Learn more about claims procedures.
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Experiencing a loss or damage can be stressful. At Agostini Insurance Brokers Limited, we aim to alleviate that stress with a straightforward and transparent claims process. Our goal is to ensure that you receive the support and compensation you deserve in a timely and efficient manner. Below, we outline the key steps in our insurance claims procedure, ensuring you know exactly what to expect at every stage.
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Claims Handling
Claims Procedures
Learn more about claims procedures for various risks:
- Take all reasonable steps to secure and protect remaining property as well as to minimize loss or damage to machinery/ property and disruption to the business.
- Immediately identify and obtain details of all employees and/or witnesses who were on the spot at the time of the occurrence.
- Leave as much of the evidence as possible available for inspection by the Loss Adjuster providing that this does not cause further damage or danger.
- With regard to physical damage losses, unless an emergency, do not undertake repairs to property until first discussed with the Adjuster.
- In the event of urgent remedial steps being required, keep accurate records and sketches / photographs or video recording to prevent later disagreements as to the extent of the remedial measures that were necessary.
- It is essential to furnish accurate details of the incident as far as possible and submit such details without delay, in order to give the Loss Adjuster an opportunity to investigate the circumstances of the accident whilst the facts are still fresh in the minds of all concerned.
- Nominate a person(s) to lead the restoration task and assign specific roles and responsibilities to required personnel.
- If damaged is caused by a suspected defect, check similar equipment.
- Consult with Architects, Engineers and Quantity Surveyors to determine the extent of damage and obtain the relevant estimates.
- Obtain quotation for removal of debris, if applicable.
- Obtain information from local or foreign suppliers on both the availability and replacement cost of Stock, Plant, Machinery, and Equipment.
- Where possible, obtain agreement from the loss adjuster on all actions to be taken and the process for settlement request. Do not commit to a significant purchase or expenditure without the prior approval of the loss adjuster or insurer
- Consider measures to expedite the repair and or replacement process and any other possibilities to mitigate the loss and its impact
- Report the matter to the nearest Police Station. Ensure you note the details of the Police Officer taking your report, and note also the time and date of your report.
- Secure the premises if required, in order to reduce further losses.
- Obtain and complete the necessary claim form from our Offices.
- Take an inventory in order to establish exactly what has been stolen and the extent of any damage to the premises.
- Prepare and present to us a detailed statement of claim, together with copies of invoices and estimates to substantiate amounts being claimed. The list of missing items can be submitted on a separate sheet of paper, if necessary.
- Substantiate the total value at risk on
- each item of insured property.
- Identify the areas of financial loss
- Discuss with us the possibility of:
- The use of alternative premises
- Alternative source(s) of supply
- Salvage sale
- Any additional expense, which you feel if incurred will minimize the loss of your Gross Profit
- Staff requirements in prevailing circumstances
- Savings in standing charges, e.g. telephone, water, electricity, Internet.
- Adjustments for trends and special circumstances affecting the business
- Turnover achieved for the benefit of the business, other than on the premises
- Set up separate books of accounts for recording extra expenses incurred to minimize loss
- Establish with the Insurer/Adjuster the probable period of interruption
- Record all trends or circumstances affecting the business during the interruption period
- In attempting to continue trading, do not incur expenses over and above what the business will possibly have lost in Gross Profit
- The turnover achieved in the interruption period
- The turnover achieved in the similar period in the last financial year
- Standing charges, as defined in the policy, taken from the last completed financial year
- Total turnover for the last financial year
- Wages
- Notify the Police immediately
- Prepare notice in writing to us stating the circumstances of the loss
- Take immediate steps to ascertain the full extent of claims and obtain all particulars and documents of evidence to substantiate your claim to insurers
TIP: There are several things you can do in order to greatly reduce the likelihood of suffering a cash loss.
- Staggering timings and dates of bank visits so that they are unpredictable to the observer.
- Try as much as possible to reduce the amount of cash carried by an unprotected person – if large quantities of cash must be moved, consider having an armored guard service instead of an employee.
- Small, regular deposits are preferable to large weekly ones.
- Having a system whereby cash is put in a locked safe (with a deposit slot) at specified intervals would reduce the amounts lost in a hold-up or burglary, provided that the key to the safe was kept off-site, of course.
