General Claims instruCtions
taBle oF Contents
item
nsloss PaGe
Acknowledgment of Claims ... 3
General Claims Instructions ... 1
Larger Fire and Storm Claims ... 3
Notice of Loss ... 1
Suggestions on Minor Losses ... 2
Summary ... 3
Theft Claims ... 2
Forms
ACV Loss Settlement Guidelines for Shingles - (CF-1601) ... 4Release of Purchase Information - (CF-517)... 8
Theft Loss Statement - (CF-86) ... 5-6 Theft Loss Letter - (CF-356) ... 7
IA, MN, NE, ND, SD
North Star Mutual Ins. Co.
General Claims instruCtions
When you as an agent sell an insurance policy, you are not only selling protection against loss but you are also sell-ing a service. If you have provided the policyholder with complete coverage that fits his individual needs, your best advertising comes about when a loss occurs. How a claim is handled by the agent, the adjuster and the company often determines whether the business is retained or whether a dissatisfied policyholder looks elsewhere for insur-ance needs.
Know your policies, attaching forms and endorsements. Know your policyholder, since more and more people rely on their agent to know what insurance they need and what optional coverages are available and necessary. Dis-cuss ACTUAL CASH VALUE (losses that are subject to depreciation) versus REPLACEMENT COST (not subject to depreciation), so that your client is aware of which of these two will apply at the time of a loss. Farm outbuildings can be covered for either actual cash value or replacement cost coverage as indicated on the policy, as can mobile homes, but farm personal property is always insured for actual cash value.
A Homeowners policy provides replacement cost coverage on the dwelling except for antennas, carpeting, window coverings, awnings, domestic appliances and window air conditioners. Under all Homeowners policies except the All-Star, personal property is subject to depreciation unless the "Replacement Value" endorsement for such personal property is attached to the policy.
Common items which may be damaged on a building structure and which are subject to depreciation under actual cash value policies are shingles, storm doors, awnings and exterior and interior paint. Ordinary composition shingles have a life expectancy of approximately 25 years . . . better grades of composition and cedar shingles and shakes will last longer. Storm doors, antennas, and awnings have a life expectancy of approximately 10 years and exterior and interior paint 5 years. Personal property will vary almost item by item. Depreciation is applicable to the entire repair bill.
notiCe oF loss
It is very important that all claims be reported to the Company as soon as you are made aware of them. Even though you anticipate that a claim will be settled shortly, don't wait to send the original notice of loss. A record of each loss must be made as soon as possible for reserve purposes. All claims assigned to our field representatives must be reported to the Home Office before they can be assigned to field personnel. Immediate notice of a claim is essential if our policyholders are to be kept satisfied.
Whenever possible use the on-line Notice of Loss. Please use ACORD forms for all losses. You may order a supply directly from Insurance Services Office, 1 Blue Hill Plaza, P O Box 1529, Pearl River, NY 10965-8529, Telephone 1-800-444-3341 or from the Home Office. You will note that there are two different forms, a Property Loss Notice and a General Liability Notice. A copy should be kept in your file. The forms may appear to be complicated, but they only need to be completed as they pertain to the particular loss being reported. Take the time to get all of the information from the insured that is necessary to properly complete the form. There isn't one question on the notice of loss form that won't serve some purpose. Make sure that we have the telephone numbers where the insured and the claimant, if it is a liability claim, can be reached during the day. If a notice of loss is completed as it should be it will be of great help in determining what to do with a given loss . . . write a letter, make a telephone call, or assign it to an adjuster for handling.
Do not make the mistake of misleading a policyholder. If you know a loss is not covered under the policy, tell the insured so immediately. If you are not sure whether coverage applies to a given loss, tell the insured that you will submit the claim to the Company for consideration. Inform the insured of an applicable deductible; it makes handling a claim much easier for you and the adjuster if the insured is told of the deductible at the time a claim is submitted.
suGGestions on minor losses
Frequently an agent will decide to handle small losses and this, of course, leads to a good relationship between the agent and the policyholder. This is a part of the service you provide to your policyholder and can speed up the handling of smaller value claims. Our agents have never been given a specific dollar authority for handling small claims simply because we believe an agent will handle only those claims with which they feel comfortable and which are within their range of ability. If you have any doubts about handling a specific claim, feel free to call North Star; we'll be happy to work with you.
