Page 7 - Personal Underwriting Mandates & Guidelines - Binder product rules & addendums - Version 1

General Procedures
1.3 Fraud
1.3.1 Fraud can present itself in a number of ways:
1.3.1.1 The fraudulent creation of a claim 1.3.1.2 Overstatement of the claimed amount 1.3.1.3 Misrepresentation to get cover
1.3.1.4 Insider fraud
1.3.2 There are three stages at which fraud can enter the claims process:
1.3.2.1 The event
1.3.2.2 The quantification of the loss
1.3.2.3 The information in support of the claim
2. CLAIMS TO BE REPORTED TO HOLLARD
Claims will be administered by you according to the delegated authority and mandate agreement. As soon as the claim is above the agreed upon mandate (inclusive of VAT and prior to excess deduction, recovery or salvage money), the claim must be reported to Hollard.
2.1 Claims that exceed the claims mandate may therefore NOT be authorised by your office without Hollard’s authorisation. Authorisation will be provided by the Hollard Insure claims specialist once all the claim documentation has been received and reviewed.
2.2 Claims outside mandate
The following are claims that are considered to be outside of your claims mandate and should be referred to Hollard Insure as soon as you become aware of these types of claims. You cannot proceed with the claim until you have received authorisation to proceed by Hollard Insure.
2.2.1 All claims over the value of the agreed mandate (as stated above)
2.2.2 All fire claims, irrespective of the quantum, are to be referred to Hollard PRIOR to any loss
adjusters/assessors being appointed
2.2.3 Any claims where drunken driving is suspected must be referred to Hollard immediately
2.2.4 Any claims where fraud is suspected must be referred to Hollard immediately
2.2.5 Late notification – claims older than 45 (forty-five) days
2.2.6 Liability (except General Motor)
2.2.7 Any staff claim (including Hollard staff)
2.2.8 Ex gratia claims
2.2.9 Sasria claims: There are various specific Sasria requirements. Any Sasria claims should be reported to Hollard and on receipt Hollard will further engage with Sasria
2.2.10 Any possible rejections
2.2.11 Business Interruption claims
2.2.12 Fidelity Guarantee claims
2.2.13 Stolen vehicles
2.2.13.1
2.2.13.2 2.2.13.3 2.2.13.4
For ALL stolen vehicle claims, a stolen vehicle data entry form needs to be completed and forwarded to Hollard – hollardinsurestolenvehicle@hollard.co.za.
An investigator must be appointed on all stolen vehicle claims regardless of quantum. If the claim is below your mandate, the claim can be settled if all in order.
Should the claim exceed your mandate, the file and all investigation reports and claim documents need to be reported to Hollard for authorisation.
2.2.14 Forward original vehicle deregistration and keys for stolen vehicles to Hollard
Full Binder Claims Mandates and Guidelines – V3: 2019 Page | 5