Sabtu, 18 Nopember 2017
Indonesian (Indonesia)English (United Kingdom)
Fire Claims Procedure (Head Office)
  • OBJECTIVES

    a. Provide claims handling guidance and settlement of freight so that each process can be carried out properly, accurately and on time.

    b. Facilitate the implementation and control work procedures.

  • SCOPE:

    a. Fire claims include:

    • Partial Loss claims
    • Total Loss claims
    • Business Interruption claims (BI)

    b. Guidelines and procedures applicable to fire insurance claims filed by through the head office.

  • DEFINITIONS:

    a. Management: Management consists of the Directors of PT. Asuransi Reliance Indonesia.

    b. Preliminary Loss Advice: Reports temporary losses, addressed to the Reinsurance

    c. Definite Loss Advice: Reports Losses End / Definitely, addressed to the Reinsurance

    d. Cash Payment Loss: The provisions in the agreement (Treaty), that if the loss exceeds a certain value, the company can request payment from the Reinsurance prior losses.

  • POLICY

    Claims Approval Authority

    Authority to sign and approve the fire claims is set as given:

    a.Up to Rp. 200.000.000,- (two hundred million rupiahs) for simple cases and Non-Ex-Gratia Claims required verification from the Supervisor for approval from the Assistant Manager and Technical GM.

    b. Claims ranging from Rp. 200.000.000,- up to Rp. 1.000.000.000,- required verification from the Assistant Manager for the approval of Technical GM.

    c. Beyond the items a & b above, verification is required from the Assistant Manager and the Technical GM for further approval from Management, provided at least two signatures of Management.

  • REPORTING

    5.1 The Insured, after knowing or at the time he considered should have been aware of any loss or damage to property and / or interest insured in this policy, shall:

    a. Immediately notify the Insurer.

    b. Within 7 (seven) calendar days after paragraph 5.1. above, provide a written statement containing the circumstances he knows about loss or damage. Written statement should elaborate on all that burned, destroyed, lost, damaged and saved as well as to the cause of loss or damage that occurs 5.2 No later than 12 (twelve) months since the loss and or damages, submitted claims for compensation to the underwriters regarding the amount of losses suffered.

  • CLAIM SURVEY

    a. No later - than within 2 (two) working days after the report as oral / papers from the Insured must be done immediately survey the location of loss, unless there is a problem of premium payment or policy validation that experienced losses.
    Survey implementation "on the spot" is the best way to obtain accurate data. In practice, despite being said to be "on the spot" is in fact still exist between the branches that are late in implementing the claims survey, so the claim settlement process encountered many obstacles, both because the lacking data / information or even no data at all.

    b. Cursory of the picture survey task may be an easy task, but in reality is not always the case, the results of the survey is a starting point for analysis of the extent of the commencement of the insured losses is the responsibility of the Insurer in a loss (Liability Policy).

    c. To handle the survey claims, will be made blank survey report as a guide to center / branch in fulfilling their surveys according to the conditions and situations (both general and special factors).

    d. Which must be completed at the time of the survey are:

    • Photos of buildings or other property losses
    • Scene photo
    • Estimated losses
    • Complete survey report, including recommendations from the appointment of surveyor adjuster (if necessary)
  • LIST OF DOCUMENTS

    List of documents to be completed by the Insured (damage Partial / Total)

    The completion of transportation list of claim documents is in order to:

    a. Request of claims document to the Insured can be done at once and not repeated - which will re-impress unprofessional or buying time.

    b. If the document has been received fully it is expected to immediately to process solution by the branch, as in it's appropriate limit authorization (Special Branch Medan).
    With these data, the branch is required to study and calculate the compensation to be paid according to the provisions and the calculation is accountable to the central office and head office will not have difficulties to account for co-member or to the reinsurance.

  • ANALYSIS OF CLAIMS

    In the process a claim, first of all must realize that in general the Insured shall make a claim that is higher than the actual loss.
    Principally the insured is only entitled to receive the maximum compensation amounting to the sum insured in the policy.

    Objectives:

    General:

    a. Ensuring the cause of losses to determine the security policy.

    b. The estimated actual price of the item being suffered losses just before the loss to determine the possibility of closing below the price (Under Insured).

    c. Investigated whether these objects are also insured in other insurance (double Insured).

    d. Investigated the possibility of the presence or absence from the remaining loss value / fire (salvage).

    Building:

    Normally the replacement for the price of buildings are the cost of repairs or reconstruction to its original state immediately before the loss.
    The necessary measures:

    a. Determine the maximum damage and the most appropriate way to recovery whether the renovation or rebuilding, in order to compare the insured contractor estimated proposal.

    b.Taking special account of the possibility of development or the addition from the previous initial conditions that do not fit with what is agreed in the policy. It's like building a larger expansion from the the original or better building materials.

    c. Taking into account the possibility of maintenance work that had nothing to do with damage to buildings and should be excluded from the calculation of damages. Contractors often provide additional ideas outside the actual buildings damage or the Insured own ideas.

    d. Any changes / rebuilding of the damaged buildings to be better or new, the Insured must be included in compensation contributions.

    Engines:

    Normally to calculate the machine compensation are:

    a. The cost of repairs to its original state immediately before the loss / incident

    b. The cost of replacing the machines used to it's similar age, capacity & its original state to implement such things are not easy and had to be calculated with the price of new machines should take into account depreciation. This reduction should be done because the original engine was not made anymore and the replacement should be with a better engine or replacement with the same machine but must be with the new for old and depreciation must be taken into account.

    Stock:

    Base price for the stock compensation is based on invoice price paid by the insured and not the selling price that includes profit (profit). Discounts received by the insured to purchase stock from the manufacturer should be reduced in compensation. For the stock of old (obsolete) or out of style, in the calculation of compensation should be applied to "slow moving or obsolescent".

    a. Retailler Stock
    Compensation is usually based on the wholesale price paid by the insured, not the Selling Price, Selling Price is included for Profit. Likewise, the insured obtained the discount should be reduced because the insured get similar discounts when goods stock was replaced with new stock.
    Reduction should also be made for stock, especially for an old-fashioned stock. In some cases whole price at the time of replacement is greater than that paid by the insured because of the inflation factor.

    b. Manufacture Stock
    In the case of goods that have been made but not yet sold in the event of loss / fire, compensation is based on production costs including raw material costs, overhead and administration but excluding profit factor. If the total cost exceeds the Market Value, then the market value is the actual compensation. If the goods are still in the process, burned, then the basic payment of the loss is the price of raw materials which is already in use plus the cost of production until the event of fire. In the case of the burned items are goods which have been sold but not yet delivered, then the responsibility (liability) Insurer will be based on the Contract Price (Contract Price Clause).

    c. Farm Produce
    For growing crops it's essential price is at the nearest market reduced the cost-cutting and logging and transport. For Corn in Stock (Grass & Straw) is essentially the market price at the farm.

    d. Lives Stock
    Basic pay is the market price on the spot and at the time of the loss. Claims arising usually is a risk of lightning, and backed by a veterinarian certificate of injury or death data and the value of livestock related.

  • CLAIM PAYMENTS

    Insurers required to complete compensation payments within 30 (thirty) calendar days from the existence of a written agreement between the Insurer and the Insured or certainty about the amount of compensation to be paid.

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