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You are claims specialist at PYY Insurers, and you have just received a new claim notification from one of your clients, Mrs TR . According
You are claims specialist at PYY Insurers, and you have just received a new claim notification from one of your clients, Mrs TR According to your records, Mrs TR is a very good client who has never missed a premium payment on her personal policy for the past five years. She has, to date, paid a total of R in premiums. Mrs TRs current loss ratio is with only two minor claims cellphone screen repair and windscreen replacement over the past five years.
The claim notification you have just received is due to a big fire that burned a large portion of her home, with her vehicle in the garage at the time.
Due to the nature of the new claim, you have appointed a Loss adjuster.
According to the Loss Adjusters recommendations on their preliminary report,
the claim is valid, and the costs are as follows:
Homeowners: Sum Insured SI R; Total claim
R less the excess of R
Householders: Sum Insured SI R; Total claim R less the excess of R
Motor Section: Sum Insured SI R; Total claim R less the excess R
AllRisk Section: Sum Insured SI R; Total claim R less the excess R
On his final report, the Loss adjuster has recommended that the laptop claim of RAll risk section is invalid since it was owned by her friend, who has already claimed for it under her own policy.He also went on to state that the suspected cause of the fire was an inverter system that Mrs TR purchased at a local retailer, and which had not been professionally installed. The loss adjuster recommended that the claim be paid since this was not an exclusion on the policy.
The loss adjusters invoice including the report and Adjustment expenses was R
Based on the scenario answer the following questions
Describe the type of losses Mrs TR has had over the past five years, and the type of loss she has suffered in the fire.
Consider the cause of loss, and advise on the underwriting terms and conditions that you would implement in response to Mrs TRs overall risk following this fire claim.
Calculate Mrs TRs new loss ratio following the fire claim. Show all calculations and the formula. Round your answer off to two decimal places.
Consider the interdependency between the various departments in an insurance company and explain the responsibility of the Claims Department after confirming Mrs TRs claims and after settling the claims.
Explain three reasons why it is important for the Claims Department to keep the Underwriting Department updated following any claim.
By applying the quota share retentions, calculate the amount that each company will carry for the Houseowners and Householders combined. Show full calculations.
Considering the combined total loss for the Homeowners and Householders sections, calculate the amount that the insurer and reinsurer would each accept. Show full calculations.
Explain how dual insurance is different from reinsurance.
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