Page 16 - Personal Underwriting Mandates & Guidelines - Binder product rules & addendums - Version 1

10.4
Appointment of Loss Adjusters and Motor Assessor
A Loss Adjuster must be appointed where the claim es mate is over R50 000.00 (non-motor claims) and R250 000 (motor claims). All claim es mates over R1 million must be referred to Sasria for instruc ons prior to appoin ng a Loss Adjuster. When appoin ng a loss adjuster, the Agent or broker must provide the loss adjuster with a copy of the loss adjuster’s mandate.
Loss Adjusters’ mandate:
10.4.1 At all mes act in the best interest of the insured and Sasria.
10.4.2 To con rm and make sure that the NMI has supplied a copy of the Coupon/Policy including all Endorsements and a achments to the Coupon/Policy.
10.4.3 Obtain the underlying policy schedule and applicable wording.
10.4.4 To submit reports directly to Sasria and the NMI.
10.4.5 To verify cover as per the Coupon and the underlying policy schedule and comment on the adequacy of cover (underinsurance, no cover, sec ons etc.)
10.4.6 All the ac vi es of the Loss Adjuster are to be treated as con den al.
10.4.7 Inves gate all the circumstances surrounding the loss or damage and to obtain su cient proof, statements and other informa on to substan ate all ndings to enable Sasria to assess their obliga ons and liability.
10.4.8 To quan fy the loss or damage in accordance with the cover provided.
10.4.9 In the case of a ‘cash in lieu’ se lement the loss adjustor must agree quantum on a without prejudice basis.
10.4.10 Where reinstatement or repairs are to be carried out the following must be undertaken:
10.3.9.1
10.3.9.2 10.3.9.3
10.3.9.4 10.3.9.5
Submit all the above required documents at rst no ca on (schedule & wording, claim form and proof of premium).
Within seven days submit copy of Sasria coupon and proof of premium payment.
Where current month proof of premium is not available, proof for the previous three months must also be submi ed in seven days.
Within seven days of no ca on from the loss adjuster or assessor, submit all circumstan al reports.
All enquiries must be replied to within seven days.
10.4.10.1 10.4.10.2 10.4.10.3
10.4.10.4 10.4.10.5 10.4.10.6
10.4.10.7
A compe ve bidding process must be followed for any procurement.
The loss adjuster will be provided with the names of companies from Sasria’s database.
Local suppliers should also be invited to bid. Since they are not on Sasria’s database the following documents must accompany their bids.
a. BBBEE cer cate
b. Tax clearance cer cate
c. Latest AFS
d. Company Registra on Cer cate
e. VAT Cer cate number
f. Bank le er con rming account number
The invita on to bid must be in wri ng.
A record of site mee ngs must be kept at all mes.
Submission dates must be communicated to all bidding companies and fair melines must be allowed.
Once all the bid documents are received the loss adjuster must prepare a report advising his recommenda ons on the results.
General Procedures
The following will be required from the NMI
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Binder Claims Mandates and Guidelines – 2015/2016