Page 39 - Personal Underwriting Mandates & Guidelines - Binder product rules & addendums - Version 1

Non-motor Claims Procedures
NON-MOTOR CLAIMS PROCEDURES
1. CLAIMS PROCEDURE FOR NON-MOTOR CLAIMS
As soon as the insured advises you of a loss or an event that could result in a loss:
1.1 obtain a completed claim form from the insured.
1.1.1 The claim form has to be completed and signed and dated by the insured himself.
1.1.2 You or any marketer within your organisation may not complete or sign the claim form for or on behalf of the insured.
1.1.3 You will normally either meet the insured face to face in your offices, or communication will alternatively be by telephone or email.
1.1.4 It is important to pay special attention to the date of loss and the description of the loss. This is important because it is the client’s disclosure of how the loss occurred and details of the claim. If this information is not completed the claim form cannot be accepted.
Example: DOL 16 May 2010 at 3pm.
I left my laptop on the back seat of the vehicle when I went shopping.
NOTE: The description indicates where the client was at the time of the loss and where the item which the client is claiming for was at the time it was stolen.
1.1.5 Manage the client’s expectations and inform him what the Claims department will do in order to process the claim accordingly.
1.1.6 Provide the client with an approximate time that it may take for assessors or loss adjusters to meet and report on the claim. If you have committed to a time – abide by it diligently and keep your client informed about unexpected changes that may occur.
1.2 Register the claim on the relevant computer system as soon as you receive the claim form together with any other relevant claims documentation. For example quotes, proof of purchase and ownership. Open a claim file and use the action sheet/s to keep detailed notes on the file.
1.3 Advise and report the claims to Hollard by contacting Hollard where the claim is any one of the following:
1.3.1 value over your claims mandate
1.3.2 any liability
1.3.3 late notification
1.3.4 staff claim
1.3.5 ex gratia
1.3.6 Sasria
1.3.7 any possible rejections
1.3.8 technical (assistance required).
1.4 You may proceed with the appointment of the appropriate assessor, loss adjuster or investigator where the merits of the claim allows you to do so. If you are unsure as to how to proceed, please contact your Claims handler. Appoint a loss adjuster to assess the loss subject to the following criteria:
1.4.1 Appoint only loss adjusters that are approved by Hollard. Make use of the Hollard Procurement Pages to assist you with the appointment.
1.4.2 All assessments are instructed on a ‘without prejudice’ basis. The loss adjuster is not authorised to negotiate settlement or to formulate and to present the agreement of loss to the insured.
1.4.3 Where the value of the claim adds to the merit of appointing a loss adjuster.
Full Binder Claims Mandates and Guidelines – V3: 2019 Page | 37