Claims Settlement Procedures
Step 1: Notice of Loss from Client
- Notice the loss to Insurer at the soonest time
- Collect & inform relevant information as much as possible, for instance:
- Time and Date of loss?
- Place of loss?
- Type of loss? What was damaged?
- How much do the Insured estimate their loss?
- Do the police participate in investigation of loss?
- Does the Third Party get involved? And how?
- Is there any injured person?
- Has the Insured’s business got back to normal operation or still stopped? And how long?
- Other information depends on circumstances of loss
Step 2: Verify the policy coverage
Verify the coverage of policy to see whether the loss is covered or not under the policy
- Is there any exclusion to be applied?
- Does the loss under deductible?
If the loss is clearly not covered, close the claim. Otherwise proceeds with other steps
Step 3: Site survey
- UIC will send surveyor attend to the site as soon as possible for loss survey
- Assessing the loss to consider that Independent Loss Adjuster/Survey need to be appointed or not. If No, jump to Step 5; if Yes, go to Step 4
Step 4: Loss Adjuster/Surveyor Appointment
- Loss Adjuster Appointment
- Supervising their inspection / investigation and loss adjustment
- Keep close contact between the Insured/ Insurer and Loss Adjuster
- Receiving and Analyzing surveyor/adjuster reports then proceeds with payment or decline.
Step 5: Proceed with Loss Survey
- Take photographs of damages (digital pictures with date of all the loss details)
- Make a site minute with the Insured to determine the nature of loss and extent of damages (this site minute signed by both parties)
- Instruct the Insured to preserve the rights to claim against Third Party (if any)
Step 6: Documents Request
Depending on the claim type/product, Insurer sends a letter/fax/email to request the Insured for necessary documents to prove their claim.
Step 7: All necessary documents are completely submitted?
- If ‘Yes’, go to Step 8
- If ‘No’, back to Step 6 to ask more
Step 8: Checking all relevant documents, determine the proximate cause of loss; Is the cause covered under the policy?
- If ‘Yes’, go to Step 9
- If ‘No’, explain to the Insured & decline
Step 9: Claim Adjustment
- Checking carefully all relevant documents to see if the claim amount is correct or not. If it is not correct, make an adjustment based on documentation.
- If there are some quotations of repairing or replacement submitted by the Insured, check with present market.
Step 10: Proceed with Settlement Process:
- Submit a report of claim settlement to Claims Manager or Board of Director for approval.
- After getting the approval, send to the Insured the Declaration of Settlement and Claim Discharge for confirmation on Final Settlement Amount in writing with signature and also Insured’s bank account details
- After getting the confirmation with signature from the Insured, transfer to Accounting Department for remit the money.