Page 37 - Claims Binders Mandates and Guidelines

Non-motor Claims Procedures
1.4.4 Provide the loss adjuster with the appropriate details of the loss as well as the details of your claimant.
1.4.4.1 It is always beneficial to provide the loss adjuster with a copy of:
a. the applicable policy wording
b. policy schedule
c. proposal form.
1.5 The value of the claim should be considered with the circumstances of the incident. If subsidence and landslip or fire are suspected the value is irrelevant. Hollard Insure needs to be advised to enable the correct loss adjuster or engineer to be appointed. The value of the claim will be determined by, but not restricted to:
1.5.1 the nature of the claim.
1.5.2 if the claim forms a part of a catastrophe claim. For a catastrophe claim:
1.6 Quotes:
1.5.2.1 make a separate listing of the claim on the catastrophe register.
1.5.2.2 provide Hollard Insure with the follow-up information weekly as you progress through the claim and specifically when the claim has been finalised in order for the correct settlement amounts to be processed by Hollard Insure (please note that you must advise Hollard Insure monthly of all your catastrophe claims for reinsurance purposes).
1.6.1 Ask the claimant to obtain quotes for items claimed. This will assist with correctly estimating the loss and understanding the type and make of item for which the claimant is claiming.
1.6.2 Quotes are generally a requirement on all property loss claims and will be required to be placed on the claims file for audit purposes. There are various alternatives available to assist in quantifying a loss besides a written quote.
1.7 A loss adjuster’s report MUST contain the following minimum information:
1.7.1 A detailed description of the value at risk, to establish whether the claimant is adequately insured.
1.7.2 Details about the risk, for example address, construction of the house and roof, or any other material information about the risk.
1.7.3 Circumstances surrounding the loss. Does this correspond with the description on the claim form?
1.7.4 Description of the loss.
1.7.5 Recommendations regarding the validity of the loss in terms of the policy, i.e. was the loss as a result of an insured peril or not, or an event where the policy would respond.
1.7.6 Costing in terms of the claim. The loss adjuster has to confirm that the quote is fair, reasonable and comprehensive.
1.7.7 Photographs depicting the loss for file purposes.
1.7.8 Remedial action to be taken by the claimant should the claim be rejected.
1.7.9 Remedial action (if any) to be taken in order to prevent similar losses from occurring again in the future, i.e. installation of burglar bars. Ensure that these recommendations are sent through to underwriting for comment or re-underwriting of the risk.
1.7.10 The previous insurance check has to be done.
1.7.11 Dual insurance determined.
1.7.12 Description of any possible salvage.
1.7.13 Claims history check.
1.7.14 Hollard Insure building rates must be applied.
Claims Binder Holders Mandates and Guidelines – V6: 2022
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