UK MOTOR EXAMPLE BESPOKE CLAIMS PROCEDURE
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1 UK MOTOR [POLICYHOLDER]: [POLICY NUMBER]: EXAMPLE BESPOKE CLAIMS PROCEDURE IN ASSOCIATION WITH [BROKER DETAILS] 2008 QBE European Operations is a trading name of QBE Insurance (Europe) Limited, no ( QIEL ), QBE Underwriting Limited, no ( QUL ), QBE Management Services (UK) Limited, no ( QMSUK ) and QBE Underwriting Services (UK) Limited, no ( QSUK ), whose registered offices are at Plantation Place, 30 Fenchurch Street, London, EC3M 3BD. All four companies are incorporated in England and Wales. QIEL and QUL are authorised by the Prudential Regulation Authority and regulated by the Financial Conduct Authority and the Prudential Regulation Authority. QUL is a Lloyd s managing agent. QMSUK and QSUK are both Appointed Representatives of QIEL and QUL.
2 CONTENTS 1. INCIDENT REPORTING, ADMINISTRATION & STATISTICS. 2. REPAIRS 3. TOTAL LOSSES 4. OUTLINE POLICY COVER 5. PERSONNEL INVOLVED 6. SERVICE LEVEL SUMMARY
3 1. INCIDENT REPORTING, ADMINISTRATION & STATISTICS INCIDENT REPORTING 1.1 Driver to report incident to [TRANSPORT MANAGER] using QBE Motor Accident or Motor Theft Report Form. ALL INCIDENTS MUST BE REPORTED AS SOON AS POSSIBLE TO AVOID ANY PREJUDICE TO UNDERWRITER S POSITION AND TO ASSIST WITH THE QBE THIRD PARTY PRO- ACTIVITY. Wherever possible incidents should be reported within 24 / 48 hours. Serious incidents should be reported immediately by telephone. 1.2 Transport Manager to ensure that the report form is fully completed and immediately submitted to [HANDLING BROKER] for the attention of [CONTACT NAME]. 1.3 The completed claim form will then be passed to QBE, bearing the Depot Code (where applicable) for the attention of [QBE CONTACT NAME]. 1.4 Any delay on incident reporting to be reported by QBE to [BROKER NAME] for the personal attention of [CONTACT NAME]. ADMINISTRATION 1.5 Repairs above the policy excess of [ AMOUNT] to be paid by QBE less VAT. 1.6 Recovery of uninsured losses to be undertaken by [BROKER NAME] in close liaison with QBE as and when required. 1.7 Third party correspondence to be passed to QBE immediately following the immediate acknowledgement to the claimant or claimant representative. 1.8 Police proceedings to QBE by fax and post for the attention of [QBE CONTACT NAME] to discuss any legal representation necessary. QBE to acknowledge receipt and confirm the necessary action required as soon as possible. 1.9 Civil Court Proceedings to QBE by fax and post for the attention of [QBE CONTACT NAME]. [BROKER NAME] to telephone QBE on knowledge of Proceedings so that IMMEDIATE action can be taken. QBE to acknowledge receipt and confirm action taken as soon as possible Indemnity problems to be referred immediately to [QBE CONTACT NAME] for urgent discussion with [BROKER NAME] if deemed necessary. STATISTICS 1.11 Claims experience listings to be submitted by (Excel attachment) on a monthly basis to [BROKER NAME] in [ENTER FORMAT OPTION] 1
4 2. REPAIRS MOBILE VEHICLES 2.1 Single repair estimate to be submitted by [BROKER NAME] by fax transmission for the attention of the QBE staff engineer if the total cost of the repairs is expected to exceed the policy excess. 2.2 QBE staff engineer will telephone the repairer to agree repair costings and authorise the repairs subject to the policy excess and vat status of the Policyholder. Claims negotiator to authorise repairs in writing to the repairer and confirm to [BROKER NAME] the action taken. 2.3 Repair account to QBE for payment. Vat and excess invoice to Policyholder. IMMOBILE VEHICLES 2.4 When a vehicle is immobilised as a result of an incident [BROKER NAME] to instruct an Independent Engineer from the QBE Directory of Independent Engineers to inspect the vehicle damage and authorise repairs subject to the policy excess and vat (subject to the General condition below). 2.5 It is essential for the cost of vehicle collection from the scene of accidents to be controlled by the Insurer. QBE s preferred agents provide a fixed price menu for vehicles on and off road up to 3.5 tonnes, an HGV pricing menu, no hidden extras and for all invoices in excess of 500 photographic evidence is supplied to support the charges presented. QBE provide accident recovery throughout the UK and Europe through a network of over 500 recovery operators and average incident attendance time is only 30 minutes through a 24 hour national freephone call centre. Please refer to QBE s recovery leaflet for driver and/or cab packs. If an insured vehicle is involved in a road traffic accident and requires recovery please IMMEDIATELY telephone: GENERAL AUTO-RESCUE LOGISTICS LIMITED Subject to policy cover repairs may be authorised if [BROKER NAME] is satisfied with the completion of the incident report form before submission to QBE. If there are any potential indemnity issues the Policyholder will proceed with repairs under their own authority and such indemnity issues will be discussed with [BROKER NAME] as soon as possible. WINDSCREENS 2.7 Replacement to be carried out wherever possible by Autoglass Ltd using Freephone number Subject to policy cover and excess. Autoglass provide QBE with competitive rates, the benefit of which can be passed on to the Policyholder where costs fall within the policy excess. 2
