Fire Claim Adjustment and Investigation.
Burglary Claim Adjustment and Investigation
Theft Claim Adjustment and Investigation
Motor Vehicle Own-Damage (OD) Survey and Investigation
Third Party Property Damage (TPPD) Claim Investigation
Personal Accident (PA) Claim Investigation
Surveillance report
Industrial Investigation
Fraudulent Claim Investigation
Location of Defendants (Insured) and witnesses for court cases
Public Liability (PL) Claim Investigation
Goods in Transit (GIT) Claim Investigation
Fidelity Guarantee (FG) Claim Investigation
Motor Liability/Third Party Bodily Injury Investigation (TPBI)
Private Investigation
High risk Motor Vehicle Survey
Medical Claims Investigation
House Owner/House Holder Claims
Life Insurance Claim Investigation
Fire Claim Adjustment and Investigation.
Burglary Claim Adjustment and Investigation
Theft Claim Adjustment and Investigation
Motor Vehicle Own-Damage (OD) Survey and Investigation
Third Party Property Damage (TPPD) Claim Investigation
Personal Accident (PA) Claim Investigation
Surveillance report
Industrial Investigation
Fraudulent Claim Investigation
Location of Defendants (Insured) and witnesses for court cases
Public Liability (PL) Claim Investigation
Goods in Transit (GIT) Claim Investigation
Fidelity Guarantee (FG) Claim Investigation
Motor Liability/Third Party Bodily Injury Investigation (TPBI)
Private Investigation
High risk Motor Vehicle Survey
Life Insurance Claim Investigation
Medical Claims Investigation
House Owner/House Holder Claims
Claims Handling Procedure
MOTOR – OWN DAMAGE CLAIMS
CONTACTS
Reports
IMMEDIATE ADVICE
Immediate Advice will be sent to Insurers within 24 hours of assignment.
Or
Within 48 hours if the Insured cannot be reached immediately after assignment.
Immediate Advice (IA) shall contain the following information:-
• Policy number and policy period
• Name and address of Insured
• Time, day and date of loss
• Situation of loss
• Type and cause of loss (do not re-quote assignment detail)
• Trade
• Recommended Reserve (mandatory requirement)
• Date and time of assignment
• Date and time of first contact
• Coverage
• Remarks
PRELIMINARY REPORT
A Preliminary Report shall be sent to Insurers within 21 days of assignment. The report shall be addressed to the examiner, quoting Insurer’s file number.
The report shall include details under the following headings:-
• Immediate Advice information (except date of assignment and date of contact.)
• Description of premises - A brief description of the risk building together with good photographs identifying the risk premises
• Description of business - Only a brief description is required unless moral hazard is an issue.
• Discovery
• Cause
• Policy Liability
• Warranties
• Third Party Aspect
• Other Insurance
• Adequacy of sum insured
• Nature and extent of damage
• Reserve – Any changes in Reserves, such reserves shall reflect final exposure
STATUS REPORT
Status report will be issued every 30-45 days. Longer or shorter periods may be agreed upon by the claims executive handling the file. Status/Update reports shall only contain new information relating to claim status. (There shall not be any repetition of information advised earlier, except for a brief information).
FINAL REPORT
Upon receipt of all the claims supporting documentation, the adjuster shall immediately proceed to verify and adjust the loss with settlement recommendations. A final report shall be sent to the Insurers within 14 days.
DOCUMENTATION
Originals of all supporting documents shall Accompany the preliminary or subsequent reports.
EXPERT
Unless circumstances require immediate action, (i.e. emergency) prior approval shall be obtained before retention of outside experts (Forensic Engineer, Accountant, Computer Consultant, Lawyer).
PHOTOGRAPHS
Good photographs will record valuable evidence. Good judgement will be used in taking photographs.
POLICE
An occurrence number is required on all losses reported to or investigated by police. Notice of interest letter is to be addressed to police in the event of property recovery. Police reports shall always be obtained in situations involving theft, liability dispute and suspicious fire.
STATEMENTS
Written statements shall be obtained on losses where these are deemed necessary for example when coverage is in question or the quantum is in dispute.
RELEASE/DISCHARGES
Upon request by claim executive, the adjuster shall proceed to obtain a duly signed release / discharge letter for Insurers to process the settlement cheque.
CORRESPONDENCE WITH THE INSURED
In compliance with the Bank Negara guidelines on claims settlement practices
CORRESPONDENCE LETTER FOR CLAIM DOCUMENTATIONITH THE INSURED
Within 7 days upon notification of a claim, the adjuster shall furnish a letter to the Insured confirming site inspection, delivery of claim forms and proper instructions to the Insured to substantiate the claim. In the event of delay, an explanation shall appear in the preliminary report.
ADDITIONAL INFORMATION
Appropriate reply/subsequent request for additional information and further supporting documents for processing of the claim shall be made in writing within 14 days following receipts of a claim/all subsequent communication.
REMINDERS
When the requested information is not forthcoming, a minimum of two reminders shall be sent at a time of about 14 days each.
