Claims department Flashcards
What does the consumer insurance contracts act apply to?
Contracts of indemnity and non-indeminity for less than €3
Define a claim
A formal demand to an insurance company for reimbursement for a loss or damage to an insured object in accordance with the terms of the policy
What does the way in which a claim is handled depend on?
- Class of business (Personal or commercial)
- Type of cover
- Amount of claim - decide hoe much investigation is necessary
What is included in the technical department
Claims, underwriting and reinsurance
Who does a broker work for?
Insured
What is a broker
An agent of the insured that is an accredited expert in insurance. They must deal with at least 5 insurers and they are liable for any mistakes they make in terms of whats covered and whats not.
If a broker says something is covered is it?
Only if its in the policy
Who does an agent work for?
Inured
What is the difference between an agent and a broker?
An agent can deal with less than 5 insurers
Who does a tied agent work for?
The insurer
Who is liable for any mistakes a tied agent makes?
The insurer
Who hires a loss adjuster
Insurer
Who does the loss adjust or work for and what do they do?
They work for the insured and they see if a valid claim exists.
What does a loss adjuster do?
- Investigate the claim
- Objectively evaluate
- Investigate quantum
- Report to the insurer whether to settle or defend and recommend a reserve amount
Who hires a loss assessor
The insured