Knowing the process of doing the right insurance claim procedures
are important to the client, because it helps settle claims quickly and seamlessly.
If the claims procedure
is not done, it
can lead to delay settlement of claims, and
in certain circumstances, may cause
the insurance company denied the claim.In particular, we will examine:
(a) How the
incident should be reported to THE
INSURANCE COMPANY
(b) What
immediate action should be taken
(c) What
information THE INSURANCE COMPANY will require you to provide to substantiate
the claim
Please
assure that you follow these procedures:
Reporting the Loss
1. Report the
Incident to Claim Department of THE INSURANCE COMPANY immediately not later
than 7 days.
Action to be Taken
2. Regardless of
whether or not the incident has been reported or a loss adjuster appointed, you
must immediately do whatever is necessary to prevent further loss of life or
property damage. For example:
· Call the fire brigade, ambulance,
police or other emergency services
· If during business hours – ensure
the evacuation (if necessary) of all staff and neighbours
· If critical machinery fails –
commence search for replacement plant/equipment or service
· Engage a security firm to protect
the site (if required)
· Erect temporary protection over
broken windows or roofing if possible to do so in safety
· Remove property which is exposed
to further damage to a more secure location
· Remove vital business records if
possible to do so in safety
· Take plenty photographs of the
damage and of any salvageable equipment
The
Claim Process
· THE INSURANCE COMPANY will normally appoint a Loss Adjuster to
investigate the cause of the loss/damage and determine the settlement amount.
Loss Adjuster is independent experts but their services are paid for by THE
INSURANCE COMPANY. The Adjuster / THE INSURANCE COMPANY will visit the site at
a convenient date and time with you. It is normal for the surveyor to take
photographs and interview your personnel regarding the incident. Full
cooperation must be extended to the Adjuster / THE INSURANCE COMPANY.
· It will speed up the process if
you are able to prepare a chronology of accident/incident and obtain estimates
of loss/quotations for repair from the suppliers/contractors and have these
items ready for presentation to the Loss Adjuster / THE INSURANCE COMPANY when they visit.
· All requests for documentation
will be made in writing, and the Loss Adjuster / THE INSURANCE COMPANY will
provide guidance and explanations as required.
· You will be required to provide
the documentation requested as soon as possible but if the claim settlement is
proceed quickly you should endeavour to submit the documents no later than 15
days after the request is received. In the event that you are unable to provide
any item requested by the Loss Adjuster / THE INSURANCE COMPANY you will need
to provide a written explanation to THE INSURANCE COMPANY.
· Once received, the Loss Adjuster /
THE INSURANCE COMPANY will check the information to ensure it is complete and
that it matches what the Loss Adjuster / THE INSURANCE COMPANY has asked for.
· If all is in order, The Adjuster
will study the documentation and will submit a report to THE INSURANCE COMPANY detailing the recommended settlement offer.
THE INSURANCE COMPANY will advise you of the settlement offer and ask for your
approval. This process would normally take about 15 days but if the claim is
particularly large or complex this may take longer.
· Once the terms of the settlement
offer has been discussed and agreed with you, THE INSURANCE COMPANY will
prepare a Discharge Form which they will ask you to sign, prior to their
transferring the claim monies within 7 days (on average).
Information / Documentation Required
Here are some examples of documents
that are usually asked SERVICE INSURANCE COMPANY. This list is not binding
and INSURANCE COMPANY may request other
specific documents.
Buildings
· Drawings, Schematic Diagrams, Site Plans
· Contractors estimates for the repair, reconstruction, replacement
of the damaged property on a like for like basis. These estimates need to be
itemized to show both the cost of materials and labour costs.
· If you use your own inventory of materials you will need to
provide THE INSURANCE COMPANY with
invoices / requisitions etc to support this. If your own labour is used you
will need to show this at cost plus any usual allowances.
· A reconstruction cost for the building may be required. Adjusters
/ THE INSURANCE COMPANY will usually need to check the value of the building(s)
damaged to ensure that the sum insured is adequate.
Machinery
· Fixed asset list showing all machinery at the insured premise
showing new market value (or original purchase cost if insured on indemnity
basis). (The Loss Adjusters / THE INSURANCE COMPANY will require this to ensure
the sum insured is adequate)
· Original purchase invoice for the machinery / equipment damaged
(if available)
· Technical Reports detailing the cause of the loss / damage to the
machinery
· If the machine can be repaired – a list of the parts required for
repair, along with purchase invoices / quotation etc.
· Details of labour costs of repair work.
· Details of labour costs for installation work.
· Quotation for replacement of the machine / equipment if it cannot
be repaired.
Stocks
· Stock records for the 6 months preceding the loss, showing income
and outgoing stock
· Sales invoices for stocks for the 6 months preceding the loss.
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