CGU & UIP CLAIMS PROCEDURES INDUSTRIAL SPECIAL RISKS (DAMAGE TO OWNED PROPERTY & LOSS OF REVENUE Typically this policy covers claims arising from loss or damage involving such events as: Fire, including bush fires Storm (Hail, wind, rain, lightning) Flood Burst water pipes Theft/burglary Malicious damage Breakage Accidental damage Impact by vehicles Earthquake
COUNCIL S IMMEDIATE ACTION If something happens that causes loss or damage to Council s own property (Building, Contents, Plant, Equipment) or property for which Council is responsible for (E.g Leased Premises/ Equipment): 1. Take all necessary and/or reasonable precautions to protect Council s property from further loss or damage either by the same peril or by a possible future event (e.g. Rain); 2. Call the police or other emergency services as considered necessary. Any loss by theft or wilful or malicious damage should immediately be reported to the nearest Police Station. Any instructions from Police should be noted and actioned accordingly. 3. If you suspect that the loss or damage will exceed your Council s specific ISR policy deductible, obtain as much information as possible of: a) The incident; b) The estimated amount of loss or damage; c) Any witnesses to the event; d) Take photographs/video of the damaged property.
CONTACT POINTS CONTACT CMA IMMEDIATELY TO ADVISE DETAILS OF THE LOSS/DAMAGE AND TO RECEIVE INSTRUCTIONS ON THE IMMEDIATE ACTION REQUIRED TO MANAGE THE CLAIM First Contact IAN BARKER 1300 133 903 0409 904 216 ianb@claimsmanagers.com.au Alternate Contact TONY HATGIS 1300 133 903 0422 002 780 tonyh@claimsmanagers.com.au If known, advise CMA of the person within Council who will be responsible for managing the claim going forward. Complete the standard claim form and supply to CMA
CMA ACTION WHERE INITIAL LOSS ESTIMATE IS <$20,000 & ANNUAL AGGREGATE DEDUCTIBLE ($750,000) HAS NOT BEEN EXHAUSTED. 1. CMA will determine the need to engage the services of a specialist Loss Adjuster to assist them in ascertaining the circumstances of the loss, cause(s), quantum, obtain substantiating documentation and generally assist with organising repairs and/or replacement as the circumstances may require. Please note that the Loss Adjuster s fees and expenses form part of the overall cost of the claim and therefore will be paid either by Council (within deductible) or UIP. 2. CMA will confirm back to Council and provide details of Loss Adjuster (if appointed) and agree an appropriate time for the loss adjuster to inspect the damaged property. CMA will also attend inspection if required
CMA ACTION (cont d) 3. CMA will continue to manage the claim for and on behalf of Council. All Loss Adjuster correspondence is to be via CMA including claim payments, fees and expenses whether in part or final. 4. CMA to provide Willis with a Claims Report monthly detailing all reported losses. 5. CMA to report each and every claim to CGU that exceeds the UIP deductible. 6. CMA to liaise with CGU to confirm agreement of indemnity on losses above $70,000 and obtain a quarterly confirmation of erosion of the aggregate 7. Contentious claims will be referred to CGU for confirmation of indemnity.
WHERE INITIAL LOSS ESTIMATE IS <$200,000 (Note: Claims exceeding $250,000 do not contribute to the annual aggregate deductible) 1. CMA will report the loss to CGU Insurance s dedicated UIP Claims Manager. Upon receipt of the claim notification, CGU will engage the services of a specialist Loss Adjuster (to be agreed with CMA) to assist them in ascertaining the circumstances of the loss, cause(s), quantum, obtain substantiating documentation and generally assist with organising repairs and/or replacement as the circumstances may require. Please note that the Loss Adjuster s fees and expenses form part of the overall cost of the claim and will be paid by CGU. 2. CMA will confirm back to Council once CGU has been advised and provide details of Loss Adjuster and agree an appropriate time for the Loss Adjuster to inspect the damaged property. CMA will also attend inspection if required. 3. CMA will continue to manage the claim for and on behalf of Council. All Loss Adjuster and/or CGU correspondence is to be via CMA including claim payments whether in part or final.
CLAIMS >$20,000 ONCE ANNUAL AGGREGATE DEDUCTIBLE ($750,000) HAS BEEN EXHAUSTED 1. CMA will report the loss to CGU Insurance s dedicated UIP Claims Manager. Upon receipt of the claim notification, CGU will engage the services of a specialist Loss Adjuster (to be agreed with CMA) to assist them in ascertaining the circumstances of the loss, cause(s), quantum, obtain substantiating documentation and generally assist with organising repairs and/or replacement as the circumstances may require. Please note that the Loss Adjuster s fees and expenses form part of the overall cost of the claim and will be paid by CGU. 2. CMA will confirm back to Council once CGU has been advised and provide details of Loss Adjuster and agree an appropriate time for the Loss Adjuster to inspect the damaged property. CMA will also attend inspection if required. 3. CMA will continue to manage the claim for and on behalf of Council. All Loss Adjuster and/or CGU correspondence is to be via CMA including claim payments whether in part or final.
CASE STUDY Council amenities block partially destroyed by fire. Estimated at $100,000.00 1. Emergency work- who can carryout? What authority is needed? 2. Define the work (the scope) who prepares? 3. Additional work eg risk improvements how is it dealt with? 4. Extra costs to meet current codes. 5. Tender process- Insurer & or Council contractors or even Council itself.
Case study REINSTATEMENT OF DAMAGE BY THE INSURED (UMAKEXB4) If the Insured shall, after obtaining the consent of the Insurer(s), reinstate damaged property insured, the Insurer(s) shall pay the cost of such reinstatement including the value of labour and other overhead charges expended thereon together with a reasonable margin for profit. The liability of the Insurer(s) shall not exceed the amount which would otherwise have been payable hereunder had such reinstatement been carried out by outside contractors.
Case study 6. Appointment of the contractor Who decides? Who signs the contracts? Who pays?