Duties of the insured after a loss

Duties of the insured after a loss:

  1. Implied – at common law, insured should take all reasonable measure to

mitigate the loss

  1. Expressed – usually written in the policy

a. Notification – usually by telephone

b. Documentary evidence – completed claim form.

c. First Notification of Loss (FNOL)

i. Benefits to Insurer:

  1. Control over costs, claims are notified, and insurers have more opportunities to use

their approved repairers and suppliers and benefit from discounts.

  1. Fewer exaggerated claims, the insured is talking directly to the claims handler and may find it more

difficult to embellish their claim, also the quick notification gives less time for them to invent claims.

ii. Benefits to the Insured:

  1. Immediate access to the insurer’s services
  2. The claims process is simplified
  3. Claims are settled more quickly
  4. The quality of repair and replacement work is generally of a high and standards by the vetted third partied.

d. Claim Forms – These may be required at the end of the FNOL call or in some cases by the insured’s brokers

  1. To establish whether a claimant is entitled to indemnity under the policy.
  2. The insurer must then conduct their due diligence to ensure the actual or potential loss is covered under the policy.
  3. That the details on the claim form are the same as to those stated in the proposal form, was good faith observed?
  4. To provide sufficient information to the insurer to permit them to to begin processing the claim
  5. To enable the insurer to assess the severity of the claim
  6. To also assess if there is likely any third-party claimant and and (RTA) liabilities.
  7. To check to see if there can be any subrogation rights.

e. Contents of a claim form or notification form – They consist of several questions which vary according to the class of insurance, although the basic purpose is the same

f. The supporting evidence will again depend on the type of policy cover.

  1. Motor Liability Claims- engineering report, dash cam footage
  2. Theft – police report with crime reference number
  3. Personal Accident & Sickness – doctor’s report and certificate, death certificate.

h. Other experts – At times, additional details may be requested from :

  1. Solicitor – legal opinion
  2. Surveyor – estimate of rebuilding costs
  3. Doctor – to assess the severity of an injury and well as rehabilitation costs
  4. Restoration experts – may be consulted to restore property.