Liability Insurance Claims
Liability Insurance Claims - An Article for Excellence in Claims Handling.
Duties of the Parties Involved with a Liability Claim This is a partial part of the post and the full article is only available to subscribers.
You can subscribe to “Excellence in Claims Handling” at barryzalma.substack.com/subscribe Barry Zalma Jul 17, 2024n Every policy of third party liability insurance requires, as a condition precedent,[1] that the insured give prompt notice to the insurer and cooperate with the investigation of the loss and the defense the insurer promised to provide. The insured is also required to cooperate in the investigation of the insured, assist in the defense of any litigation brought against the insured, assisting in the preparation of answers to interrogatories, requests for admission, sworn declarations and attending and testifying at deposition and trial. After the report of loss the insurer will assign an insurance adjuster to deal with the claim. Duties of the Adjuster When a claim is made, the insurer provides an adjuster to help the insured understand the policy and comply with its conditions. The role of the liability adjuster is slightly different to that of the property adjuster. Like the property adjuster, the liability adjuster represents the insurer and deals directly with the insured. But these responsibilities play out in a distinct way for the liability adjuster, who has a threefold duty: 1 to the insured, to protect him or her against exposure to liability to third parties as a result of an accidental tort that falls within the definition of “occurrence”; 2 to the claimant, to treat him or her fairly and, if liability exists, to resolve the claim promptly without ignoring the duty to the insured; and 3 to the insurer, before agreeing to resolve a claim, to establish that coverage exists for the loss under the terms and conditions of the policy, that the insured is liable to the third party, and the most reasonable resolution of the claim has been achieved. The liability adjuster works with the insured to provide the best possible defense to the claim presented against the insured by a third party. The adjuster must understand the meaning of complex contracts (not just insurance contracts) and the rules for interpreting them and be able to explain them in language that a lay insured will understand.
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