Chap 7 Handling Prop And Bi Claims

Question 0

Loss adjustor - prop claim could investigate

Answer 0

Weather reports or expert meterological evidence
Newspaper reports
Witness statements
Police fire brigrade reports

Question 1

Basic questions to review coverage

Answer 1

Which policy trigger applies - claims made or losses occurring
Is the date and time of loss within the pol period
Is the party making the claim a named insured
Is geographical loc if risk in scope of pol
( prop pol, schedule of locations and values
What r the insured perils, was the loss caused by an insured peril
Do any endorsements, warranties or conds apply
Has prem been paid
Facts of claim consistent with uw file pre policy info
Si adequate
Does average apply

Question 2

Reservation of rights (icobs 8) it may be concluded later that the claim cannot be covered..

Answer 2

This is a (reservation of rights)
Insurer must tell the insured they have received the claim but that further info is required to make a decision
Leading case kosmar villas

Question 3

First loss basis (often applies to buildings and premises

Answer 3

Insurer and insured mutually agree that the si does not represent the full value of the insured property
Seperate excesses may also apply eg for storm, subsidence, mal damage
Excess by day eg first 7 - 14 days not covered

Insured may impose an upper limit on amount of deductible they wish to pay, if they have lots of losses , this is known as the aggregate limit

Worker or working excess - insured will take care of themeelves to improve risk mgmt

Question 4

Average - insured will pay the uninsured part of the risk which will be csalculated proportionally, calc is

Answer 4

Sum insured at time of loss
/
Value of risk at time of loss. X amount of loss = insurers liab

Question 5

Loss adjustor on valuing the property loss

Answer 5

Check damaged stock
Ensure no stock is out of date
Review purchase receipts, review salvage info and whether there is any salvage value

Question 6

Measure of indemnity, for property, buildings, machinary equipment. Manufacturers stock, wholesale and retail stock, farming stock, precuniary ins
Liability
Marine

Answer 6

Prop - value at date and place
Buildings - and machinary costs of wear and tear and any deduction for betterment
Manufacturers stock - costs at time and place of loss
Farming stock - the local market price
Precuniary- standard value stated in wording
Liab - settlement plus costs and expenses
Marine insurable value

Question 7

Other useful forms of adr
Early neutral evaluation
Expert determination

Answer 7

Early neutral evaluation
Neutral 3rd party to evaulate both sides - non binding
Expert determination - mutually agreed expert decides - binding decision, offerd valuations, disputes over quantum, where a decision will be very technically based