Often when a loss is reported to your office, a few questions asked of the insured will tell you how to proceed with the claim. If a policyholder reports minor windstorm damage to the shingles on his home and you find that they can be repaired for a few hundred dollars, tell him to have the repairs done and to submit the bill to you. Then send a notice of loss with a notation that repairs are being made and you will submit the bill when the work is completed. A television antenna . . . have it repaired or replaced and furnish the bill. If replacement is necessary, find out the age and so indicate on the notice of loss. Losses on storm doors, small awnings, and similar items can be handled in the same manner. Acquainting yourself with reliable carpenters and repair people in your area that you can rec-ommend to your policyholders or our adjusters will be of benefit.
Occasionally on a smaller claim an insured is able and willing to make repairs. This is fine, and the material bill and the amount of time spent on the task should be submitted to the Company. You may check with the Home Office as to a fair hourly rate for the work and then come to an agreement with the insured to complete the settlement of the claim. Remember that depreciation and betterment are to be considered whenever applicable. Insurance policies are not maintenance policies and only damage that is a direct result of a peril insured against should be considered, not normal wear and tear. Even with replacement cost coverage, an item such as a storm door or an antenna must be replaced with one of like kind and quality, or else an allowance for betterment must be considered.
Losses involving electrocution, suffocation or drowning of livestock must be verified by a veterinarian.
theFt Claims
When you submit a theft claim, in most instances a specifically designed form is mailed directly to the insured along with a letter of instruction. When a theft claim is reported to an agent, the insured should be advised that they will probably be receiving this form and letter directly from the Company to complete and return. A sample of both are enclosed, and they are self-explanatory. As you can see, the form asks for a waiting period of 30 days for possible recovery by the authorities.
If after these theft forms are sent you receive a call for help in completing them, please remind the insured to com-plete the form in detail answering all of the questions asked and provide us with the needed information regarding when and where the stolen items were purchased and what the replacement cost and actual cash value of each item is. When it is determined that the theft loss involves a larger amount of property, the claim will be assigned to an adjuster for handling.
IA, MN, NE, ND, SD
North Star Mutual Ins. Co.
larGer Fire and storm Claims
Whenever possible our own field staff is used to handle claims, especially those submitted under farm windstorm policies. When a situation arises that a particular claim cannot be handled by one of our own field staff, the claim will be assigned to an independent adjuster. Once again, direct assignments from agents to independent adjusters are not authorized unless such authorization is received from the Home Office. If an adjuster is needed immediately, please feel free to call the Home Office at once.
When a large loss occurs necessitating the assigning of an adjuster, the insured should be advised to do whatever can be done to prevent further damage. If personal property or contents is involved, the insured should begin to prepare a list of all damaged or destroyed property. If a building is involved, an estimate of repair from a reliable contractor in the insured's area will be of benefit to the adjuster assigned to the claim and will expedite settlement. In the event of a catastrophe, much the same procedure applies. Temporary repairs can be made to roofs and other openings caused by the storm. Windows may be replaced immediately. Debris from buildings blown down can be moved aside or removed to the extent necessary to carry on normal operations as soon as practical. North Star has in place a Catastrophe Coordinator who will be sent to a storm area to facilitate the handling of claims and to oversee the entire operation. There is a staff of adjusters situated throughout our coverage territory who will be available on short notice to be sent to help in catastrophe storm situations.
aCknowledGment oF Claims
When a claim is received in the Home Office, you and either our policyholder or the claimant (if it is a third-party claim) will receive a written acknowledgment of the claim. If the claim is to be handled by an adjuster, both you and the insured or claimant will be informed as to whom the claim has been assigned and will be given the address and telephone number of that adjuster.
If North Star is simply asking for an estimate of the damages or for some additional information regarding the claim, you will receive this request on your Agents Summary Sheet and the insured will receive a note advising him that you are helping us with the handling of this claim.
summary
The more closely you and North Star work together in the handling of claims the more beneficial it will be for your policyholders. When a serious loss occurs your customers will have difficulty dealing emotionally with the trauma of their home burning or being destroyed in a windstorm or someone being seriously injured on their premises. They will expect professional help from you and North Star in dealing with the physical aspects of such claims. Only through full cooperation between you and North Star can this be accomplished.
aCV loss settlement Guidelines
For shinGles
Roofing materials have a limited lifetime. Roofs wear out due to exposure to the elements
including:
temperature extremes
sunlight
rain
sleet
snow
wind
The expected life of most asphalt shingles is about 20 years and 35 years for cedar
shingles. However, when figuring the Actual Cash Value (ACV) of shingles, use 25 years
and 40 years as shown below.
normal useful
depreciation
life
Per year
Asphalt Shingles
25 years
4%
Organic and Fiberglass
Wood Shingles and Shakes
40 years
2.5%
P O Box 48 Cottonwood MN 56229 - 0048 507-423-6262 Fax 507-423-6323
theFt loss statement
to north star mutual insuranCe ComPany
ConCealment or Fraud:Coverage is not provided for any insured who has intentionally concealed or misrepresented any material fact or circumstance relating to this insurance or claim.
