Page 11 - Claims Binders Mandates and Guidelines

General Procedures
6.9 Check recent policy amendments.
6.10 Check policy endorsements and the claimant’s proposal form that may state specific terms and conditions.
6.11 Check previous claims history, and/or previous insurance.
6.12 Salvage: where applicable we require a full report from the repairer.
6.13 Do reinsurance and/or co-insurance contributions apply?
6.14 Are there any recovery prospects to consider on this matter?
Remember to always communicate corrective underwriting suggestions made by the loss adjuster and to adjust the policy with the applicable no claims bonus (NCB) and/or endorsements after a claim where the need for this becomes apparent. For example: delete cover, upgrade cover, upgrade security, change address, change underwriting details on file. (Refer to the relevant underwriter.)
6.15 The second page of a property loss claim form often requires the claimant to state and list specifically what he is claiming for. Please ensure the claimant has completed this.
7. CLAIM PAYMENTS
7.1 All payments must be set out clearly and must contain a full breakdown of payments and deductions.
7.2 The accounts department in your office is responsible for requisitioning the payments payable to VAT (Value-Added Tax)/non-VAT vendors.
7.2.1 If the invoice has VAT included in the amount, calculate the VAT implication, and show the two amounts separately. VAT = 15/115 of the total amount, for example on an amount of R228:
7.3 On receipt of a request for payment the following procedures should be followed:
7.3.1 On all invoices:
7.3.1.1 check that the amount on the invoice is as authorised
7.3.1.2 check that supporting documentation is attached
7.3.1.3 check that the release/discharge form is attached; check that the release/discharge form has been signed by the claimant or the nominated representative
7.3.1.4 ensure that a valid tax invoice was received if the supplier is registered for VAT
7.3.1.5 if the above requirements are not met, advise the panel beater/supplier/assessor, giving details of the problem being experienced
7.3.1.6 for motor repair invoices, all additionals must be checked and queried, the loss adjuster or assessor also needs to sign this off
7.3.1.7 ensure the correct VAT numbers (if applicable) are on the invoices.
7.3.2 For repairs:
7.3.1 check to see that the documents are correct according to the letter of authorisation for that particular claim
7.3.2 check to see that the negotiated discount has been applied by the creditor according to the list of pre-arranged discounts
7.3.3 ensure that the invoice complies with the guidelines as in 7.2.1 above.
7.3.3 Write-off/Theft/Hijack
Upon receipt of the signed agreement of loss/discharge form/approved calculation, the binder holder is to ensure that the de-registration certificate as well as all other documents that might have been requested, are on file.
VAT = 228 X 15/115 Therefore VAT = R30
Claims Binder Holders Mandates and Guidelines – V6: 2022 Page | 9