6 Handling Personal Lines Claims

Question 1

Common features of personal insurance

Answer 1

Consumers
1st party claims
Significant to policyholder
High frequency / low value

Question 2

Which rules apply to policy coverage?

Answer 2

CIDRA

Question 3

FCA requires

Answer 3

6 outcomes

Question 4

Preliminary assessment of claim may allow

Answer 4

rejection / acceptance / loss adjustor / lawyer / more info

Question 5

First step in assessing cover?

Answer 5

has premium been paid

Question 6

Expert advisor has duty to:

Answer 6

Insurer

Question 7

Expert witness has duty to:

Answer 7

court

Question 8

Experts for building claims

Answer 8

surveyors / accountants / fire investigators

Question 9

Experts for personal injury claims

Answer 9

doctors / rehab / lawyers

Question 10

Limit of liability is…

Answer 10

the maximum policy will cover

Question 11

what is pairs and sets clause

Answer 11

only replace damaged item, not full set

Question 12

FOS has ruled that if crucial insurer must replace

Answer 12

whole set

Question 13

excess

Answer 13

amount policyholder pays towards any claim

Question 14

franchise

Answer 14

no liability for any claim upto franshise amount. Any loss over franchise amount is paid in full

Question 15

What is agreed value policy?

Answer 15

Amount paid regardless of value at time of loss

Question 16

If claim rejected who can policyholder complain to?

Answer 16

FOS (after completing insurers complaint process)

Question 17

If policyholder wants to proceed to court regarding denied claim, which rules apply

Answer 17

Civil Procedure Rules