Page 12 - Personal Underwriting Mandates & Guidelines - Binder product rules & addendums - Version 1

7.2.3 Write-off/Theft/Hijack
7.2.3.1 Upon receipt of the signed agreement of loss/discharge form/approved calculation, the broker is to ensure that the de-registration certificate as well as all other documents that might have been requested, are on file.
NOTE: The payment requisition should not be approved by the authorised signatory unless all the requested documents are on file, i.e. all required claim documentation, signed agreements of loss, vehicle de-registration papers and the like.
7.2.4 Ex gratia payments
7.2.4.1 On receipt of the signed ex gratia agreement of loss, ensure that all conditions which may have been stipulated on the ex gratia agreement of loss have been complied with.
NOTE: Ex gratia payments are non-VAT rateable, zero rated. 7.2.5 Service providers
7.2.5.1 On receipt of the invoice, ensure that the amount is as per the approved fee structure negotiated discount. This can be checked and verified on Hollard’s Procurement Pages.
7.2.5.2 Ensure that the invoice complies with the guidelines as in 7.2.1 above.
8. CLAIM REJECTION
8.1 On receipt of information where the claim should be considered for rejection, the file has to be referred to Hollard without delay for consideration.
8.1.1 If the rejection is not justified, Hollard will liaise and provide reasons and comments for the decision.
8.1.2 If further information is required to assist with the decision to be made, Hollard will request the required documentation and a decision will then be made regarding the validity of the claim.
8.1.3 If the rejection is justified, Hollard will draw up a rejection letter based on the standard rejection letter template.
NOTE: It is of utmost importance that the grounds of rejection are supported by the necessary documents/evidence (for example, where client has made a verbal statement this must be supported by a written statement to the same effect).
8.2 The original signed letter of rejection will be sent by Hollard to you, the broker, and it is your responsibility to ensure that the letter is forwarded to your client. The rejection letter will contain the reason for the rejection and comprehensive details of the escalation process should the client wish to challenge the rejection.
8.3 The original signed letter of rejection is distributed by Hollard in terms of Policyholder Protection Rules requirements and a copy of the letter will be sent to the insured's representative. It is then the insured's broker/representative's responsibility to ensure that the client is advised of the rejection of the claim and the reason for the rejection. You as the insured's broker/representative must discuss the escalation process with the insured as to how to complain, should the insured be dissatisfied with the outcome/rejection of the claim. The Hollard Insure complaint process and contact details are contained in the policy disclosure notice. In the rejection letter, the Hollard complaints contact details, the internal adjudicator details, as well as the details for the Ombudsman for Short-term Insurance should be noted. The insured should be encouraged to first engage with Hollard.
8.4 Broker needs to keep evidence on record.
8.5 The broker notifies other interested parties (i.e. contractor and panel beater).
8.5.1 8.5.2
If the vehicle is salvage/burnt-out or stolen, the relevant registers are to be updated.
If the vehicle is with a repairer or salvage contractor, the insured and/or the finance house must be advised to collect the vehicle. The towing and storage costs will be for the account of the insured, and the contractor must be advised of this urgently in writing by email.
General Procedures
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Full Binder Claims Mandates and Guidelines – V3: 2019