverse event — a claim.

In simple terms, the “moment of truth” in the insurance world happens when a claim is made. Until a claim happens, the insured has merely purchased a promise and an expectation; an assurance that, if a given event takes place and certain requisites are met, the insurer will, against receipt of a premium, pay out a given amount. When a claim arises, insurance as a protective mechanism comes into its own as the necessity, efficacy and benefits to damage mitigation are recognised and life is able to return to normal.


  1. General Principles
  2. The Claims Process
  3. Conclusion
  4. Case Study
  5. Appendix: Iconic Claims


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Paulo Pereira

Paulo Pereira

Director - Advanta

Has over 20 years’ experience working in the insurance sector as a loss adjuster. Before joining Advanta in 2005, he held a number of directorial positions with leading claims management companies. Paulo’s specialities include industrial all risks, machinery breakdown and energy.

Pedro Pinhal

Pedro Pinhal

Technical and Claims Director - MDS Portugal

Pedro Pinhal began his career in the insurance industry in 2003, with insurer Tranquilidade. 
At this company, he started out as a Personal Injury Settlement Specialist. In 2011, until he joined MDS in 2016, he took over as head of the Claims Service, leading the following teams: Personal injury settlement experts; Personal Accidents Claims; Life Risk and Life Financial; Auto claims with personal injury; Civil Liability Claims with with personal injury and International Claims. 
In parallel, he was a Specialist Arbiter under the Claim Settlement Convention of the Portuguese Insurance Association. Before joining Tranquilidade, he had worked as a lawyer.  
He holds a law degree and a post-graduate diploma in Insurer and Pension Fund Managements, and another in Forensic Medicine.