What Is an Insurance Claims Manager?

Insurance claim refers to the claim made by the insured to the insurer when the insured's goods suffer a risk loss within the scope of the insurance liability. In international trade, if the seller applies for insurance, the seller will endorse the insurance policy to the buyer or his receiving agent after delivery. When the goods arrive at the port of destination (place) and the damage is found, the buyer or his receiving agent As a legal assignee of an insurance policy, you should ask the insurer or its agent for compensation in situ.

Insurance claim

Insurance claim refers to the claim made by the insured to the insurer when the insured's goods suffer a risk loss within the scope of the insurance liability. In international trade, if the seller applies for insurance, the seller

China

Report a case

1. Report in a timely manner within the time limit specified in the clauses.

2. Reporting methods: On-site reporting, telephone (fax) reporting, salesman's report.

3 Report contents (1) Time, place and cause of insurance (2) Current status of the insured (3) Name of the insured, type of insurance, sum insured, date of insurance (4) Telephone number, contact address

Documents for case acceptance application insurance premium

1. Insurance contract;

2. Application for insurance benefit payment (the beneficiary needs to sign the application form);

3, be

File inspection

After receiving the notice of danger, the insurer shall immediately send someone to conduct an on-site inspection to understand the losses and reasons, check the insurance policy, and register the case.

Audit certificate and information

The insurer reviews the relevant certificates and information provided by the insured, insured or beneficiary to determine whether the insurance contract is valid, whether the insurance period has expired, whether the loss is the insured property, whether the claimant has the right to claim compensation, and the accident Whether it happened within the coverage, etc.

Approved insurance liability

After the insurer receives a request for compensation or payment of insurance money from the insured or beneficiary, after checking the facts and examining the various documents, the insurer should make a timely determination of whether it should bear the insurance liability and how much responsibility it should bear. The result of the verification shall be notified to the insured or beneficiary.

Performance of payment obligations

On the basis of the approved liability, the insurer

For the insured, if an accident occurs after the insurance is bought, the insurance company should make a claim. But what should be paid attention to in the claim? The related experts of Sunshine Property and Casualty Sichuan Branch explained the various causes of the principle of recency to consumers from the determination of recency and the determination of insurance liability.

(A) single cause

That is, the loss is caused by a single cause. If there is only one cause of loss caused by the accident, it is clear that the cause is the proximate cause of the loss. If the proximate cause is an insurance risk, the insurer shall be liable for loss; if the proximate cause is an excluded risk, the insurer will not pay.

Case: If someone insures against vehicle damage, because the vehicle has not been moved for 7 months, the vehicle parts will naturally decay and the vehicle will not start. Because the proximate cause of the inability to start the vehicle is natural decay, which is the exclusive liability of car damage insurance, the insurer does not bear insurance liability to the insured.

(2) Multiple reasons coexist

That is, the loss is caused by a variety of reasons, and these reasons occur almost simultaneously, and it is impossible to distinguish the order of time. If there are multiple causes for the loss and they are decisive for the loss, they are all proximate causes. Whether the insurer bears the liability for compensation should be distinguished from two cases: first, if these reasons are insurance risks, the insurer bears the liability for compensation; on the contrary, if these reasons are excluded risks, the insurer does not assume the liability for compensation. Secondly, if there are both insurance risks and exclusion risks among these reasons, whether the insurer bears the liability to pay depends on whether the loss results can be easily decomposed, that is, to distinguish the causes of losses. For the loss results that can be calculated separately, the insurer is only responsible for the loss caused by the insurance risk; for the loss results that are difficult to divide, the insurer generally does not pay.

(Three) consecutive reasons

That is, the loss is caused by several consecutive causes, and the causal relationship between the causes is not interrupted. If the loss is caused by a continuous accident with a causal relationship, whether the insurer is liable for compensation should also distinguish between two cases: first, if there is no excluded risk among these reasons, these reasons are the immediate cause of the loss, The insurer shall be liable for compensation. Second, if there are both insurance risks and exclusion risks among these reasons, it depends on whether the antecedent of the loss is insurance risk or exclusion risk. If the antecedent is an insurance risk, the antecedent is an excluded risk, and the antecedent is an inevitable consequence of the antecedent, the insurer shall be liable for the compensation; on the contrary, if the antecedent is an excluded risk, the antecedent is an insurance risk, and the antecedent is The inevitable result of the antecedent, the insurer is not liable for compensation.

(IV) Intermittent occurrences for various reasons

That is, the loss is caused by a variety of reasons for the discontinuity. If the causal relationship between the occurrence of a risk accident and the loss is interrupted by the intervention of another independent new cause, the new cause is the near cause of the loss. If the new cause is an insurance risk, the insurer shall be liable for compensation; on the contrary, if the new cause is an excluded risk, the insurer shall not be liable for compensation.