Will your insurance pay out if you have a claim?

I run a scaffolding company, and a few weeks ago I had a conversation that I have not been able to stop thinking about. I was on a job talking to an insurance broker who had come to look at a property next door, and we got chatting the way you do. He said something that has stuck with me ever since. He told me he was sick of the way a big part of his own industry works: sell a business a shiny policy, take the premium every year without fail, and then, on the one day it actually matters - the day that firm has a serious claim - start going through the small print looking for a reason not to pay. "Have you got a risk assessment for that? Have you got the training records? Have you got the inspection report?" And if the answer is no, the cheque never comes. He said he did not want to work like that. He wanted to sit down with a customer before anything went wrong and make sure they were genuinely covered, not just sold. And then he said the line that made me want to write this: "The trouble is, most of them have no idea that this is how it works. They think paying the premium is the cover." He is right. It is not. The paperwork is.

The comfortable lie we all tell ourselves

Here is the story most of us in the trades quietly believe, whether we admit it or not. We take out public liability and employers liability because we have to - a main contractor demands it, or we know we would be mad not to have it. We pay the premium, it is not cheap, and once it is paid we file the certificate and forget about it. In the back of our minds a comforting thought settles in: I am covered now. If something goes wrong, the insurance will sort it. That thought lets us get on with the actual work, which is what we would rather be doing anyway. And ninety-nine times out of a hundred nothing tests it, so the belief never gets challenged. It just sits there, feeling like a fact.

The problem is that it is not a fact. It is an assumption, and it is wrong in a way that only reveals itself at the worst possible moment. Because an insurance policy is not a guarantee that the insurer will pay whatever happens. It is a contract, and like every contract it has conditions - things you have promised to do in exchange for the cover. Meet them and the insurer pays. Fall short on the one that matters when it matters, and they have a contractual right to reduce what they pay, or to refuse the claim entirely. The premium does not buy the cover outright. It buys a conditional promise, and the conditions are almost all about doing your compliance properly and being able to prove you did.

What the small print actually says

I did something after that conversation that I suspect most trades never do. I got out my own policy and I read it properly - all of it, including the conditions and the endorsements at the back that you normally skip. It was a sobering hour. Buried in there, in flat legal language, were a series of promises I had apparently made. That I would carry out suitable risk assessments for my work. That I would take all reasonable precautions to prevent accidents and injury. That any plant and equipment would be maintained in efficient working order and inspected as required. That the work would be carried out by competent, adequately trained people. Nothing in there was unreasonable - it was all stuff I would say I do anyway. But that word "prove" kept nagging at me, because there is a world of difference between doing something and being able to show, months or years later, that you did it on a specific job on a specific day.

That is the gap the insurer lives in. When they investigate a claim, they are not asking "is this a decent firm run by decent people?" They are asking a much narrower, colder question: "can this business demonstrate that it met the condition connected to what went wrong?" If you can, the cover responds and does its job. If you cannot - even if you genuinely did everything right but simply have no record of it - you are exposed, because in an insurance dispute a lack of evidence can be treated much like the absence of the thing itself.

"Have you got this, have you got that"

Let me make this concrete, because it is easy to nod along to the theory and still not feel it. Imagine one of your lads takes a bad fall from height. He is hurt - properly hurt, the kind of injury that changes a life and generates a claim with a lot of zeros on it. You report it to your insurer expecting them to step in and handle it. Instead, a loss adjuster gets in touch and starts asking questions, and the questions are all the same shape. Have you got the risk assessment for that job? Not a generic one - the one for that job, showing you identified the fall risk and how you were controlling it. Have you got the inspection record for the scaffold or the access equipment he was using? Have you got his training records, proving he was competent for what he was doing? Have you got the method statement, and can you show he was briefed on it and signed to say he understood it? Have you got your health and safety policy?

Every one of those is a "have you got this, have you got that" - exactly what my broker friend described. And here is the cruel part: this is the worst possible moment to discover a gap, because there is nothing you can do about it. You cannot write the risk assessment now. You cannot go back and inspect the scaffold last Tuesday. You cannot create a training record for a course he never went on. The documents either existed at the time or they did not, and whichever it is, that is now fixed forever. The claim - and it might be the biggest financial event your business ever faces - turns entirely on records you either kept or you did not, back when you had no idea you would ever need them. I have written a fuller breakdown of exactly which documents they ask for in the paperwork your insurer will ask for after a claim, because it really is worth knowing before you need it, not after.

Two firms, one accident, opposite endings

To show you how much rides on this, let me tell you about two firms - and I have seen versions of both. Same trade, same kind of job, and imagine the exact same accident happens to each: a worker falls and is seriously hurt.

