Claims are an integral part of insurance business. Claims are paid out of the insurance fund of the insurers. Insurance fund is a pool to which the members of the insuring public contribute by way of premium and from which the losses suffered by a few are indemnified.
While dealing with claim, the insurers have to discharge a three-fold obligation as follows:
i) They have to be fair to the few unfortunate insureds who are compelled to lodge claims;
ii) They have to be fair to the large majority of the insureds who are fortunate enough not to have sustained losses;
iii) They have to ensure that the losses are kept to a minimum, so that the nation does not suffer.
In order to fulfill the above obligations, the insurers usually incorporate conditions and warranties in the policy which stipulate the duties to be performed by the insured in the event of a loss.
DUTIES OF THE INSURED IN THE EVENT OF A LOSS:
1) The insured has to give a written notice to the insurers, immediately after happening of any claim.
2) The insured has to follow up the notice with full details of the claim within the time limit prescribed by the policy.
3) The insured has to give to the insurers all such information and assistance as the insurers may reasonably require.
4) Every correspondence with concerned has to be forwarded to the insurers immediately on receipt by the insured.
5) The insured has to lodge immediately a complaint with the policy, if applicable.
6) The insured cannot make or give any admission, offer, promise, payment or indemnity likely to affect the insurers without the written consent of the insurers.
Some Important claim papers/documents in certain classes of business:
1. Claim form duly completed in all respects and signed by the insured and endorsed by the bank
concern and co-insured, if any.
2. Copy of F.I.R./GD
3. Final Policy Investigation Report, if applicable
4. Fire Brigade Report, if applicable.
5. Quotation for repairing
6. Monthly stock report (for Warehouse)
7. Written statement of the operator counter signed by the insured
8. Meteorological report, if applicable
9. Loss Voucher duly executed
1. Original Marine Policy/Certificate
2. Original Bill of Lading/Air Way Bill/Truck Challan/Rail Receipt
3. Original Invoice
4. Original Packing List
5. Claim Bill
6. Copies of correspondence exchanged between the Insured and carrier or third parties in
connection with the recovery of claim from them
7. Original Survey report (in case of non delivery, Short Landing Certificate)
8. Original Bill of Entry (Not always)
9. Affidavit/Note of Protest
10. Letter of Subrogation, when asked for
11. Letter of Indemnity, when asked for
12. Loss voucher duly executed