There are two types of claims,
- Property material damage claims
- Third party claims
Property (Material Damage) claims
Property or material damage claims are more fairly straightforward than liability claims because they involve the insured and the insurer only. An important aspect which loss adjusters consider is the policy liability. In event the proximate cause of the loss must be ascertained – an area that is not easy to investigate.
Consequently, adjusters sometimes make guess on causes such as indicating in fire claims that the cause is” probably electrical “however, investigators guess are very well informed by the prevailing circumstances.
Third Party Claims
These are liability claims which involve third party property damage and personal injury claims. Investigators are involved in scrutinizing liability claims.
Liability claims are settled by paying the lawyers of third parties or to third parties themselves.
Third party personal injury claims are, on average more complex and expensive to settle and account for a substantial proportion of insurers total claims outlay.
When a third party is injured in a traffic accident, the insured must be informed as soon as possible. The insurer will appoint an investigator to scrutinize the circumstances surrounding the injury, and whether the injury is fatal or non- fatal. The insurers report will guide the insurers as whether there is a policy liability.
Documents required in settlement of third party claims
- Investigators report
- Initial treatment records
- Medical reports issued by qualified doctors
- Police abstract
- PA form
Although the claim may go to courts, most of the are settled out of court where the lawyers of insurers and insured agree on suitable out of court settlements.