The first firm is the one that does it properly. When the loss adjuster asks for the risk assessment, they produce a site-specific RAMS for that exact job that named the working-at-height risk and set out the controls - the access method, the edge protection, the exclusion zone below. When he asks for the inspection record, they have the scaffold inspection, dated, with the name of the competent person who did it. The training records are there for the man who fell. The method statement was briefed and he signed it. From the insurer's point of view, this is a firm that did everything it promised in the policy, and can prove it. The conditions were met. The cover responds. The injured man is compensated, the firm survives, and the premium they have paid all these years does exactly what they thought it did.

The second firm is not run by bad people. They are busy, they work hard, and on the day of the accident they were probably doing the job much the same way as the first firm. But their paperwork tells a different story, because there is barely any. The risk assessment is a laminated generic sheet that mentions "working at height" in passing but says nothing about this job. There is no scaffold inspection record - they inspect, they will tell you, they just never write it down. Nobody can find a training record for the man who fell. The method statement was never signed by anyone. From the insurer's point of view, this can look like a firm that fell short of the conditions of its policy - and the insurer may have grounds to argue exactly that. The claim is challenged. Maybe it is refused outright; maybe it drags through a fight the firm cannot afford. Either way, a business that thought it was covered discovers, far too late, that it was paying for a promise the insurer could walk away from. Same accident. Same premium. Completely different ending - decided by paperwork. I go deeper into how a fall claim specifically plays out in the records that decide a fall claim.

It is a shorter list than you fear

If you are reading this with a sinking feeling, let me steady the ship, because the situation is far more fixable than it sounds. The records an insurer actually leans on are not some vast, exotic library. For most trades it is a short, familiar list: your risk assessments and method statements for the work, your training and competence records for the people doing it, your inspection and maintenance records for the equipment, your health and safety policy, and the evidence that your team were briefed and signed on to the job. Behind those sit a few supporting bits - toolbox talks, COSHH assessments for the substances you use, your accident book. That is more or less it. Every single item on that list is ordinary compliance that you are supposed to be doing anyway, and that a well-run firm largely already does. The gap between the two firms in my story is almost never that one did the work and the other did not. It is that one kept the record and could produce it, and the other did the same work but let the evidence evaporate.

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Why the trades get hit hardest

There is a reason this matters more for us than for someone sitting safely at a desk. The heavier the risk in your work, the heavier the conditions the insurer attaches, because they are relying more on you to manage that risk day to day. If you work at height, with power tools, with hazardous substances, on other people's sites, around the public - you are exactly the sort of firm whose claims get gone over with a magnifying glass, and exactly the sort of firm most likely to be carrying paperwork that has quietly drifted out of date, or was never job-specific in the first place. Scaffolders, roofers, groundworkers, builders, decorators, electricians - the more physical and the more hazardous the work, the truer this is. Public liability is where a lot of it comes home to roost, and I have written separately about why public liability claims get refused, because that policy in particular is riddled with conditions people never read. Keeping cover live matters just as much — here is how to track contractor insurance expiry dates so it never lapses unnoticed.

Compliance and insurance are the same job

Here is the shift in thinking that the broker was really getting at, and it is the whole point of this piece. We tend to treat compliance and insurance as two separate chores. Compliance is the health and safety paperwork the HSE might want. Insurance is the certificate the main contractor demands. They feel like different worlds, run by different people, filed in different folders. But they are not two jobs. They are one. The site-specific RAMS you write to be compliant is the identical document the insurer asks for after a claim. The training records you keep to run a safe site are the identical records that prove competence when it is questioned. The inspection log you keep because you know you should is the identical log that decides whether a fall claim gets paid. Do your compliance properly - genuinely, currently, and in a form you can produce in seconds - and you are not doing two things. You are doing one thing that happens to satisfy the HSE and the insurer at the same time. Neglect it, and you fail both at once, and you find out on the day you can least afford to.

That is why the tidy phrase the broker and I kept coming back to is actually the literal truth of it: keeping yourself compliant is what keeps you covered. There is no version where your paperwork is a mess but your insurance is watertight. The paperwork is the insurance, in every way that counts when a claim lands.

Where Complys fits

This is exactly the problem we built Complys to solve, and honestly, it is the reason I care about it as much as I do - because I have watched good firms get caught out by nothing more than missing records. Complys keeps you compliant, and by doing so, keeps you covered. It builds a proper site-specific RAMS for each job in minutes rather than the hours it takes to write one by hand, and it captures your team's sign-off so the briefing is evidenced, not assumed. It keeps every risk assessment, inspection, training record and policy on file, current, and ready to produce. Your site notes, photos and evidence sit alongside them, time-stamped and located, so if a job is ever questioned you can show exactly what you did, when, and where. It all lives in one place as your construction compliance software, instead of scattered across vans, inboxes and a drawer in the office where nothing can be found the day it matters most. So that if you ever get that call from a loss adjuster, and the questions start - have you got this, have you got that - the answer, every time, is yes. And here it is.