Page 46 - Claims Binders Mandates and Guidelines

Recoveries and Third Party Procedures
Recoveries and Third Party Procedures
1. RECOVERY AND THIRD PARTY CLAIMS TO BE REPORTED TO HOLLARD INSURE
All recovery and third party claims will be administered by you as per the delegated authority and mandate agreement. The mandate will be agreed, and therefore as soon as a claim falls outside of the mandate it must be referred to Hollard Insure.
1.1 Recovery and third party claim outside of the mandate may therefore NOT be attended to by the partner.
1.2 Claims outside of the binder holder mandate will include:
1.2.1 claims over the agreed mandate value (own damage and third party liability combined)
1.2.2 claims that fall within the personal or public liability section of the policy (including defective workmanship and product liability).
2. THIRD PARTY CLAIM AGAINST CLAIMANT (if the binder holder mandated to handle on behalf of Hollard Insure) NOTE: Estimate for the third party claim must be raised immediately on receipt of a third party demand.
If the claimant has notified the binder holder of a potential claim, even if no own damage exists, or damage is less than the applicable excess, the claimant must submit a completed claim form and supporting documents.
2.1 The claimant must further report the incident to the SAPS.
2.2 Even if there is no damage to the claimant vehicle, the Section II excess is still payable and the claimant must be advised of this, at the initial notification of the claim.
2.3 Once liability has been admitted by Hollard Insure or the binder holder subject to their mandate, the binder holder will be responsible for collecting the Section II excess from the claimant.
3. GENERAL RECOVERY AND THIRD PARTY PROCEDURES
3.1 The claims handler must establish what type of matter is being dealt with, i.e. whether the matter is a recovery or liability, and be familiar with the procedures to follow for that type of matter.
3.2 Preliminary assessment:
3.2.1 Ensure that all the required documents are on file. If any documents are missing, take steps to obtain them. Documents should preferably be requested by letter/email and a copy of the letter/ email kept on file.
3.2.2 Ensure that estimates are correct and updated as necessary.
3.2.3 Ensure that the matter has been registered on the claims system, and that all the required information is completed, and the system is updated as necessary.
3.3 For the purposes of conducting a merit assessment and before any third party claim is settled the following must be checked for all classes of business:
3.3.1
Documents required for uninsured third party claims:
1.1.1.1 Registration certificate
1.1.1.2 Affidavit of no insurance/no claim letter
1.1.1.3 ID/driver’s license
1.1.1.4 Duly completed claim pack (claim form/s, witness statement/s, accident report, etc.)
1.1.1.5 Quotations for the repairs to the third party's vehicle
1.1.1.6 Rates and tax billing in respect of damages to third party property.
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Claims Binder Holders Mandates and Guidelines – V6: 2022