Advice on claims and process

Advice on claims and process

a)    Motor Private/Motor Commercial- Own damage

  1. Duly filled & signed claim form
  2. Two repair invoices from two different suppliers/garages
  3. Copy of the driver’ s permit
  4. Copy of the car log book
  5. Claim photos
  6. Statement of the driver
  7. Police accident report
  8. Accident sketch map for extensive damages
  9. IOV report- For extensive damages
  10. For windscreens and minor claims, items 1-5

In case of accidental third-party death- Requirements for the beneficiary

  • Letters of administration – if the deceased was 18 years and above
  • Affidavit- in case the deceased was less than 18 years or birth certificate
  • Copy of postmortem report
  • Copy of death certificate
  • Formal identification document- eg national ID
  • LC1 introductory letter
  • Police report
  • Demand note

In case of accidental third party bodily injuries

  • The original medical bills and medical reports
  • The police report
  • Formal identification document- eg national ID
  • Demand note

b)    Workers’ Compensation and Group Personal Accident

  • Duly filled & signed claim form
  • The original medical bills and medical reports
  • Copy of signed sick leave forms
  • Copy of pay slips for three months prior to the accident date inclusive of the month of injury
  • Copy of the appointment letter
  • Copy of the company ID
  • Labour office (LD) forms- LD 31, 35, 87,78 forms or medical report indicating the level of disability attained.
      • LD 31, 35, 78- Death cases
      • LD 31, 35, 87- When Permanent incapacity has been awarded
      • LD 31- Medical bills and temporary incapacity
      • LD 31, 35, 87,78 not required if only medical bills are being claimed 

c)    Fidelity Guarantee

  • Duly filled & signed claim form
  • Internal audit report explaining how the fraud was conducted & discovered.
  • Police investigation report
  • Copy of employee appointment & termination letters
  • Details of retirement benefits due to the employee,
  • Detailed breakdown of the amount lost with supporting documents,
  • Steps taken to avoid re-occurrence of a similar incident
  • Advise on how much has been recovered so far
  • Prosecution details of the suspect

 

d)    Professional indemnity (PI)

i)      PI , FG and Guarding All Risks for Security firms

  • Duly filled & signed claim form
  • Police report
  • Copy of the signed guarding contract
  • Copy of the internal investigation report
  • Demand note
  • Written response from client
  • Termination letters of the guards
  • Copy of appointment letters
  • Details of benefits due
  • Copy of the purchase invoice for stolen items
  • Two replacement invoices for stolen items

 

e)    Electronic Equipment –(EE), All Risks claims-(AR)

  • Duly filled & signed claim form
  • Two alternative replacement / repair quotations
  • Police report (for theft cases) or police reference
  • User’s statement
  • Technical report explaining the cause, extent of damage and necessary recommendations

 

f)      Burglary (BU)

  • Duly filled & signed claim form
  • Replacement / repair quotations
  • Police report (for theft cases) or police reference
  • Statement on how the loss occurred

g)    Money/CIT claim

  • Duly filled & signed claim form
  • Police investigation report
  • Audit report Internal Auditors /Stock taking Report Before and After Incident.
  • Documents in support of the stolen money (Invoices, receipts & cash book)
  • Statement from the person collecting or withdrawing money
  • Supervisor’s statement
  • Bank statement

 

h)    Goods in transit/Marine

  • Duly filled & signed claim form
  • Loss computation
  • Driver’s statement
  • Packing list
  • Delivery note
  • Photos
  • Police report- theft cases, accidents
  • Commercial invoice
  • Bill of lading
  • Acknowledged letter holding transporter liable-if there is a transporter
  • Copy of the transporter’s contract

 

i)      Machinery breakdown

  • Duly filled & signed claim form
  • Technical report
  • Maintenance reports
  • Detailed breakdown of the amount lost with repair or replacement quotations

 

j)      Travel

  • Dully filled & signed Claim form
  • Loss report
  • Proof of ownership of the items claimed
  • Replacement quotes
  • Demand to the airlines and response thereto
  • Flight itinerary (AIR LINE TICKET, PASSPORT COPY SHOWING VISA STAMPS)

 

k)    PUBLIC LIABILITY INSURANCE                 

  • Completed claim form with detailed statement of loss
  • Independent witness statement if any
  • Police investigation report.                       
  • Any demand letter from the third party unanswered.
  • Investigators report where necessary.
  • In case of litigation the court sermons and plaint.
  • Purchase/proforma/replacement invoices,
  • Repair quotation if repairable

 

l)      CONTRACTOR ALL RISKS/EAR/CPM

  • Completed Claim Form with detailed statement of loss/
  • Statement of user where applicable.
  • Police Investigation Report where necessary.
  • Purchase Invoices/ Proforma invoice / Receipts for lost or damaged property.
  • Repair/Replacement quotation for damaged items, at least two
  • Quantity Surveyors report/Architects/civil engineers/structural engineers report whichever is applicable.
  • Handover Reports
  • Testing and Commissioning Reports(EAR)
  • Completion Reports(EAR)
  • Technical Reports

 

j)      FIRE/IAR

v Material Damage

  • Completed Claim Form with detailed statement of loss.
  • Police/fire brigade Investigation Report.
  • For stock: Purchase Invoices/ Proforma invoice / Receipts or damaged property.
  • At least two Repair quotations of damaged Premises from different providers
  • Internal Auditors reports/Account documents /Stock taking Report Before and After Incident.
  • Investigation/ Loss Assessment Report
  • Consultant’s report e.g. Quantity Surveyor’s report
  • Forensic Report.

 

v) Business Interruption

 Same requirements as in above, plus

  • Audited Accounts
  • Business Plan/ Budget
  • List of Costs (Fixed and Variable)
  • Basis of calculation of Gross Profit/ Revenues.

 

k)    Loan protection

  • Duly filed and signed claim form
  • The loan application form
  • Loan agreement
  • Loan statement
  • Death certificate in case of death
  • The fire brigade report in case of catastrophe
  • Birth certificate in case of birth