Reporting a Claim or Incident

Claims reporting procedures are somewhat different depending upon the Insurer and type of policy.  To follow is a general outline of procedures for:

 

Animal Life and Health Insurance Policies

Liability Insurance Policies

Property Package Insurance Policies

 

Animal Life and Health Insurance Policies

THIS IS VERY IMPORTANT.  PLEASE GIVE THE REQUIREMENTS TO ANYONE

WHO IS RESPONSIBLE FOR THE CARE OF YOUR INSURED ANIMALS.

 Should an insured animal become sick, lame, or injured, you (the insured) must perform certain actions to secure the validity of your insurance: 

1. Immediately secure a qualified veterinarian, at your expense, to give proper care for the animal and to use every means to preserve the life and usefulness of that animal.
2. Immediately notify the insurance company by phone, fax, or e-mail.  Emergency claim reporting numbers are located on your policy, and round the clock service is available. The notice should include:  a. Policy number b. Name of the animal  c. Nature of the injury or illness  d. Date injury or illness took place  e. Name and contact information of the attending veterinarian   f. Your name and contact information.
   
3. If an insured animal is injured or sick to a degree that may necessitate humane destruction, permission must be obtained by the Insurer prior to doing so.   Sometimes extenuating circumstances involving trauma injury may require humane destruction without consent.   Such may be the case if an animal is mortally injured in a public roadway and a person in a position of authority, such as a policeman, patrolman, or conservation officer is available to provide proof and documentation for the reason of humane destruction.
4. In case of theft, shooting, malicious injury or death, or an accidental vehicular loss, call a police authority and request a written report from that person concerning the incident  In cases involving attack by wild animals or stray dogs, a conservation officer or animal control authority may need to be notified for a report.

 Should an insured animal die, or you believe you may have a claim due to a health condition you must:

1.      Immediately notify the insurance company by phone, fax, or e-mail advising them of the type of claim you wish to open.  The notice should include:  a. Policy number  b. Name of the horse  c.  Nature of the loss  d. Date of loss e.  Name and contact information of the attending veterinarian  f.  Insured’s name and contact information

2.     If the animal has died suddenly and without apparent cause, prepare to arrange for a necropsy (autopsy), as the company claims adjuster will likely request this. Do not remove the body of the animal until the claims adjuster authorizes you to do so.

 PROCESSING YOUR CLAIM

Our company claims examiner (adjuster) will provide you with instructions on how to navigate through the claims procedures.  What is requested will depend upon the type of claim and circumstances leading to loss.  However, these documents are usually required to complete the process:

• Attending Veterinarian Report
• Original Breed Registry Certificate or Breeder’s Certificate
• Proof of Ownership, Bill of Sale or Cancelled Check for Purchase of the Animal
• Owner’s Version of the Occurrence that Caused the Loss
• Trainer’s, Handler’s, Stable Manager’s Version of the Occurrence That Caused Loss (If applicable)
• Breeding Record, Racing or Show Record (If applicable to claim)
• Police, Fire or other Authority Reports (If applicable to claim)
• “Proof of Loss” Form (Provided by the Insurer; complete all questions, sign and date it, and have it notarized.
• Release to Pay Form

 The best way to hasten the time between a loss and payment is to give the company adjuster a prompt response to all requests for specific items.  In addition, a quick response from the attending veterinarian and their reports should result in expedient claim payment.

Ark Agency Animal Insurance Services

310 Washburne Ave., PO Box 223

Paynesville, MN  56362

Ph:  800-328-8894 or 320-243-7250

Fax:  320-243-7224

E-mail: insurance@arkagency.com

Liability insurance protects you when you become legally obligated to pay sums as damages because of “bodily injury” or “property damage” occurring to clients or other people in relation to your insured business activities as stated in your liability insurance policy.

In the event of such an occurrence, the Insurer has the right and duty to defend any “suit” seeking those damages, whether groundless or substantial.  And the Insurer may at its discretion investigate any “occurrence” a settle and claim or “suit” that may result, up to the limits of and within the scope of your insurance policy.

As third party coverage, this type of insurance does not pay the Named Insured, his or her family members, or the officers of your company for damages or injuries they may incur.  This type of coverage also does not pay for the damages or injuries incurred by employees, contract laborers, exchange laborers, and volunteers working on the Insured’s behalf.  Worker Compensation and Employer’s Liability Insurance are not part of the general liability policy.

INSTRUCTIONS FOR

LIABILITY INCIDENT OR CLAIM REPORTING

AND RELATED MATTERS

 When an Incident, Accident, or Claim occurs, proceed as follows:

 1.   Notify Ark Agency immediately by fax or e-mail and/or by forwarding a written First Report.  Send to address or numbers listed below.   Do not hesitate to call if you have questions.

Use NAHA Form 14:  FIRST REPORT – INCIDENT / ACCIDENT / CLAIM

 

2.  Have all staff members who were witnesses to the incident or involved, immediately complete the Staff Witness Reports. Make additional copies of the forms as needed.  Fax, e-mail or mail these to Ark Agency along with the First Report.

