CLAIMS SERVICE LEVEL AGREEMENTS. Group. Group

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1 CLAIMS SERVICE LEVEL AGREEMENTS Authorised Financial Authorised Services Financial Provider Services Provider A member of the A member of the Group Group

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3 OUR VISION To be the short-term insurer of choice. We will achieve this by building a multi-channel business focused on delivering value to the customer, while fostering close relationships with our strategic business partners. OUR VALUES Accountability Being prepared to make commitments and be judged against them. Taking ownership for actions and problems and being responsible for actions. Respect Treating others as you would have them treat you. Leveraging the strengths of diversity. Actively listening to others and treating people with dignity. Pushing beyond boundaries Playing to the maximum as individuals, teams and as an organisation, across boundaries. Always striving to break new ground with innovation and creativity. Integrity Being honest, trustworthy, consistent and open. Acting in accordance with the highest ethical standards. Passion Giving the best and being dependable in exceeding goals successfully. Having a sense of optimism and enthusiasm to spend energy voluntarily.

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5 CONTENTS 1. What sets us apart from our competitors 2. Claims Service Level Agreement 3. Reporting a Non-motor claim 4. Reporting a Motor claim 5. Mutual & Federal Centres 6. Mutual & Federal Claims contact information pg 1 pg 2 pg 4 pg 5 pg 7 pg 8

6 WHAT SETS US APART FROM OUR COMPETITORS We have one of the best equipped and structured fraud investigation unit in the industry. Our staff are high performance individuals who possess a wealth of knowledge and experience. We work on an Intermediary model so our core business is based on a broker-centric claims structure. Throughout South Africa you will find Mutual & Federal Assessment and Multi -purpose Centres. Engagement with our brokers is vital to our business, therefore we have a dedicated team of Claims Relationship Consultants to help grow these relationships. We have a mobile digital solution for non-motor assessments. A dedicated Stolen/Recovered Vehicles Unit and an experienced Legal department to handle litigious claims. We have created a broker-centric digital platform called mfonline, where brokers can register, attach documents and monitor the status of their claims easily and efficiently. For certain non-motor claims under the value of R20 000, we offer a Fast track claims processing methodology, allowing claims to be settled quickly. We are continuously managing and auditing our preferred suppliers to ensure quality and service that meets our standards. Mutual & Federal is the first insurer in Gauteng to provide a mobile claims service manned by Motor Engineers who can assist in the event of a multitude of claims resulting from a natural disaster, catastrophe or other eventuality. Mutual & Federal was voted three years in a row as the Best Employer of the Year in the Short-Term Industry. 1

7 CLAIMS SERVICE LEVEL AGREEMENT The Claims Service Level Agreement (SLA) serves as a document that informs you of the processes, timelines and contact details when lodging a claim. Claims Below is a list of our SLAs: Activity Duration Generic SLAs (Motor and Non-motor) Acknowledgement of new or amended claim requests Within 1 working hour Reply to routine queries Within 1 working day Reply to claims queries requiring urgent attention Within the timescale specified by Claims management Registration of Claims Within 2 working days Communicating rejection of a claim, after establishing the status of the claim. Within 10 working days Appointment of an assessor or motor engineer Scheduling assessments after registration in urban and outlying areas for Non-motor claims Arranged within 2 working days Scheduling Motor Engineers for motor claims Arranged within 1 working day Scheduling appointments of repairer or suppliers Arranged within 1 working day Non-motor claims Fast Track claims will be settled, provided Within 1 working day Mutual & Federal receives all relevant information. Once agreed, settlements or payments will be effected, provided Mutual & Federal receives all relevant Within 2 working days documentation. Car hire Car hire requests are managed by Mutual & Federal. Arranged within 3 working hours from time of request Car hire queries must be referred to Mutual & Federal and not to the service provider directly. Within 1 working day 2

