Page 44 - Personal Underwriting Mandates & Guidelines - Binder product rules & addendums - Version 1

Non-motor Claims Procedures
5.1.1.3 List of items claimed, where and when purchased and if proof of ownership is provided
5.1.1.4 Detailed description of loss
5.1.1.5 SAPS details and report verified; insurer's interest with SAPS noted
5.1.1.6 Costing relating to claim and where possible costing from more than one supplier
5.1.1.7 Photographs, especially to show visible, forced and violent entry or exit if applicable. Photographs are also needed to illustrate point of entry and exit from premises and any other detail to illustrate the claim
5.1.1.8 Verification of proof of quantum and ownership
5.1.1.9 Check previous insurance, and any potential non-disclosure referring to proposal form
5.1.1.10 Risk profile relating to security requirements
5.1.1.11 Assessor to report on occupants, permanent and otherwise, as well as occupation, and identity numbers where possible
5.1.1.12 Check proposal and verify underwriting details
5.1.1.13 Suggested corrective underwriting and possible steps that can be taken to limit similar future losses
5.1.1.14 Detailed description of any salvage.
Should a further investigation be necessitated by the preliminary investigation, then the loss adjuster/assessor may negotiate a further fee. These could be considered as minimum requirements for an assessment. We suggest using the Hollard Procurement pages for preferred suppliers and we encourage feedback about these assessors and loss adjusters on the Procurement Pages website.
6. INSURED PERILS EXPLANATION PER INSURED EVENT
When the insured seeks to claim from his insurers he must show that the loss was caused as the result of a peril covered by the policy. On the other hand, the onus of showing that the loss is not covered by reason of a specific exception in the policy, rests with the insurers. THE POLICY WORDING SHOULD ALWAYS BE CAREFULLY EXAMINED, NOTWITHSTANDING THE EXPLANATIONS GIVEN IN THIS DOCUMENT.
6.1 Proximate cause
Proximate cause means the active, efficient cause that sets in motion a train of events which brings about a result, without the intervention of any force started and working actively from a new and independent source.
6.2 Fire
Active principle operative is combustion, in which substances join chemically with oxygen in air and usually give out bright light and heat, flame, incandescence.
There is no fire within the meaning of a fire policy unless there is an ignition either of the property insured or of the premises where it is situated. Damage caused by heat or fermentation, unaccompanied by ignition is not covered. The loss to the insured property must be proximately caused by the ignition. Loss due to lightning is not covered by a fire policy but if the lightning results in fire, damage caused so is covered. The fact that the insured’s negligence caused the fire will not exempt the insurer from liability. Similarly the insured may recover where the fire is caused by the wilful act of a third party without his knowledge or consent. But the insured will not be able to recover where the loss is caused by his own wilful act or that of someone acting with his knowledge or consent. The onus will be on the insurer to prove the insured committed arson. Damage by water used to extinguish the fire or to prevent it from spreading will be covered. So will damage caused by explosion caused by fire. Loss by theft during the fire will be covered. So will expenses incurred in the reasonable removal of property in order to save it from the fire.
6.3 Lightning/thunderbolt
Visible electric discharge between clouds or cloud and ground causing damage to the insured property. The electric flash is usually followed by thunder.
Damage as a result of power surge from the power supplier is not insured. (It presents itself in a similar manner as lightning.)
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Full Binder Claims Mandates and Guidelines – V3: 2019