- Complete the related claim form affixing company stamp
- Provide copy of invoice for the damaged / lost item(s).
- Obtain a pro forma invoice for the same or similar make and model of the computer equipment that is damage or stolen
- All incidents of larceny must be reported to the Police and the receipt provided. Please note the “Locked Vehicle Clause” (see policy for details) which is applicable to laptops.
- Technician reports are required for physical loss or damage to computer equipment
- Retain any damage computer equipment for further inspection by Insurer / Reinsurer/ Loss adjuster
- Immediately notify AIB as soon as you become aware of an incident or an allegation of a wrongful act.
- Immediately submit to AIB any letter or notice of claim from a third party or through their solicitors any writ, summons, proceedings, pending prosecution or inquest. Unless approved by Insurers (due to court imposed deadline), documents should be forwarded unanswered.
- Insurers will appoint legal counsel to take the appropriate action and to liaise with the Insured to gather evidence and defend the matter.
- Ensure that deadlines identified in legal correspondence is adhered to.
TIP: It is important that liability is not admitted. Do not make any offer, compromise, promise, payment or settlement without written consent of the Insurer.
- Immediately upon discovery of the loss, or reasonable cause for suspecting a loss, prepare notice in writing, of particulars of the acts or defiance of the employee which must be submitted by Insurers.
- Notify the Police
- Take immediate steps to ascertain the full extent of claims and obtain all particulars and documents of evidence for insurers, to substantiate claims
- Obtain all information which will lead to the whereabouts, if unknown, of the employee
- All monies due to the employee/suspect to be deducted from the amount being claimed.
- Take reasonable steps to secure and protect the remaining property
- Implement contingency business plan and advise us on how you wish to proceed
- Consult with Architects, Engineers and Quantity Surveyors to determine the extent of damage and obtain the relevant estimates
- Obtain quotation for removal of debris
- Obtain information from local or foreign suppliers on both the availability and replacement cost of Stock, Plant, Machinery and Equipment
- Prepare and itemized list of all real and personal property damaged as a result of the loss. Keep separate worksheets and files on all loss details.
- Present a detailed Statement of Claim with supporting documentation.
- Keep us informed of any developments as they arise
- When meeting with Insurers/Adjusters, establish agreement as to the nature and extent of salvage. Sell or dump as agreed.
- Notify the Police immediately
- Prepare notice in writing to us stating the circumstances of the matter
- Take immediate steps to ascertain the full extent of claims and obtain all particulars and documents of evidence to substantiate your claim to insurers
TIP: The following factors will influence both the frequency and severity of Goods in Transit loss:
- Adequate packaging materials
- Care in loading and unloading
- Using the proper equipment for the job
- Special care with fragile items
- Caution in carrying high valued goods and in moving goods through areas of high crime
- Use of security guards on trucks for those items to high value
- Secure unattended vehicles
- Completed Claim Form (duly stamped and signed by the attending Physician/Dentist)
- Original receipts for incurred expenses, indicating prescription number, Patient’s name, date of purchase, name and quantity of drugs
- Claim Forms should include the following information:
- Policy number
- Employee’s Certificate number
- Company stamp
- Plan Administrator’s signature
- Claims should be submitted no later than ninety (90) days from the date expenses were first incurred.
- Completed Claim Form
- Certified Death Certificate
- Certified Birth Certificate
- Life Insurance Certificate
TIP: Documentary proof of attendance must be supplied with respect to a child or children under the age of 19 years and attending an Accredited College of University
Homeowners Comprehensive
- Take reasonable steps to secure and protect the remaining property
- Consult with Contractors, Architects, Engineers and/or Quantity Surveyors to determine the extent of damage and obtain the relevant estimates
- Obtain quotation for removal of debris
- Submit claim form with itemized list of all real and personal property damaged as a result of the loss and quotations for repair or replacement (as applicable).
- Obtain a Technician’s Report for any damaged electronic items that you have insured. These items must be kept for inspection by the adjuster.
- Keep us informed of any developments as they arise.
- When meeting with Insurers/Adjusters, establish agreement as to the nature and extent of salvage. Sell or dump as agreed.
- Contact person and telephone number
- Date and time of loss
- Cause of loss
- Loss estimate
- Obtain/secure full and detailed statements from eye witnesses on the circumstances of the accident.
