5 Handiing and Settlement

Question 1

Key aspects of claims process TACC

Answer 1

Timely
Actively managed
Cost efficient
Correct decision

Question 2

Considerations for international claims

Answer 2

Different legal systems
Codes of practice
different timescales
training needs
language / cultural

Question 3

Insurance fraud CUSE

Answer 3

Underwriting
Claims
Staged
Exaggeration

Question 4

Case law fraud - Britton

Answer 4

No loss

Question 5

Case law fraud - Barnes

Answer 5

False evidence

Question 6

Identifying fraud - clues from loss

Answer 6

Inconsistencies
unrealistic
large £

Question 7

Identifying fraud - clues from policyholder

Answer 7

familiar with process
prior contact to check cover
vague about loss
previous claims

Question 8

Identifying fraud - clues from policy

Answer 8

increased cover
delay making claim
after loss, policy cancelled

Question 9

Identifying fraud - clues from documentation

Answer 9

docuementation looks unprofessional
Details don’t exist
Signatures different

Question 10

Fraud registers

Answer 10

Art Loss Register
Mylicence
CUE
Motor Insurers Anti Fraud and Theft Register
National Plant and Equipment Register
Insurance Fraud Register

Question 11

Which act deals with remedies for fraud?

Answer 11

Insurance Act 2015

Question 12

Which section of IA2015 deals with remedies

Answer 12

s.12

Question 13

Does the IA2015 only apply to 1st part fraud? Yes/No

Answer 13

Yes

Question 14

Remedies under IA2015 for fraud

Answer 14

Insurer not liable
Recover sums
Treat contract terminated from fraud act
Keep premium
(claims prior to fraud must be covered though)

Question 15

Criminal Justice and Courts Act - which section for PI claims

Answer 15

s.57

Question 16

s.57 allows dismissal of claim where….

Answer 16

fundamental dishesty can be shown

Question 17

If fundamentally dishonest then…

Answer 17

dismiss entire claim + costs (less amount of genuine claim)

Question 18

Subrogation brought in name of…

Answer 18

Policyholder (except riot compensation act)

Question 19

Subrogation must be brought in single claim? Yes / No

Answer 19

Yes

Question 20

Express subrogation clause does what?

Answer 20

Allows insurers to bring proceedings against 3rd party before claim is settled

Question 21

what does contractual waiver do?

Answer 21

insurer agrees not to exercise subrogation against certain other parties.

Question 22

Contribution arises when:

Answer 22

Two policies
Both cover subject matter
Both cover peril
Both cover interest
Both are liable

Question 23

Rateable proportion clause

Answer 23

responsible for proportion of loss only if other policy exists

Question 24

Two methods for calculating contribution

Answer 24

Independant liability method

Maximum liability method

Question 25

Market agreements reduce

Answer 25

disputes and admin costs

Question 26

Abandonment definition:

Answer 26

Insured gives up subject matter

Question 27

Salvage

Answer 27

insurer takes over subject matter

Question 28

Actual total loss

Answer 28

subject matter destroyed or owner deprived of it

Question 29

Constructive total loss

Answer 29

insured is deprived of ship

Question 30

Constructive total loss requires insured to serve notice of abandonment? Yes / No

Answer 30

Yes

Question 31

Constructive total loss is for marine only?

Answer 31

Yes