General Claim Guide
a. NOTIFICATION:
Notification immediately of a claim is very important otherwise a claim may be prejudiced. There are provisions in all policies on time limits of claims. In order to comply with the provisions of the policies, we strongly advise that claims be notified immediately after a loss occurs even if full details are not yet available. Please refer to your policy document for precise contractual notification requirements which may differ from one policy to another
b. COMPLETED CLAIM FORM:
This is the first document to be submitted. In case of difficulty in completing a claim form, it is better to advise us immediately rather than delay the return of the form as this may prejudice or delay settlement of claim. The claim form must be duly signed by the insured or an authorised official of the insured with the stamp of the insured endorsed.
c. SUPPORTING DOCUMENTS:
Supporting documents are as listed under the various classes and must be procured and submitted. If there are problems in procuring any document, kindly let us know. In some cases insurers may request for additional documents depending on the circumstances surrounding the loss.
d. DISCHARGE VOUCHERS:
In all cases, the discharge voucher must be signed by the insured or an authorized official of the insured and stamped with the stamp of the Company.
e. WARRANTIES:
It is of utmost importance that warranties on the policies are adhered to as non-compliance with warranties if proved will inevitably lead to declinature of a claim.
The following are common examples of warranties found in various classes of insurance. Please note that the below list is not exhaustive. A thorough understanding of the warranties applicable is necessary and if you require further clarifications please contact us.
FIRE
a. No Smoking Warranty
b. Sprinkler Installation to be in good working order
c. Documentary Evidence Warranty
BURGLARY
a. Protection Warranty
b. Day and Night Watchman Warranty
c. Documentary Evidence Warranty
d. Air-conditioner Warranty
GOODS-IN-TRANSIT
a. Escort Warranty
b. Documentary Evidence Warranty
CASH-IN-SAFE
a. Safe Warranty
b. Documentary Evidence Warranty
c. Key Warranty
CASH-IN-TRANSIT
a. Escort Warranty
b. Documentary Evidence Warranty
MOTOR
a. Fixing of an Immobilizer
b. Documentary Evidence Warranty
f. EXCESS:
Kindly note that most classes of insurance, particularly motor, have excesses imposed on the policies. An excess is that first part of a claim amount for which the insurer is not responsible (i.e. is for the insured’s account).For claims below the policy excess it is not necessary to make a claim. It is however highly recommended that all incidents involving other parties be notified to us as it is not possible to pre- determine the amount of claim to be made by third parties.
g. DEDUCTIBLE:
A deductible is larger excess and is usually chosen by the insured (in consideration for a premium discount) rather than imposed by insurer. The amount adopted as deductible is at the discretion of the insured. Both deductible and excess work in exactly the same way as far as their effect on claims is concerned.
h. DECLARATION:
Some policies are written on the basis of estimated figures. Such policies are said to be subject to declaration i.e a deposit premium is paid at inception or renewal and at expiry of the insurance period actual figures (or declarations) have to be made for necessary premium adjustment.
It is in the interest of the insured to declare accurately and promptly as failure to forward declarations in accordance with the policy conditions will affect the ability to maintain the adequacy of sums insured and may result in under-insurance thereby adversely affecting the quantum of a claim or in extreme cases declinature. Whatever the case, non-submission of outstanding declarations results in delay in the final processing of Claims.
The following are examples of policies where Declarations are required:
| Class | Declaration Required |
|---|---|
| Burglary | Actual value of stock held |
| Cash-In-Transit | Actual total Cash carried |
| Business Interruption | Actual Gross Profit earned and wages paid |
| Fidelity Guarantee | Total number of employees engaged per category. |
| Fire | Actual value of stock held |
| Goods-In-Transit | Actual total value of goods Carried |
| Marine Open Cover | Declaration of imports and exports |
| Public Liability | Actual wage roll (where premium paid has been based on estimated wage roll) in the period under review. |
| Product Liability | Actual turnover achieved (if applicable) in the period under review. |
| Workmen Compensation | Actual Gross Earnings paid per category of employees in the year under review. |
| Group Personal Accident | Actual total basic salaries (or earnings depending on the basis under the policy) paid per category of employees |
| Industrial All Risks | Total value of assets at risk during each quarter. |
| Combined GPA/WC | Actual Gross Earnings paid to insured’s employees per category of employees for each period of insurance |
Where the declaration condition is applicable to a wider definition of property insured (total assets) then the declaration required is the total value of the property actually at risk on the respective declaration dates.
It is normally warranted that declarations are submitted within 30 days of their respective due dates. With the exception of Fire and Burglary declarations, which are due either quarterly or monthly depending on the specific arrangement, all others are due annually.