Chapter 7 Flashcards
Define Pair and set clause
Establishes that loss or damage to one of a pair or set of individual items does not represent the loss of the entire pair or set
Define parts clause
Establishes that loss or damage to one part of an item does not represent the loss of the entire item
Define replacement clause
A clause found in the conditions of property and automobile policies. Instead of making payment, the insurer has the option to repair, rebuild, or replace the property damaged
Define meditation
An alternative method of dispute resolution in which representatives of each party meet in private with an impartial mediator to try and reach a settlement
Define arbitration
A method of resolving disputes between parties whereby impartial, neutral persons are chosen by the parties in dispute to determine their rights and/or obligations. The parties agree in advance to abide by the arbitration. Each party has a chance to be heard, issues are examined, and a settlement is developed. The settlement can be final and binding
What are the different evaluation that could be used?
(Type of payments being made)
Actual cash value- a fair value of the item at the time of the loss (calculated as replacement of item less deprecation for age, wear, and tear)
Replacement cost- the cost of an item of like kind of quality
Schedule item value- the insurer will not request an estimate to replace it but will pay the value stated on the policy
Competitive pricing- having two or more companies compete or bid on a project
Safety requirements- additional costs required to ensure the replacement or repair are safe and up to code
Court decisions- adjusters can look at prior court decisions to determining settlement on certain types of losses
Explain negotiation skills in practice
-Loss adjusters should prepare to negotiate by obtaining and reviewing all information in advance
-Adjusters who can visualize the end result of their negotiations will usually get where they need to go
-when one strategy is not working, they should attempt another
What are some ways a loss adjusters actions can be scrutinized in court at a later date?
Was the insured placed under duress?
Did the loss adjuster ask the insured to sign an agreement, such as a non-waiver agreement, before it was properly or throughly explained?
Did the insured have a legal disability that the loss adjuster should have considered?
Should the insured have sought independent legal advice?
What are some helpful ways to resolve conflict when the adjuster and claimant disagree?
Separate the person from the problem
Determine the options for mutual gain
Avoid being defensive or aggressive
Focus on the interests of both parties
To claim privilege over a document, the document must meet what two-part test?
Was litigation a reasonable prospect at the time the document was produced?
If so, was the dominant purpose for the documents production to conduct or aid in the conduct of litigation or to obtain a legal opinion?