5 3. TOTAL LOSSES 3.1 Total Loss claims will be settled within 21 days of claim form, all vehicle documents & keys being received by QBE. 3.2 QBE to negotiate settlement with the Policyholder via [BROKER NAME]. If a finance house or leasing company is involved they must be advised of the claim and should be invited to present vehicle documentation and settlement / write down figures for consideration in negotiations with the Policyholder on market value. Following market value agreement the finance house or leasing company will normally request settlement direct with notice of payment to the Policyholder. 3.3 Where a vehicle is heavily damaged but is repairable and the repair is expected to take a long period of time, QBE to advise [BROKER NAME] so that consideration can be given to the Policyholder making a contribution to a total loss settlement to avoid heavy uninsured losses. 3.4 In the case of vehicle theft, all vehicle documents/keys to be submitted along with claim form and brief description of circumstances surrounding theft. QBE to keep [BROKER NAME] fully advised in terms of any investigations considered necessary. 3.5 If after the initial examination of a heavily damaged vehicle the Policyholder considers that the vehicle may be a constructive total loss or write off they will provide all available vehicle documentation at the time of vehicle examination to assist the engineer with the full vehicle specification and cost to include production of servicing/maintenance and refurbishment records. The intention is to assist the engineer with an accurate market valuation at the earliest possible opportunity. 3.6 Any delays on total loss negotiations to be reported to [QBE CONTACT NAME] for investigation. 3
6 4. OUTLINE POLICY COVER Inception: Cover: Excess: Vehicles: Driving Restrictions: Endorsements: Above provisional details as advised by Underwriters and subject to conformation on policy closing. 4
7 5. PERSONNEL INVOLVED 5.1 [POLICYHOLDER NAME] [Address line 1] [Address line 2] [Address line 3] [Postcode] Phone : Fax : Contact: 5.2 [BROKER NAME] [Address line 1] [Address line 2] [Address line 3] [Postcode] Phone : Fax : Contact: 5.3 QBE [Address line 1] [Address line 2] [Address line 3] [Postcode] Phone : Fax : Contact 1: Contact 2: Contact 3: 5
8 6. SERVICE LEVEL SUMMARY PRIMARY CLAIMS QUALITY OBJECTIVES (Weekly/Monthly Process Measurement) SUMMARY OBJECTIVE DETAIL TIME FRAME New Claims Post Handling Payments New claim registration onto claims 2 working days system First actions 2 working days To register all new claims received onto Last day of the month wherever the system by the last day of each month possible To identify and prioritise and action 3 working days urgent post To respond to/action all other post 10 working days Raise payment on claims system or Within 3 working days of manually agreement Authorise payment on claims system or Within 1 working day of raising form Total period from receipt/agreement or 4 working days validation to raising, authorising & cheque evidencing SECONDARY CLAIMS QUALITY OBJECTIVES (Six-monthly Audit Measurement) SUMMARY OBJECTIVE DETAIL TIME FRAME Claim Forms Claim forms to be despatched 1 st class Day of request Decision makers To provide access to decision makers Within 3 hours Post Handling Identify or return unreferenced post Within 3 working days urgently Telephone calls Answer and not transfer more than Within 3 rings once Provide name of department and own name as appropriate or requested Record details of call using Telephone File Note Get back to the caller and respond to query On the same day unless advised to the caller that it will be later Offers Ensure basis of offer is fully set out, including reason for any deductions Referrals Respond to urgent referrals 3 hours or 1 working day Total Loss Handling Respond to non-urgent referrals Arrange immobile vehicle inspection Issue cheque for Total Loss Claim Within 3 days 2 working days ASAP but no later than 21 days following receipt of the vehicle documents Within 2 working days Broker Correspondence New claim acknowledgement correspondence sent to broker (by where Updates to be provided where possible) requested Final advice letter to be sent at point of file closure Complaints Refer to a supervisor Team/Departmental Response times Telephone complaint Within 1 working day complaint Acknowledgment of written complaint Within 2 working days Lloyd s complaint Acknowledge/respond Within 14 days Maximum resolution time 6 weeks Returned Within 5 working days Documentation Returned Cheques Returned cheques should be re-issued Within 5 working days
9 6
Please don t delay - report same day
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