24 Nov
24Nov


Here is a summary of a relatively long article about claims settlement, a fascinating and important topic. The author begins by emphasizing the importance of the claims department in insurance companies, as it reflects the company's true standing with third parties. He states that the effectiveness of insurance coverage is measured by how the insurance company handles claims and its willingness to fulfill its obligations to policyholders. It's as if the author encapsulates much of the insurance narrative in these sentences. He then discusses the variety of procedures in claims settlement, attributing this to differences in insurance coverage and the size of the claim. The first and most important procedure, he says, is for the insured to notify the insurance company of the claim immediately upon the loss occurring or becoming aware of it. The author chooses the term "loss" over "damage," though this is likely a semantic difference that doesn't affect the underlying meaning. The author explains that payment from the insurance company is usually in cash to the insured, and the amount depends on the nature of the coverage, the amount of insurance, and its adequacy. It seems he is hinting that compensation may be in kind, which often happens depending on the type of damage, the subject matter of the insurance, and the type of policy. The author mentions that determining the payable compensation amount in life insurance policies is a simple process compared to other types of insurance, as it can be said that the amount payable upon claim is predetermined in the policy at the time of contract signing. The author then looks at other types of insurance, stating that their policies guarantee an amount representing the maximum liability of the insurance company. He mentions that the final cost of any claim depends on "the size of the loss and the nature of the cover." He also mentions that an insurance policy may be based on the "principle of compensation," which stipulates restoring the insured, after the loss occurs, to the same financial position they were in before the loss, and the compensation does not exceed the actual loss. In the event of loss to the insured's property, the insurance company deducts the depreciation value of the damaged property and the value of any wreckage. Or it may be based on "reparation of damage," where the insured receives the cost of reparation without deducting for depreciation. This cover is called "new cover in place of old cover." Regarding civil liability claims, he says that determining the value of compensation is relatively easier. He states that liability insurance policies provide coverage for the insured against their legal liability. The third party and the determination of the compensation ceiling paid by the insurance company is determined by the court or arbitration in agreement with the third party. In the end, the insurance company will not pay more than the insurance amount unless the document indicates that the liability is not specified. In conclusion, this article on claims settlement could be the subject of a book, but the writer, with his experience as the general accidents manager at Trust International Insurance Company, was able to summarize the settlement issue and explain it as it should be.

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