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CORPORATE LAW
SUBMITTED TO: SIR ASIF ALI
Insurance Claims:An insurance claim is the actual application for benefits provided by an insurance company. Policy holders must first file a claim before any money can be disbursed to the hospital or repair shop or other contracted service. The insurance company may or may not approve the claim, based on its own assessment of the circumstances. Individuals who take out home, life, health, or automobile insurance policies must maintain regular payments called premiums to the insurers. Most of the time, these premiums are used to settle another person's claim or to build up the available assets of the insurance company. Occasionally, however, an accident will happen that causes real financial damage, such as an automobile wreck, a tornado, or a work-related accident. At this point, the injured policy holder has the right to file an insurance claim in order to receive money from the insurance company. In general, the insurance claim is filed with a local representative of the insurance company. This agent becomes responsible for investigating the specific details of the claim and negotiating the payment from the main insurers. Many times, a recognized authority, like a medical professional, repair shop, or building contractor, can file the necessary forms directly with the insurance company. The policy holder may not want to file if the damage is minor or another party has agreed to pay out-of-pocket for their mistake. Claims and loss handling is the materialized utility of insurance; it is the actual "product" paid for. Claims may be filed by insureds directly with the insurer or through brokers or agents. The insurer may require that the claim be filed on its own proprietary forms, or may accept claims on a standard industry form, such as those produced by ACORD. Insurance company claims departments employ a large number of claims adjusters supported by a staff of records management and data entry clerks. Incoming claims are classified based on severity and are assigned to adjusters whose settlement authority varies with their knowledge and experience. The adjuster undertakes an investigation of each claim, usually in close cooperation
with the insured, determines if coverage is available under the terms of the insurance contract, and if so, the reasonable monetary value of the claim, and authorizes payment. The policyholder may hire their own public adjuster to negotiate the settlement with the insurance company on their behalf. For policies that are complicated, where claims may be complex, the insured may take out a separate insurance policy add on, called loss recovery insurance, which covers the cost of a public adjuster in the case of a claim. Adjusting liability insurance claims is particularly difficult because there is a third party involved, the plaintiff, who is under no contractual obligation to cooperate with the insurer and may in fact regard the insurer as a deep pocket. The adjuster must obtain legal counsel for the insured, monitor litigation that may take years to complete, and appear in person or over the telephone with settlement authority at a mandatory settlement conference when requested by the judge. If a claims adjuster suspects under-insurance, the condition of average may come into play to limit the insurance company's exposure. In managing the claims handling function, insurers seek to balance the elements of customer satisfaction, administrative handling expenses, and claims overpayment leakages. As part of this balancing act, fraudulent insurance practices are a major business risk that must be managed and overcome. Disputes between insurers and insureds over the validity of claims or claims handling practices occasionally escalate into litigation.
Five types of insurance claims are following: Auto Insurance Claim Homeowners Insurance Claim Life Insurance Claim Accident Insurance Claim Home Insurance Claim
If the loss is caused by theft, notify the police Notify banks and credit card companies about any missing debit or credit cards Keep accurate records of what you spend repairing things Separate items that may be cleaned and/or repaired Check with your claim representative before you discard any items you plan to claim as damaged Review your policy for specific coverage information.
Marine Insurance:
Marine insurance covers the loss or damage of ships, cargo, terminals, and any transport or cargo by which property is transferred, acquired, or held between the points of origin and final destination. Marine insurance is split between the vessels and the cargo. The Marine Insurance Act includes, as a schedule, a standard policy, which parties were at liberty to use if they wished. Because each term in the policy had been tested through at least two centuries of judicial precedent, the policy was extremely thorough. However, it was also expressed in rather archaic terms. In 1991, the London market produced a new standard policy wording known as the MAR 91 form and using the Institute Clauses. The MAR form is simply a general statement of insurance; the Institute Clauses are used to set out the detail of the insurance cover. In practice, the policy document usually consists of the MAR form used as a cover, with the Clauses stapled to the inside. Typically each clause will be stamped, with the stamp overlapping both onto the inside cover and to other clauses; this practice is used to avoid the substitution or removal of clauses.
S.33(3): If a warranty be not complied with, then, subject to any express provision in the policy, the insurer is discharged from liability as from the date of the breach of warranty, but without prejudice to any liability incurred by him before that date. S.34 (2): where a warranty has been broken, it is no defense to the insured that the breach has been remedied, and the warranty complied with, prior to the loss. S.34 (3): a breach of warranty may be waived by the insurer. S.50: a policy may be assigned. Typically, a ship-owner might assign the benefit of a policy to the ship-mortgagor. S.60-63: deals with the issues of a constructive total loss. The insured can, by notice, claim for a constructive total loss with the insurer becoming entitled to the ship or cargo if it should later turn up. S.79: deals with subrogation i.e. the rights of the insurer to stand in the shoes of an indemnified insured and recover salvage for his own benefit.