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Article 9 Claim Procedures

IA-BOD-RES 3/2010 Effective from 21/3/2010

When processing a claim submitted thereto by a Client, the Company shall comply with the following:

  1. Set a mechanism for processing claims submitted thereto, including:
     
    1. Preparing claim forms according to the respective type and class of insurance to be provided free of charge to the Insured or the Beneficiary. Such forms shall be written in a clear language and shall define the information required to be provided by the Insured or the Beneficiary.
       
    2. Defining the documents that should be submitted for the examination and settlement of the claims.
       
    3. Specifying an appropriate period of time for the settlement of the submitted claims.
       
  2. Settle the claims without undue delay in accordance with the provisions of the law and the terms and conditions of the Policy.
     
  3. Inform the Insured or Beneficiary of the progress in the examination of the claim and the date of issuing a decision thereon whenever anyone of them so requested.
     
  4. Notify the Insured or Beneficiary when the examination of the claim is completed, whether by approval or disapproval, within 15 days as of the date of receipt of the complete documents. If there is any reason requiring a longer period, the Company shall notify the Client of such period with the reasons thereof.
     
  5. The Company shall pay to the Insured or Beneficiary the payable amount without delay in case the claim was approved and the parties agreed on such amount. Accordingly, the Insured or the Beneficiary shall sign a document to discharge the Company, a subrogation or a transfer of rights (if reasonable required) when the amount of indemnity is paid.
     
  6. If the Company rejects a claim, in total or in part, it shall inform the compensation requester about the reasons for such rejection in writing. The reason for rejection may not be in general and inaccurate expressions. In addition, a rejection may not be simply due to failure by the compensation requester to carry out certain procedures or provide certain data, unless such procedures or data are necessary to verify the accident and its causes, or the size of damage it has caused, or are required to enable the Company to exercise its legally established right of recourse.
     
  7. Subject to the condition of the Policy, the Company may take, on its own initiative, action to repair or replace property of the Insured as soon as possible, provided that such action is consistent with its obligations.
     
  8. In case of multiple items of the claim where the dispute is related only to some of them, the Insured or Beneficiary may claim compensation related to the items agreed thereupon under the final settlement.
     
  9. The Company shall maintain a special file for each claim where all relevant correspondence, reports and documents are kept for reference in performing the control or audit task.