1. Since under Fire Insurance variety of buildings, machineries, equipments and stocks are involved, in addition to a competent surveyor it is recommended that the Company officials should visit site of losses reported as far as possible.
1.1 If the estimate of Loss is within RS. 20,000/- and loss of profits claim is not involved, the office shall have the discretion to waive an independent survey and settle the claim on the basis of the claim form and other supporting documents and after being satisfied that it is admissible under the policy and that the amount claimed is reasonable and consistent with the extent of damage. Where necessary, an authorised official in the DO may inspect the damage, if necessary.
2. PROCESSING OF CLAIMS :
2.1 The documents generally required for processing fire claims are :
(i) Copy of the policy complete with term, conditions and warranties.
(ii) Claim form duly completed by the insured.
(iii) Survey report should include –
a) Indication of the cause of loss
b) Establishment of liability
c) Assessment of loss
d) Confirmation of compliance of policy terms, conditions & warranties
e) Admissibility of the claim
(v) Police report and } if necessary
(vi) Fire Brigade report }
Note : Items (v) and (vi) may be waived if the survey report is clear and does not cause any doubt on the occurrence as well as the extent of loss.
2.2 Claims Arising out of Act of God perils:
In addition to the documents specified under 2.1 above, other documents like newspaper cuttings, photographs and meteorological reports are helpful in substantiating such losses. Where the incident is localised, not reported in the media or not recorded by any Meteorological Department, the surveyor should enquire about the incident from local government/statutory authorities and support the description of the occurrence and the loss by taking photographs of the damage. Where the Surveyor confirms the incident clearly and unambiguously, the documents detailed above may be waived.
2.3 While processing the claims, attention is to be paid to concurrent policy (ies) and Financial Institute clauses.
2.4 Losses reported under the RSMTD peril:
In case of isolated losses under the above endorsement, copy of the First information Report lodged with police and their Final Investigation report should be furnished.
The Surveyor should give a detailed report on the occurrence and confirm that the loss/ damage is admissible under the policy. Loss/ damage, if any, arising out of omission or commission not involving physical damage should be segregated.
3. DISPOSAL OF SALVAGE:
3.1 Salvage from Fire and allied perils losses tend to deteriorate faster Therefore, disposal of the salvage should be undertaken on priority basis for and on behalf of the concerned parties without waiting for the liability to be established. However, the provision of the disposal of salvage guidelines should be followed.
3.2 It would be in the interest of the organisation if officials visit site of loss and hasten disposal of salvage. It will also give moral support to clients at the time of need.
4. DISPOSAL OF CLAIMS WHERE ALL RECORDS REQUIRED FOR THE ASSESSMENT OF CLAIMS ARE DESTROYED IN FIRE AND/OR ALLIED PERIL RISKS LIKE FLOOD ETC.:
4.1 Settlement in these circumstances would generally be a negotiated one because of non-availability of accounting records and other evidences. Therefore, the Surveyor should be advised to assess such losses on a realistic and reasonable basis after discussions with the Insured. Bank/ Financial Institutions (if involved), and if required with suppliers/customers/ statutory bodies like tax authorities, excise authorities etc. and the concerned Insurance company.
Where the loss estimate is more than Rs. 50 lacs intimation is to be sent to LPA requesting for inspection. Where the loss estimate is more than Rs. 1 Crore intimation is to be sent to TAC also.
6. LOSS OF PROFITS / CONSEQUENTIAL LOSS / BUSINESS INTERRUPTION LOSSES:
6.1 Claims under these policies have to be monitored regularly by the office to ensure that the insured is doing the needful to minimise the period of indemnity as much as possible.
6.2 In case the surveyor for MD Loss is different from the consequential loss, co-ordination between the two has to be ensured. Control is to be maintained by the Insurer.
7. INDUSTRIAL ALL RISK POLICY:
Claims under these policies will be dealt with as per the relevant section under which the claim has arisen.