Chapter 3 Flashcards
Role of a claims handler summarised?
Estimate accurately final cost of outstanding claims
Real and fraudulent claims
Quickly and fairly deal with all claims
Settle claims with minimum leakage
3 main reasons customer service is important now
Increased consumer awareness
Great expectations of service
Competition
What is a third party?
Third party is anyone else involved in a loss event
What is a reserve?
An amount allocated to a claim as the expected value of future liabilities in respect of that claim
What four forms can insurance fraud take?
A loss event is invited that never took place
An insured exaggerates the amount of a claim
Exaggerated the effects of a claim
Insured event is deliberately created
What is the purpose of the motor insurance anti fraud and theft register?
Enables insurers to check whether a total loss or theft claim is being claimed for more than once
2 main ways of seeking to resolve disputes by alternative dispute resolution?
Meditation and conciliation
Insurer become involved in a conflict of interest when handling a claim?
One likely circ relates to motor or liability claims involving several parties, some or all of which are insured by the same insurer
Whatever job you are currently doing there will no doubt be targets and goals. What targets are set in job?
90% of incoming calls are to be answered within three rings
Why is it important that a fraudulent claimant should have their entire claim rejected, even though only part of it is fraudulent?
If only part was rejected the claimant would have lost nothing. Would not be discouraged from trying it again.
What is meant by Non disclosure Material fact Misrepresentation Warranty
Non disclosure is when the insured withheld info that would have a bearing on the insurers decision to offer insurance and at what rate
A material fact is any circ that would influence the judgment of a prudent insurer in fixing the premium or determining whether they will take the risk
Mis-representation happens when an insured, either deliberately or accidentally gives the insurer incorrect info
Warranty is a promise made by the insured that a certain fact is as they say or that they will or will not do something it is almost always included in the policy