Use NAHA Form 210:  STAFF WITNESS REPORT

 3.  If a horse caused or was involved in the reported accident and was being ridden, driven, or used in some way by the public as part of your business operations, you may be required to remove the horse from public use until NAHA risk managers can determine if the horse can again be placed back into public-use.  Most horses can be reintroduced back into public use within 2 to 14 days.  This request will usually be made when the horse acted to cause a serious injury and / or when a horse acted in one or more of the fol1owing ways:  ¬Ran out of control and could not be stopped within 50 feet.  ­ Bucked and threw a rider.  ® Kicked, causing injury to a person or animal. ¯Laid down or fell down for no obvious reason.  °Reared and unseated rider.  ± Bit without provocation and caused injury to a human.  You may be required to take one or more of the following actions to prepare the horse for re-use. ¬ Have the horse vet checked. ­  Re-school the horse for up to 5 hours. ® Test the horse for Remembrance Reaction or action tendencies that caused the accident.

Your underwriter at Ark Agency will turn your First Report and attachments over to Insurance Company Claims Examiners the same day received.  An insurance company claims examiner and a claim number will be assigned to your incident. The Claims Examiner will investigate the incident to determine liability and whether payment of any claims or medical expense is appropriate in each case.  It is the Claims Examiner’s responsibility to gather the facts and to protect your interests.  It is your responsibility to cooperate fully with the examiner and to complete your reports as completely as possible.

Should you receive a letter from an attorney or a law suit summons, it must be turned in to the adjuster and the Insurance Company immediately.  Serious legal ramifications can result from the Insured not responding to a summons and complaint made against him within the required timeframe.  The Insurer will usually handle it, but it must be provided to them immediately.

 PLEASE DO NOT:

*  Do not admit responsibility for an incident, accident or injury.  Do not state or promise to anyone that damages or injury costs will be paid for by you or your Insurance Company.   Discuss such issues with your Claims Examiner and follow his or her instructions.

*  Do not divulge information about your insurance coverage.  Your policy, policy number, Insurance Company name, liability limits, and coverages should be kept in strict confidence for your own protection.  Confer with your adjuster before divulging this type of information to anyone and follow his or her instructions.

 *  Do not discuss an accident or injury with anyone other than your authorized Insurance Company adjuster, insurance agent, Ark International Group personnel, or attorney who is assigned to your incident by your Insurance Company.

NORTH AMERICAN HORSEMEN’S ASSOCIATION (NAHA)

HORSEMEN OF NORTH AMERICA SAFETY CONTROL PURCHASING GROUP

Ark Agency Animal Insurance Services

310 Washburne Ave., PO Box 223

Paynesville, MN  56362

Ph:  800-328-8894 or 320-243-7250

Fax:  320-243-7224

E-mail: insurance@arkagency.com

 

Property Package Insurance Policies

People purchase property insurance coverage to be reimbursed for costs of certain types of losses to their property as it is insured under the policy.  Property Insurance claims usually involve light to severe damage to the Insured’s house and / or household contents, garage, outbuildings or other structures, machinery, equipment, valuables, and other personal and business property that is insured under a property package or property insurance policy.  The most common causes of such claims are weather-related, such as lightning, windstorm, and hail, fire or smoke damage, theft, vandalism, collision and / or overturn.

In the event of a property claim, contact your agent immediately to file a report.  You may do this by phone, fax or e-mail. The agent will need:

 1.  Your Name and Address

2.  Named Insured on the Policy

3.  Your contact numbers – Phone Numbers, e-mail, Fax

4.  Insurance Company Name (In force at time of incident)

5.  Policy Number (In force at time of incident)

6.  Date and Time of Occurrence

7.  Types of Property Damaged

8.  Cause of Damage

9. Type of Damage Incurred

10. Physical Location Where Damage Occurred

11. Severity of Damage

12. If your dwelling is severely damaged, you’ll need to advise if you cannot live in it at the present time.

A claims representative will be assigned to your claim, and he or she will call you and guide you through the claims process. Your claim will be assigned a claims number for easy future reference when you speak with claims representatives or when you submit written reports.

Depending upon the nature of the damage, values must be established for the damaged property.  Loss settlement procedures may be different in your state.  Your policy and state law governs timing of processing and payments, as well as percentages of or amounts paid for items or building damage. How much you are paid will depend upon whether coverage is based on actual cash value or replacement cost.  Establishing values may involve making inventory lists of insured items, and some items will require brand names, model numbers, age of items, purchase price, place of purchase.  Establishing values may involve getting contractor or repair bids.  Sometimes an engineer will be assigned to assess the damage.  A claims adjuster or examiner may visit your premises to see and photograph the damage.

• If your claim involves damage by a licensed vehicle or the occurrence happened on a public roadway, a police report will likely be required.
• If the claim is due to theft or vandalism, you will need to contact police so they can issue a report.
• If the damaged property was mortgaged or financed, contact the financing company about the damage shortly after you report your claim to your agent.  Ask about the company’s procedure for endorsing your claim payment as procedures vary.
• If you are in a broad area disaster, and your damage is slight, you may have to wait a bit for adjusters to take care of more severely damaged properties first. 

Ark Agency Animal Insurance Services

310 Washburne Ave., PO Box 223

Paynesville, MN  56362

Ph:  800-328-8894 or 320-243-7250

Fax:  320-243-7224

E-mail: insurance@arkagency.com

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*General information is provided on this insurance topic.  Acting on our coverage recommendations does not guarantee coverage if you have a loss or claim.