POLICY NO. _______________________________ CLAIM NO. ______________________________________
insured:
NAME _____________________________________________________________ PHONE _____________________ ADDRESS _______________________________________________________________________________________ Location or place of theft ____________________________________________________________________________ _________________________________________________________________________________________________ Date of theft _____________________ Time discovered _________________ Discovered by ______________________ Name and Location of Police Department _______________________________________________________________ Date reported ____________________ Case No. and Investigating Officer _____________________________________ _________________________________________________________________________________________________ Damage to Premises _______________________________________________________________________________ Was theft from your primary residence? _______________ If not, where was the property at time of theft? ____________ _________________________________________________________________________________________________ If theft from auto, boat, tractor, or other vehicle, was property securely fastened to such vehicle? ____________________ Was vehicle on your own premises? ____________ If not, where was it? ______________________________________ Was property missing from inside a vehicle? ___________ Were all doors and windows closed and locked? ___________ What evidence indicated theft? _______________________________________________________________________ What evidence indicated forcible entry? _________________________________________________________________ Do you have other insurance on property? _____________ If so, give amounts and companies _____________________ _________________________________________________________________________________________________ Fully describe circumstances of theft: __________________________________________________________________ _________________________________________________________________________________________________ _________________________________________________________________________________________________ _________________________________________________________________________________________________ _________________________________________________________________________________________________ _________________________________________________________________________________________________ _________________________________________________________________________________________________ _________________________________________________________________________________________________ Suspects: ________________________________________________________________________________________ Have the police been provided a complete list and description of the property taken? Yes No
If no, give date supplementary report filed _______________________________________________________________ (Note: Consideration will be given only to those items that are reported stolen to police)
Have you had a theft loss before? ___________ If so, Date of loss? ______________ Amount of loss? ______________ What was stolen? __________________________________________________________________________________
Please use the reverse side of this report to describe the damaged or stolen property. inadequate descriptions or lack of adequate proof of ownership can cause delay in processing your claim.
in
Vent
or
y
o
F
destroyed
/
lost
P
ersonal
P
ro
Perty
(this includes only property that cannot be cleaned or repaired.)
be grouped together
. This includes movies, CDs, jeans, etc.
loss
d
ate:
insured:
Location of Item at the
Time of Damage/Loss
Retailer Purchased From
Method Date Receipts Amount Current Estimated Leave
(If in room, car
, etc.; specify where
(Include city , state if possible) of Acquired A vailable ? Paid Replacement ACV column Specifications, Etc.) within room, car , etc.)
Online? If gift, from whom?
Payment (Mo/Yr) Yes No For Item Cost of Item blank ear
, Deterioration, Obsolescence, and Lessening of value due to all factors.
after settlement, would you be willing to purchase from Company for settlement figure? ______________________________ _________________________
O DEFRAUD OR HELPS COMMIT
A FRAUD AGAINST AN INSURER IS GUIL TY OF A CRIME. Signature of Insured _____________________________________________ Signature of Insured ______________________________________________ TO tals Page ______ of ______
RE: Insured: Policy No.: Claim No.: DEAR POLICYHOLDER:
We are anxious to quickly process the claim you have made on your insurance policy. Your prompt and careful attention to the enclosed forms will help make this possible.
theFt loss statement
Please fill in all blanks on both sides. Full details of all requested information will prevent unnecessary delays. Please include a full description of each stolen item including the type of item, its make, model and any other information about its quality. attach all original invoices, cancelled checks, bills of sale, credit card receipts or any other documents that you have which would help verify values and show purchase information. it is important that all insureds sign this form.
authoriZation For release oF PurChase inFormation
many stores and other vendors require their customer’s permission before releasing purchase information. your signature on this form will enable us to help you verify your claim.
Your insurance policy contains a condition which states that you must “...notify the police when the act causing the loss is also a violation of law;”. In other words, it is necessary for you to immediately notify the police authorities before you can make a claim under this policy.
Before returning the enclosed forms to us, it would be helpful if you would give the police authorities at least two weeks to investigate and possibly recover the property which was stolen from you. Please contact the police department to determine whether or not they have made any progress in their investigation. You will note that there is a question on the “Theft Loss Statement” form that calls for information about recovered property.
There is an enclosed return envelope for your convenience. If you have any questions, please don’t hesitate to call us.
Claims Department Enclosures CF-356 (Ed. 11-13) P O Box 48 Cottonwood MN 56229 - 0048 507-423-6262 Fax 507-423-6323 www.northstarmutual.com