Claims Procedure: PUBLIC and/or PERSONAL LIABILITY CLAIMS
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If during the Period of Cover, the Insured becomes aware of any fact or circumstance that may give rise to a Claim, the Insured shall give notice in writing to THE INSURANCE COMPANY of such fact or circumstance, then any Claim which may subsequently arise out of such fact or circumstance shall be deemed to be a Claim made during the Period of Cover. PROVIDED ALWAYS THAT such written notice is given to THE INSURANCE COMPANY during the Period of Cover.
2. Reporting and Notice
a. The Insured shall give to THE INSURANCE COMPANY written notice as soon as practicable of any Claim made against the Insured PROVIDED ALWAYS THAT such written notice is given to THE INSURANCE COMPANY during the Period of Cover.
b. Notice of any Claim shall be given in writing to THE INSURANCE COMPANY,
3. Defence and Settlement
a. The Insured agrees not to settle any Claim, incur any Costs and Expenses, make any admission, offer or payment or otherwise assume any contractual obligation with respect to any Claim without THE INSURANCE COMPANY’s written consent, such consent not to be unreasonably withheld. THE INSURANCE COMPANY shall not be liable for any settlement, Costs and Expenses, admission, offer or payment, or assumed obligation to which it has not consented.
b. THE INSURANCE COMPANY shall be entitled at any time to conduct, in the name of the Insured, the defence or settlement of any Claim.
c. THE INSURANCE COMPANY may, if it believes that any Claim will not exceed the Deductible, instruct the Insured to conduct the defence of the Claim. In such situation, THE INSURANCE COMPANY will reimburse the Insured for all reasonable Costs and Expenses in the defence of the Claim in the event that any payment made to dispose of the Claim exceeds the Deductible.
4. Legal Counsel
a. THE INSURANCE COMPANY shall not require the Insured to contest any Claim unless a legal counsel (to be mutually agreed upon by the Insured and THE INSURANCE COMPANY) shall advise that such Claim should be contested.
b. In formulating such advice, legal counsel shall take into consideration the economics of the matter, the damages and costs which are likely to be recovered by the claimant, the likely Costs and Expenses and the prospects of the Insured successfully defending the Claim.
c. The costs of such legal counsel’s opinion shall be regarded as part of the Costs and Expenses.
5. Claims Mitigation and Co-operation
a. The Insured shall exercise reasonable care and skill and do and concur in doing all things reasonably practicable to avoid or diminish any liability hereunder.
b. The Insured shall frankly and honestly disclose to THE INSURANCE COMPANY all relevant information and, in addition shall provide assistance to THE INSURANCE COMPANY, as it may require to enable it to effectively investigate and to defend or resolve any Claim under the Policy and/or to enable THE INSURANCE COMPANY to determine its liability under the Policy.
c. Other than Costs and Expenses incurred to enable THE INSURANCE COMPANY to determine its liability under the Policy, compliance with this Condition shall be at the Insured’s own cost, unless otherwise agreed in writing by THE INSURANCE COMPANY.
6. Information / Documentation Required
Detailed below are some examples of documentation that is commonly requested by THE INSURANCE COMPANY. This list is not exhaustive and THE INSURANCE COMPANY may request specific items of documentation.
· Claim Form completed with details of loss or damage
· Letter of demand from the third party and all correspondences
· Official accident report (issued by the management)
· Reports of interview or Statements of witnesses
· Drawings to show the location and circumstances of accident
· Lease or other Contractual agreements
· Form, voucher or ticket
· Police report
· Statement of treating doctor (diagnosis)
· Invoices to substantiate the loss
· Picture of damage
If you have any question regarding the above, or for claims consultation please contact:
by IMAM MUSJAB at www.ahliasuransi.com
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