- In the event damage caused by another vessel, obtain the following:
- Date and time of loss
- Cause of loss
- Property location
- Property involved
- Loss estimate
- Contact person and telephone number
- Obtain/secure full information on the offending vessel i.e. name and port of registration, owners and addresses.
- Obtain/secure full and detailed statements from eye witnesses on the circumstances of the accident.
- Obtain/secure statements of full liability in negligence by the captain of the vessel and undertaking by him and/or the local agents on behalf of the vessel to settle full cost of repairs.
- In the event that the captain or local agents fail/refuse to give admission of liability and undertake payment for cost of repairs where such repairs appear not to be significant, advise Harbour Master and Immigration Office so that efforts can be made to prevent the vessel from sailing until favourable arrangements are made for settling cost of repairs.
- Where the damage appears to be substantial, advise Legal Department or external legal counsel immediately so that legal action can be taken to obtain the arrest and detention of the vessel.
- Bill of Lading
- Shipper’s Invoice
- Certificate of Insurance
- Rejected Steamship claim
- Landing Certificate or Surveyor’s Report
- The Landing Certificate will be either non-delivery of white slips issued by Port Contractors
TIP:
- No rejection of a valid claim upon the Ship-owners (through their local agents) should be accepted.
- All claims on ship-owners must be properly stated
- Claims on ship-owners, Port Authorities and insurers must be presented in writing within three (3) days of delivery.
- Report the accident to the nearest Police Station, presenting them with your driver’s permit, certificate of insurance, and a written statement of the circumstances of the accident. (Make a note of the Police Officer’s name and number who is taking your statement, as this information will be required on the claim form.)
- Complete the Claim Form, answering all of the questions and attaching a copy of the driver’s statement, together with those of any witnesses
- Obtain an estimate for repairs to your vehicle, and submit same to us.
TIP: Some important points:
- Do not authorize repairs to the vehicle until it has been seen by the insurer and/or adjuster!
- Prompt claims reporting are absolutely necessary.
- Never admit liability to third parties
- Vehicle should be maintained in a road worthy condition, with particular attention being paid to brakes, tyres and lights
- Allow a reasonable time for the insurer/ adjuster to view you vehicle
- Immediately identify and obtain details (proper name and contact information)/ statements of any witness who were on the spot at the time of occurrence, this report would form part of your claim submission
- Complete the related claim form affixing company stamp, along with Copy of ID, Medical and Fitness Certificates. Documents should not be accumulated, and ought to be forwarded as received to AIB
- If claim results in any Permanent Partial Disability, a medical report from the treating physician including full details will have to be submitted.
- In the event of accidental death, the following documents are to be submitted:
- Death certificate
- Birth certificate
- Copy of identification
- Copies of identification of beneficiaries
- Birth certificates of beneficiaries, if there are any name changes of the beneficiaries – affidavit or necessary legal documents to support same
- Coroner’s report
- Police report
- Completions of the relevant claim forms
- Date and time of accident or knowledge of damage arising from same
- Location and description of accident
- Details of the Injured person/damaged property
- Witnesses (if applicable)
- Complete the necessary Claim Form
- Complete the Accident Report Form
- Substantiate wages paid to the employee during his/her period of illness, by way of payment vouchers or signed statement by the employee, indicating clearly the monies representing Compensation for injury leave
- Submit a sick leave certificate for the entire period of absence if this in excess of three (3) days
- Provide final fitness certificate pronouncing the employee fit to resume normal duties, and advising whether employee has suffered any permanent partial disability
- Submit total wages to the employee including overtime and COLA as applicable for the twelve (12) months preceding, or the longest continuous period not exceeding fifty-two (52) weeks prior to the injury
- The standard recoverable medical expense limit is $500.00
- The sick leave wages formula is calculated as follows:
- 2/3 Average Monthly Earnings * X No. of days sick leave
- 30 days* based on wages for 52 weeks prior to the accident
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At Agostini Insurance Brokers Limited, we are committed to delivering exceptional insurance coverage and personalized service that meet the evolving needs of our clients. Our mission is to empower individuals, families, and businesses by providing them with tailored insurance solutions that offer peace of mind and financial protection.
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