This course explains that the first party property insurance policy places multiple conditions on the person or entity insured to, at the very least, cooperate with the investigation of the insurer and to treat the insurer with good faith and fair dealing. The duties include, but are not limited to, giving prompt notice to the insurer, protecting the property from further damage, permitting the insurer to inspect the property, producing books and records, assisting the insurer in creating a scope of loss, producing documents and submitting a sworn statement as proof of loss. If the insured and the insurer cannot agree on the amount of loss, they must submit to “appraisal” a form of arbitration limited to establishing the amount of loss.
The course covers the following:
- The duties a policy of first party property insurance imposes on the insured.
- The duties are basically a requirement that the insured fulfill all policy conditions.
- The use of an “appraisal” to resolve disputes over the amount of loss.
- The “Concealment, Misrepresentation, or Fraud” condition of the policy and how the insured can avoid its use to defeat its claim.
- The hazard faced by an insured who fails to fulfill the conditions of the policy.
- The need of the insured to prove his or her loss.
- The use of a public insurance adjuster.
- How the covenant of good faith and fair dealing assists the insured who does not fully comply with policy conditions.
Learning Objectives
- Recognize how the insured’s cooperation is necessary to resolve a claim
- Explore the duties that must be fulfilled before a policy claim can be resolved.
- Recognize how to fulfill the detailed conditions required of the insured.
- Recognize how to cooperate with the insurer to resolve claims.
- Explore that the covenant of good faith and fair dealing applies to the insured as well as it applies to the insurer.
- Identify what the insurer needs to obtain from the insured before a settlement can be reached.
- Explore the obligations of the insured to assist in the processing of a claim.
Included In Certifications
This course is included in the following Certification Programs:
16 CoursesCorporate Property Insurance Certification
- Introduction: Excellence in Claims Handling
- How to Acquire a First-Party Property Insurance Policy
- How to Read and Understand an Insurance Policy
- The Necessity of an Honest and Complete Insurance Application
- The Basics of the Law of Contracts for the Insurance Professional
- Ethics for the Insurance Professional
- What is the Problem with Fraud?
- Interviewing Techniques for the Insurance Professional
- Investigation of a First-Party Property Insurance Claim
- The Creation of a Scope, Statement, and Proof of Loss
- The Duties of an Insured Presenting a First-Party Property Claim
- The Insurance Examination under Oath (EUO)
- Insurance Fraud Prevention
- Compliance with Special Investigation Unit Regulations
- Compliance with Good Faith Settlement Practices Regulations
- The Obligations of a Public Insurance Adjuster
Prerequisites
No Advanced Preparation or Prerequisites are needed for this course. However, it is recommended to take the other courses in the series prior to completing this one.