Making the claim lists Chapter 8

Question 1

8 people who can claim under an insurance policy

Answer 1

Assignees

Agents

Trusts

Additional insureds

Other persons under Road Traffic Act

Claimants under Third Parties (Rights Against Insurers) Act 2010

Purchaser of property after Exchange under Law of Property Act 1925

Persons with legal interest in building under Fire Prevention (Metropolis) Act 1774

Question 2

Two things insured must prove to discharge burden of proof in claim

Answer 2

1. that the loss was caused by the operation of an insured peril; and
2. the amount of his loss.

Question 3

Four aspects of ICOBS 8 claims handling rules

Answer 3

Insurers must:

1. handle claims promptly and fairly;
2. provide reasonable guidance to help a policyholder make a claim and appropriate information on its progress;
3. not unreasonably reject a claim (including by termination or avoiding a policy); and
4. settle claims promptly once settlement has been agreed.

Question 4

Four types of fraud in claims

Answer 4

Falsification of a loss

Deliberate loss

Exaggeration of a loss

Lying about the circumstances of a genuine loss to improve the chances of claim being paid

Question 5

Three offences of fraud under The Fraud Act 2006

Answer 5

1. dishonestly makes a false representation;
2. dishonestly fails to disclose to another person information which he or she is under a duty to disclose; or
3. dishonestly abuses their position.