Page 38 - Personal Underwriting Mandates & Guidelines - Binder product rules & addendums - Version 1

Non-motor Claims Procedures
2.2.5 The acceptance of a davits as proof of ownership may not be accepted without consul ng Principals.
2.2.6 Where the loss adjuster suspects fraud of any nature, he must immediately contact Hollard concerning the ma er before dra ing any report. The report needs to be forwarded to Hollard immediately, as the insurer may wish to take legal advice.
2.3 Insurers' responsibili es
2.3.1 Clear wri en mandates and instruc ons to be given.
2.3.1 Full details of cover to be given – copy of schedule, endorsement, wording, proposal forms.
2.3.2 Be reasonable – o en the loss adjuster has to act speedily with limited informa on, for example re claim, to prevent further loss or damage.
2.3.3 A empt to es mate the Assessor's fee at me of appointment.
NB: All reports must be without prejudice.
NOTE: Whenever there is a re claim, only approved loss adjusters may be appointed. To verify which loss adjuster to appoint, please consult Hollard.
3. MINIMUM REQUIREMENTS FOR THEFT/HOUSEHOLDER'S ASSESSMENTS 3.1 Minimum requirements for the /householder's assessments are as follows:
3.1.1 We suggest that a at fee be nego ated for services rendered. More speci cally, we would suggest a checklist for a burglary assessment as follows:
3.1.1.1 ITC report
3.1.1.2 Inventory
3.1.1.3 List of items claimed, where and when purchased and if proof of ownership is provided
3.1.1.4 Detailed descrip on of loss
3.1.1.5 SAPS details and report veri ed, Insurer's interest with SAPS noted
3.1.1.6 Cos ng rela ng to claim and where possible cos ng from more than one supplier
3.1.1.7 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 claim
3.1.1.8 Veri ca on of proof of quantum and ownership
3.1.1.9 Check previous insurance, and any poten al non-disclosure referring to proposal form
3.1.1.10 Risk pro le rela ng to security requirements
3.1.1.11 Assessor to report on occupants, permanent and otherwise, as well as occupa on, and ID numbers where possible
3.1.1.12 Check proposal and verify underwri ng details
3.1.1.13 Suggested correc ve underwri ng and possible steps that can be taken to limit similar future losses.
Should a further inves ga on be necessitated by the preliminary inves ga on, then the Loss Adjuster/Assessor may nego ate 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 web-site.
4. 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 speci c excep on in the policy, rests with the Insurers. THE POLICY WORDING SHOULD ALWAYS BE CAREFULLY EXAMINED, NOTWITHSTANDING THE EXPLANATIONS GIVEN IN THIS DOCUMENT.
Page | 36 Binder Claims Mandates and Guidelines – 2015/2016