5.10 Recoveries
Recoveries is a means of controlling the cost of claims by an insurer in recovering some of its expenses. When a claim is reported, consideration is given to the following: Salvage: Is there any salvage available and is it economical to recover? Policyholder: Is there any excess payable by the policyholder? Dual insurance: Is there […]
5.9 Contribution (Dual Insurance)
The definition of contribution is that where two or more policies are in force each pays its rateble proportion of any loss. In the event of the same risk being insured by two different insurers, contribution will apply in the event of a claim in respect of that particular risk. The formula for adjusting the […]
5.8 Betterment
The amount payable is the cost of replacing property of the same kind or type, or repairing it in as good as new, but not better than new, condition. If the performance or value of the replaced item is greater than the original, the insured bears the cost of the difference in price (betterment) of […]
5.7 How Average is Applied
Average will apply where the insured is underinsured, whether deliberately or accidentally. If the damage results in a total loss, the sum insured will be paid out, which amount will be insufficient for the client to replace the lost or damaged item. If the insurance is on replacement value conditions, the basis for average is […]
5.6 Appeal of Rejected Claims
All insurers have a system of reviewing all claims, to ensure that all procedures have been correctly followed. In the event of a claim being rejected, the insured has the right to appeal. The first appeal would be directed to the insurer concerned, and in the event of the claim still being rejected, the insured […]
5.5 Fraudulent Claims
Any fraudulent claim is forfeited. This includes insureds who, for example, intentionally set fire to their own property, or arrange to have it set fire to or stolen.
5.4 Rights After an Event
The insured cannot abandon property to the insurer, but the insurer can take possession of damaged property. They must deal with the property in a reasonable manner; otherwise they can be liable for any further damage that results from their actions. The insurer can take over the rights of the insured immediately and recover against […]
5.3 Burden of Proof
The insured must prove the loss. The insured must further prove insurable interest in the loss or damage incurred. If the insurer wishes to claim that an exception operates then it is up to the insurer to supply the proof thereof.
5.2 General Claims Procedure
It is imperative to note that each insurer has their own particular claims procedure with their relevant requirements. This may differ further between the different classes of business insured by the same insurer. It is therefore very important that once a potential claim has been communicated to the relevant insurer, that the claims process for […]
5.1 Introduction FSTI
In the event of the insured suffering a loss or damage because of an insured peril, and if that loss is covered by the terms of the policy, the insured may submit a claim to his insurer. This claim is an application by the insured for the repair of damage or indemnity for the loss […]