FIRE CLAIMS

GENERAL GUIDELINESLicensed Surveyor for all claims of Rs.20,000/- and above. Servicing DO may appoint on behalf of Pol. Issuing OfficeSurveyors Categorization - A, B, C as per IRDACat A highest financial limit followed by Cat B and then CCat A eligible for Cat B jobs but not Cat CCat B eligible for Cat C jobs

Surveyors Financial Limits

Dept.

Category A

Category B

Category C

FLOP

> Rs. 50 Lacs

Upto Rs.50 lacs

Nil

Fire

> Rs.50 lacs

Upto Rs.20 lacs

Upto Rs.5 lacs

Policy verificationPolicy NumberReceipt particularsName of insuredRisk LocationPeriod of insuranceProperty coveredPremium rates chargedWarranties and Clauses attached

Survey Report verificationVerification & confirmation of policy detailsDate of lossDetails of occupationType of buildingProcess details and layout drawingCause of lossAdmission of liabilityAdequacy of sum insuredSalvage realized

Compliance with warrantiesDetails of other insuranceSubrogation detailsLab reports / salvage destruction reportEvidences to occurrence of lossBasis adopted for assessment of lossScale of depreciation adoptedSupply warranty detailsVerification of insureds recordsApplication of excessConfirmation on VAT, CENVAT, REVERSAL OF DUTY (CVD)

General Guidelines Contd.Investigator Appt. depending upon circumstances. Fees to be negotiated in advanceAll documents - from insured in one go and not piecemealPending final assessment, On A/c payment if confirmation of loss due to insd peril/estb of liability/min. liability under policy.Where reqd., subrogation letter &./or assignment to be obtained from the Insd. On requisite stamp paper

General Guidelines Contd.Co-insurance claim - Leader to process. Co-insurers to settle their share within stipulated period follg. Rt. Of demand from lead insurer otherwise interest to be chargedCo-insurers not to process the claim againLeader to intimate claim details with copies of relevant reports/documentsDecision by HCC of leader - binding on other co-insurers who may place note for information of their HCC.

General Guidelines Contd.Close Proximity Cases - Loss within 5 days of risk inception (for new Insc. Or break-in Insc.). Investigation to be instituted.Policy rectification after loss for reasons other than breach of condition/Warranty 1. Rectification by Competent Authority for claim settlement. 2. Additional premium if required, to be charged on affected policy period of claim.

General Guidelines Contd.Non-std. Claims to be known as compromised claimsCompromised claims due to breach of Policy conditions or warranties/non-compliance of tariff provisions/incorrect premium due to mis-representation., mis-declaration, non-disclosure by insured/jeopardized rights of recovery from TP Where breach or lapse of any kind not material to the loss - settlement after policy rectification. Further Deduction if required as per Cos. Internal instructions.

General Guidelines Contd.Where breach etc is material to loss settlement up to max of 75% of assessed claims.Jeopardized recovery rights - appropriate Amt representing possible recovery to be deducted from assessed claim.Ex-gratia - HO only Repudiation of claim by authority competent to settle the claimRe-opening claim- One step higher authority

Financial Authority - Fire & EnggAO - Rs.50,000/-, AM - Rs. 1.25 LACSDY.M. - 10 Lacs, MGR - Rs.15 lacsDCC - 30 lacs, CM - 40 lacsRCC - 80 Lacs, DGM - 1 CroreGM - Rs.2 Cr., CMD - Rs.4 Cr.HCC - Actuals

Single Event LossesCatastrophic Losses/Single Event Losses involving more than one claim - Total amt. Of all claims considered for Financial AuthoritySpl. Dispensation to be obtained

Other points of interestLetter for settlement of claimDetails of claim amount settledEngaging many surveyors and investigatorsTime limit for reinstatementSalvage expensesGoods held in trust

Steps by insd - Clms. And U/WIf fire, inform to Fire Brigade, Police Dept. register FIR, obtain copies of all reports from above and Govt. agencies.Inform Insurance Co. Take photos duly signed and stampedLoss minimization Submit all information witness details & required DocumentsKeep salvage in as-is-where-is basis till further instructions.Salvage disposal as per Co. norms

Steps by Insd - Clms. And U/W Contd All Insurance Policies (any Insurance. Co.) Covering affected property to be furnishedDifficulties - Contact U/W OfficeSamples - Jointly signed by Insured and surveyorAccurate details of Location., SI, Risk Discrpn. In spec.pol. To avoid dispute in assessment.Declaration. Pol.- Basis as per tariff, Monitor SIFloater Pols. - Adequacy of SI

Steps by insd - Clms. And U/W Contd.Key areas to be noted by Insd.1. Clarity regarding properties/risk covered2. Whether SI on MV or RIV basis, proper documentation to be submitted3. Surveyors report only recommendatory and insurers decision final.4. Improvements outside policy scope5. Declns. Under Decln. Pol.to be proved6. Change in Occpn./altrn/addn.- Inform immdly.7. Submit Cl. Form + Requd reports (Fire FIR etc.)

Reference Date for Loss Assessment in IAR Policy

Preamble Reads - the insurer will pay to the Insured the value of the property at the time of the happening of its accidental physical loss or destruction or damage or at its option reinstate or replace such property or any part thereof.

Reference Date for Loss Assessment in IAR Policy ContdIt further states:Provided that the liability of the Insurer in respect of any one loss or in the aggregate in any one period of insurance shall in no case exceed

As regards buildings, plant & machinery, FFF etc. the cost of replacement or reinstatement on the date of replacement or reinstatement subject to the max. liability being restricted to the SI i.r.o. that cat of the item under the policy.

Condition on underinsurance states:If the property hereby insured shall at the time of reinstatement/replacement repair following a loss or damage indemnifiable under the policy be of greater value than the sum insured under the policy, then the insured shall be considered as being his own insurer for the difference and shall bear a ratable proportion of loss.

Excluded causes regarding Design & Collapse in IAR PolicyThis policy does not cover loss to the property insured caused by:Faulty or defective design materials or workmanship inherent vice latent defect gradual deterioration deformation or distortion of wear and tearinterruption of the water supply gas electricity or fuel systems or failure of the effluent disposal systems to and from the premises unless damage by a cause not excluded in the policy ensues and then the insurer shall be liable only for such ensuing damage

Excluded causes regarding Design & Collapse in IAR Policy Contd.Collapse or cracking of buildingscorrosion rust extremes or changes in temperature dampness dryness wet or dry rot fungus shrinkage evaporation loss of weight pollution contamination change in colour flavour texture or finish action of light vermin insects marring or scratching Unless such loss caused directly by damage to the property insured or to premises containing such property by a cause not excluded in the policy