8 Motor claims Write-off or uneconomical to repair Confirmation of the vehicle status will be provided once the Within 2 working days Motor Engineer s report is received. Agreed settlements or payments, will be effected, provided Mutual & Federal receives all the relevant original Within 2 working days documentation. Stolen or hijacked vehicles An investigator will submit a preliminary report. Within 10 working days Agreed settlements or payments, will be effected, provided Mutual & Federal receives all the relevant original Within 2 working days documentation. Acknowledgement of new claims Acknowledgement of queries Recovery queries Motor recoveries progress reports Motor liabilities progress report Recoveries and liabilities Within 5 working days Within 2 working days Within 2 working days Within 30 days of previous report Within the timescale specified by the management of Recoveries For more information, please visit 3

9 CLAIMS NOTIFICATIONS You can submit your claim via , facsimile, mfonline, telephonically or in person. Mutual & Federal must be notified of all claims within the stipulated time-frame as stated in the policy conditions, failing to do so, might result in the claim being rejected. Reporting a Non-motor Claim Documentation and information required: Date of loss Details of loss Policy number Confirmation of cover and premium (Group Schemes Policy) Sum insured Excess applicable Physical address where the loss occurred Police case number for theft/burglary claims Any other relevant information which may affect the claim Description of the property and the date purchased The amount claimed Contact person and telephone numbers should a Loss Adjuster or an Assessor is appointed 4

10 Reporting a Motor claim Accident claims/written-off vehicles/uneconomical to repair Documentation and information required: Completed claim form only required if a third party vehicle or third party property is involved or it is a potential passenger liability claim. Claim forms are compulsory in respect of Motor Traders claims. Policy number Date of loss Inception date of the vehicle (Group Schemes Policy) Complete vehicle details Circumstances of the loss Police case number Details of damage Sum insured (Group Schemes Policy) Excess applicable (Group Schemes Policy) Details of vehicle location to conduct an assessment of the damages Premium and cover confirmation Confirm if the driver was tested for alcohol Clear copy of valid driver s licence and identity document Indicate if an instalment payment plan is applicable, if so, details of the finance institution Third party and witness details Stolen/hijacked vehicles Documentation and information required Completed claim form Police case number Make and model of vehicle, condition and mileage Policy number Inception date of the vehicle Date of loss 5

11 Circumstances of the loss Witness details if applicable Sum insured Excesses applicable Premium and cover confirmation Copy of driver s licence and identity document, if the vehicle was hi-jacked Indicate if an instalment payment plan is applicable, if so, submit details of the financial institution Check list for stolen/hijacked and written-off/uneconomical to repair vehicles Clear copy of valid driver s licence Completed and signed claim form Confirmation of vehicle licence Confirmation of anti-theft device or tracker, for stolen or hijacked vehicles Signed change of ownership forms Details and proof of accessories that may have an influence on the retail value of the vehicle no accessories will be considered for payment after settlement Original and spare keys required Insurable Interest must be confirmed registered owner and policyholder must be the same as mentioned in the policy document. Confirmation of the insured banking details Financed vehicles: Documentation and information required Copy of registration certificate and settlement quotation must be obtained from the Financial Institution by the insured. National Consumer Act (NCA) only permits the insured to request these documents Copy of the finance agreement when claiming for a credit shortfall Vehicles without finance: Documentation and information required Letter from the insured confirming the vehicle is free-owned Original registration certificate It is compulsory for the vehicle to be deregistered by the insured as stolen and to submit the original deregistration documentation to Mutual & Federal 6

12 MUTUAL & FEDERAL CENTRES If the vehicle is safe to drive, Mutual & Federal Motor Assessment Centres and Multipurpose Centres are available at the following locations: Assessment Centres Claims Centres Tel. No. Fax. No. Address Bloemfontein Rosenhof, 90 Zastron Street, Bloemfontein Pretoria Corporate Corner, Corner Church & Gordon Roads, Hatfield Port Elizabeth Frank Street, Newton Park Polokwane Neethling Street, Cnr Rhodesdrift Street Bendor Extension 30 Multipurpose Centres Claims Centres Tel. No. Fax. No. Address JHB City Cresta / Corner Acacia & Valley Lane, Blackheath, Cresta Benoni (Eastrand) Cape Town Montague Cape Town Claremont 38 Northrand Road, Corner Herman Pieters Str, Hughes, Boksburg Montague Drive, Montague Gardens, Milnerton, Cape Town Stadium on Main, 170 Stegman Road, Claremont Durban Intersite Avenue, Springfield Park, Durban Pietermaritzburg Victoria Road, Pietermaritzburg 7

