Claims are how the insurance industry delivers on its promise!
Everyone involved in the claims process has an important multifunctional role serving multiple stakeholders. For those working on the side of the insurer first and foremost they are an ambassador for the insurer / underwriting agency for whom they work or are engaged while all in claims have a duty to brand insurance and ensuring that trust, paramount to the long term success of insurance, is not breached. At the same time all in the claims process need to be providing genuine assistance to Insured’s who have suffered or are threatened by a financial loss. This assistance is not just limited to financial but includes emotional support while offering meaningful advice where possible to minimise the loss and in some cases the reputation of the Insured. Insurance has been built on one key underlying principle, that is utmost good faith [uberrimae fidei].
“Insurance is a contract based upon speculation. …… Good faith forbids either party by concealing what he privately knows, to draw the other into a bargain from his ignorance of that fact, and his believing the contrary.”
Lord Mansfield in his seminal judgement from 1766 in Carter v Boehm
The principle of acting in good faith, including at the time of a claim, has been enshrined in legislation in many jurisdictions.
It goes without saying that claims need to be settled in accordance with the terms and conditions of the policy to minimise claims leakage but at the same time never at the expense of any Insured’s valid entitlement under the contract of insurance.
The Institute of Insurance Claims Professionals (IICP) is an Institute dedicated to advancing the practice of ethical behaviour and promotion and sharing of knowledge to all those participating in any aspect of general insurance claims.