FIRE CLAIMS

GENERAL GUIDELINES
Licensed Surveyor for all claims of
Rs.20,000/- and above. Servicing DO may
appoint on behalf of Pol. Issuing Office
Surveyors Categorization - A, B, C as per
IRDA
Cat A highest financial limit followed by Cat
B and then C
Cat A eligible for Cat B jobs but not Cat C
Cat B eligible for Cat C jobs

Surveyors Financial Limits

Dept.

Category A

FLOP > Rs. 50

Lacs
Fire

Category B Category C
Upto Rs.50 Nil
lacs

> Rs.50 lacs Upto Rs.20 Upto Rs.5

lacs
lacs

Policy verification

Policy Number
Receipt particulars
Name of insured
Risk Location
Period of insurance
Property covered
Premium rates charged
Warranties and Clauses attached

Survey Report verification

Verification & confirmation of policy details

Date of loss
Details of occupation
Type of building
Process details and layout drawing
Cause of loss
Admission of liability
Adequacy of sum insured
Salvage realized

Compliance with warranties

Details of other insurance
Subrogation details
Lab reports / salvage destruction report
Evidences to occurrence of loss
Basis adopted for assessment of loss
Scale of depreciation adopted
Supply warranty details
Verification of insureds records
Application of excess
Confirmation on VAT, CENVAT, REVERSAL OF
DUTY (CVD)

General Guidelines Contd.

Investigator Appt. depending upon circumstances.
Fees to be negotiated in advance
All documents - from insured in one go and not
piecemeal
Pending final assessment, On A/c payment if
confirmation of loss due to insd peril/estb of
liability/min. liability under policy.
Where reqd., subrogation letter &./or assignment
to be obtained from the Insd. On requisite stamp
paper

General Guidelines Contd.

Co-insurance claim - Leader to process. Coinsurers to settle their share within stipulated
period follg. Rt. Of demand from lead insurer
otherwise interest to be charged
Co-insurers not to process the claim again
Leader to intimate claim details with copies of
relevant reports/documents
Decision by HCC of leader - binding on other coinsurers who may place note for information of
their HCC.

General Guidelines Contd.

Close Proximity Cases - Loss within 5 days of
risk inception (for new Insc. Or break-in Insc.).
Investigation to be instituted.
Policy rectification after loss for reasons other
than breach of condition/Warranty
1. Rectification by Competent Authority for
claim settlement.
2. Additional premium if required, to be charged
on affected policy period of claim.

General Guidelines Contd.

Non-std. Claims to be known as compromised
claims
Compromised claims due to breach of Policy
conditions or warranties/non-compliance of
tariff provisions/incorrect premium due to misrepresentation., mis-declaration, nondisclosure by insured/jeopardized rights of
recovery from TP Where breach or lapse of
any kind not material to the loss - settlement
after policy rectification. Further Deduction if
required as per Cos. Internal instructions.

General Guidelines Contd.

Where breach etc is material to loss settlement
up to max of 75% of assessed claims.
Jeopardized recovery rights - appropriate Amt
representing possible recovery to be deducted
from assessed claim.
Ex-gratia - HO only
Repudiation of claim by authority competent to
settle the claim
Re-opening claim- One step higher authority

Financial Authority - Fire & Engg

AO - Rs.50,000/-,
DY.M. - 10 Lacs,
DCC - 30 lacs,
RCC - 80 Lacs,
GM - Rs.2 Cr.,
HCC - Actuals

AM - Rs. 1.25 LACS

MGR - Rs.15 lacs
CM - 40 lacs
DGM - 1 Crore
CMD - Rs.4 Cr.

Single Event Losses

Catastrophic Losses/Single Event Losses
involving more than one claim - Total amt.
Of all claims considered for Financial
Authority
Spl. Dispensation to be obtained

Other points of interest

Letter for settlement of claim

Details of claim amount settled
Engaging many surveyors and investigators
Time limit for reinstatement
Salvage expenses
Goods held in trust

Steps by insd - Clms. And U/W

If fire, inform to Fire Brigade, Police Dept.
register FIR, obtain copies of all reports from
above and Govt. agencies.
Inform Insurance Co.
Take photos duly signed and stamped
Loss minimization
Submit all information witness details & required
Documents
Keep salvage in as-is-where-is basis till further
instructions.
Salvage disposal as per Co. norms

Steps by Insd - Clms. And U/W Contd

All Insurance Policies (any Insurance. Co.) Covering
affected property to be furnished
Difficulties - Contact U/W Office
Samples - Jointly signed by Insured and surveyor
Accurate details of Location., SI, Risk Discrpn. In
spec.pol. To avoid dispute in assessment.
Declaration. Pol.- Basis as per tariff, Monitor SI
Floater Pols. - Adequacy of SI

Steps by insd - Clms. And U/W Contd.

Key areas to be noted by Insd.
1. Clarity regarding properties/risk covered
2. Whether SI on MV or RIV basis, proper
documentation to be submitted
3. Surveyors report only recommendatory and
insurers decision final.
4. Improvements outside policy scope
5. Declns. Under Decln. Pol.to be proved
6. Change in Occpn./altrn/addn.- Inform immdly.
7. Submit Cl. Form + Requd reports (Fire FIR etc.)

Reference Date for Loss

Assessment in IAR Policy
Preamble Reads - the insurer will pay to
the Insured the value of the property at the
time of the happening of its accidental
physical loss or destruction or damage or at
its option reinstate or replace such property
or any part thereof.

Reference Date for Loss

Assessment in IAR Policy Contd
It further states:
Provided that the liability of the Insurer in respect
of any one loss or in the aggregate in any one
period of insurance shall in no case exceed
As regards buildings, plant & machinery, FFF etc.
the cost of replacement or reinstatement on the date
of replacement or reinstatement subject to the max.
liability being restricted to the SI i.r.o. that cat of
the item under the policy.

Condition on underinsurance states:

If the property hereby insured shall at the
time of reinstatement/replacement repair
following a loss or damage indemnifiable
under the policy be of greater value than the
sum insured under the policy, then the
insured shall be considered as being his
own insurer for the difference and shall bear
a ratable proportion of loss.

Excluded causes regarding

Design & Collapse in IAR Policy
This policy does not cover loss to the property
insured caused by:
Faulty or defective design materials or
workmanship inherent vice latent defect gradual
deterioration deformation or distortion of wear
and tear
interruption of the water supply gas electricity or
fuel systems or failure of the effluent disposal
systems to and from the premises
unless damage by a cause not excluded in the
policy ensues and then the insurer shall be liable
only for such ensuing damage

Excluded causes regarding Design &

Collapse in IAR Policy Contd.
Collapse or cracking of buildings
corrosion rust extremes or changes in temperature
dampness dryness wet or dry rot fungus shrinkage
evaporation loss of weight pollution
contamination change in colour flavour texture or
finish action of light vermin insects marring or
scratching
Unless such loss caused directly by damage to the
property insured or to premises containing such
property by a cause not excluded in the policy