13 MUTUAL & FEDERAL CLAIMS CONTACT INFORMATION Johannesburg Motor Claims Johannesburg Mutual & Federal Centre Switchboard (011) President Street, P O Box 1120, Johannesburg, 2000 Johannesburg, 2000 Personal Motor mlpmodjd@mf.co.za Commercial Motor mlcmodjd@mf.co.za Johannesburg Non-motor Claims Johannesburg Mutual & Federal Centre Switchboard (011) President Street, P O Box 1120, Johannesburg, 2000 Johannesburg, 2000 Personal Non-Motor mlclpjd@mf.co.za Personal Non-Motor - Fast Track jhbclaimsftp@mf.co.za Motor Own Damage mlmodhn@mf.co.za Agriculture & Crop mlcnmjn@mf.co.za Agriculture & Crop Fast Track jhbclaimsftc@mf.co.za Commercial Non-Motor mlcnmjn@mf.co.za Commercial Non-Motor Fast Track jhbclaimsftc@mf.co.za Johannesburg Motor Liabilities Johannesburg Mutual & Federal Centre Switchboard (011) President Street, P O Box 1120, Johannesburg, 2000 Johannesburg, 2000 Motor Liabilities mlcd@mf.co.za Johannesburg Specialist Claims Corporate mlcspjw@mf.co.za Engineering mlcspjw@mf.co.za Marine mlcspjw@mf.co.za Group Schemes bords@mf.co.za Cape Town Claims Hub Cape Town MutualPark Switchboard - (021) Jan smuts drive, Pinelands P O Box 8, MutualPark, Cape Town, 8000 Cape Town 7405 Personal Non-Motor cptclaimspnm@mf.co.za Non-Motor Fast Track cptclaimsft@mf.co.za Commercial Non-Motor cptclaimscnm@mf.co.za Engineering cptclaimssp@mf.co.za Motor Own Damage : Personal cptpmod@mf.co.za Motor Own Damage : Commercial cptcmod@mf.co.za Motor Liabilities mltp@mf.co.za Motor Recoveries mlcd@mf.co.za 8

14 Kwa-Zulu Natal Claims Hub KZN Regional Office Switchboard - (031) The Boulevard Westway Office Park P O Box 2779 Westway Office Park, 3635 Westville, 3634 Personal Non-Motor kznclaimspnm@mf.co.za Commercial Non-Motor kznclaimscnm@mf.co.za Engineering kznclaimscnm@mf.co.za Motor Commercial kzncmod@mf.co.za Personal Motor kznpmod@mf.co.za Non-Motor Fast Track - kznclaimsft@mf.co.za Motor Liabilities mltp@mf.co.za Motor Recoveries mlcd@mf.co.za Multi-purpose Centre Port Elizabeth Claims Hub Port Elizabeth Switchboard (041) kznclaimsdic@mf.co.za dbn.mpc@mf.co.za Block 1, Greenacres Office Park 2nd Avenue, Newton Park, Private Bag X60573, Greenacres, 6057 Port Elizabeth, 6045 General Non-Motor Claims pezclaimsnm@mf.co.za Non-Motor Fast Track Claims pezclaimsft@mf.co.za Motor Claims pezclaimsmd@mf.co.za Bloemfontein Claims Hub Bloemfontein Switchboard - (051) P.O. Box 1085, Bloemfontein, 9300 Lustitia Building Cnr Aliwa & St Andrews Street, 1st Floor Personal Non-Motor mlpnmhn@mf.co.za Commercial Non-Motor blmclaims@mf.co.za Motor Own Damage mlmodhn@mf.co.za Fast Track Non-Motor blmclaimsft@mf.co.za Multi-purpose Centre blmclaims@mf.co.za National Call Centre Call Centre No Claims Call Centre Personal Non-Motor mlpnmhn@mf.co.za Personal Motor mlmodhn@mf.co.za Department Tel Number Client Service Centre Broker Service Centre Old Mutual Service Centre

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