M93 - Chapter 12 Flashcards
Which ICOBS covers claims, and who does it apply too?
8
Consumers & Commercial (Except for some very large cases)
Steps to a claim in simple terms
Damage occurs
Insured does all they can to reduce impact of the damage
Insured reports claim, giving as much accurate information as possible
Insurer investigates and if acceptable
Pays claim within limits of the policy (The promise to pay)
Speed is critical to a successful claim, in……………….
- Investigating
- Setting up a proposal to pay the claim
- Proposing a claims settlement, allowing for basis of settlement and including all interested parties
Accuracy is critical in a claim, in…………
Checking the accuracy of the claims details
Checking if the loss was covered
Ensuring cover was in force at time of the loss
Claims forms are common in property claims, but not BI claims - why?
Too information is required (all the accounting info)
Cannot be completed until end of the indemnity period
For a BI claim a loss adjustor is often appointment, what do they first establish?
- The insured is intent with re-starting their business
2. Take steps to start to speed the claims process immediately
The loss adjustor will keep a complete record of the BI claim, this would include
- Any increase cost of working charges.
- Savings caused by damage (don’t have to pay certain bills, staff my leave)
- Will the damage impact future profit increases EG Stops a project from coming to fruition that has a growth number against it.
What does the bases of settlement condition give insurers the right to do?
State and choose how they will re-instate the insured after a claim…for example
- Give them money
- Repair the damage (They may have specialists to keep costs down)
- By new or replacement goods (They may obtain trade discounts)
The insured has no say in this, from a contract perspective.
Fire prevent act - How does if effect re-instatement under statute?
In the event the insured does not wish a property re-instated, preferring to take the money.
It allows for tenants and other interested parties to make a claim to have the property re-built.
Re-instatement by the Insured - When may this become apparent?
If the Insured is under contractual obligation to re-instate (A leased property perhaps)
By Statute (Mortgage term of by Law of Trusts)
On stock claims within the specimen wording, what benefit it given to the insured relating to insured values?
They can claim up to 115%
When does average kick in for property insured on RE bases?
85% under insurance.
For fire claims, the value of the effected items if the value to it at…….
- The time of loss
2. The place of the loss
For listed buildings what is the minimal % of original materials for it to be considered re-instated?
40% according of ‘Historic England’
How are ‘patterns, moulds and designs covered’
Usually under ‘all other contents’ with no limit, unless they are particularly valuable.
