Chapter 9 - Claims notification, investigation and settlement Flashcards
When a potential claim arises, who does the ‘onus of proof’ initially fall on?
The insured
What must the insured prove when they make a claim?
The an insured peril arose
The amount of the loss
Once the insured has proved an insured peril arose and the amount of the loss - what happens next?
The responsibility shifts to the insurers.
If the insurer wants to decline a claim due to a policy exclusion, who does the onus of proof lie with?
The insurer
In proving their loss there are certain legal duties which the insured must comply with. These can be divided into what two catagories?
Implied and express duties
What is an implied duty writen?
no
What is an implied duty?
One which is imposed in common law
Which duty is: acting as though uninsured and taking all reasonable steps to minimise the loss, not hindering the insurer in the claims investigation process, taking all steps to prevent a loss from spreading and advising the appropriate authorities in the event of loss or damage.?
Implied
What is an express duty?
One that is stated in the insured’s policy documents
Where are express duties normally found?
In the general policy conditions under the claims conditions section
Notification to insurers is an express duty, what does it mean?
It usually means the insured needs to notify the insurer as soon as possible of a loss.
How soon does the insured need to notify the insurer of a riot, civil commotion or malicious damage claim?
7 days
Why does the insured need to notify the insurer of a riot, civil commotion or malicious damage claim within 7 days?
The insurer can claim back the losses from the policy but only have 42 days from the riot to do so
How many days does the insurer have to claim back costs following a riot from the policy?
42 days
When must the insurer have proived full loss details to the police following a riot to claim back costs?
90 days
What is the maximum an insurer can claim back from the police following a riot?
£1M
How must an insured claim?
The inital claim can be on the phone but the particulars must be followed up in writing
How long does the insured have to send the particulars of a claim in writing to the insurer?
30 days typically
Is taking all reasonable steps to minimise the loss an implied or express duty?
Implied
Is not hindering the insurer in the claims investigation process an implied or express duty?
Implied
Is taking all steps to prevent a loss from spreading an implied or express duty?
Implied
Is advising the appropriate authorities in the event of loss or damage an implied or express claim?
Implied
Is notification to insurers an implied or express claim?
Express
In notification to other authorities an implied or express claim?
Express