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CLAIMS SETTLEMENT PROCEDURE

Prosedur Claims

1.Kewajiban Insured
In the event of a loss that can lead to a claim on the policy, there are some obligations (duties) to do insured. Obligation there is not written in the policy or the so-called “implied duties”, and there are also obligations explicitly stated or written in the policy or the so-called “express duties”

a.Implied duties
According to the law, in the event of a loss, the insured must act as if he did not object to insure losses that and he is obliged to take appropriate steps to minimize such losses. So, if the police or fire brigade units were involved in the loss, the insured must not hinder the activities of the parties with respect to the incident. Such obligations, though not written in the policy, to be carried out.

b.Express duties
-Every Events which might give rise to a claim on the policy must be immediately notified to the insurer and that a full description of losses that must be submitted to the insurer in a given period specified in the policy, for example, 14 days or 30 days after the insured knew of the incident.
-Pemberitahuan As soon as may be required in order an investigation into the incident can be done immediately. Otherwise, some of the evidence about the incident may not be obtained or the memory of the witnesses may not be full again.
-In Many cases, the insured person needs help staff claims the insurer or loss adjusters to assist in preventing further losses and to expedite the commencement of repair.
-After Notified, the insurer usually sends a claim form to the insured to be filled. This form is to obtain information about the insured, the loss, the nature of the loss, the loss of time, the details of which suffered a loss of property following its values, and insurance or other policies that cover the same interests. The answers given are matched with the proposal form.
-Kewajiban-Other obligations of the insured, who is usually defined in the policy in case of any events that could give rise to a claim on the policy are:
-Tertanggung May not act fraudulently to accidentally get a profit from their losses; and
-Tertanggung, If requested, must allow the insurer to exercise their right of subrogation and insured should not do things that could harm the rights of subrogation.

c.Proof of loss
In the event of a loss, the insured is obliged to prove:
-that he (the insured) has suffered a loss due to an incident or event that is guaranteed in the policy
-the value or the amount of damages it
But if the person believes that the loss was caused by a hazard is excluded by the policy, the mandatory penanggunglah proves it.

2.Hak Insured
Right of the insured is that after it fulfills all its obligations, he is entitled to get a compensation settlement under the terms of the policy. The compensation settlement should not be detained by the person simply on the grounds still waiting for recovery of the results of the use of subrogation rights or the rights of contribution.

3.Kewajiban Insurers
After the insured to fulfill its obligations in respect of such losses, the insurer is obligated to fulfill the rights of the insured as above.

4.Hak Insurers
After receiving notice of an event of loss, the insurer is entitled to get together with the insured person to secure the principal insured who suffered the loss. This right is usually done by the person using the services of loss adjusters.

In certain policies, the insurer was granted the right to enter the scene and securing the property without recognizing the responsibility (liability) on the claim in question. With such privileges, the insurer will be able to conduct an investigation into the incident / loss as quickly as possible.

B.Investigasi Claims
• In fire insurance claim, the insurer usually appoints the company’s loss adjusters to investigate the claims and provide recommendations on payment of the claim.
• In the insurance claims liability (liability insurance claims) the case is brought to court, the insurer usually appoints a lawyer or solicitor to represent him in court.
• In the claims are relatively small, such as motor vehicle claims, the insurer simply use tehnisinya itself to examine damage to the vehicle in question and negotiate about improvements to the workshop.

asuransi pendidikan prudential

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