Claim practice of property management liability insurance

The claim settlement of property management liability insurance refers to the management accident that causes personal injury or property loss to a third party due to the negligence or negligence of the insured. According to the provisions of the insurance contract and within the compensation limit stipulated in the insurance policy, the insured shall bear the economic compensation liability (including litigation costs) to the third party.

(1) responsibility audit

The insurer shall, according to the relevant documents provided by the insured, comprehensively analyze the subjective and objective reasons, abide by the terms and relevant regulations, and determine whether the accident belongs to the insurance accident in combination with its own investigation of the claim. To review the insurance liability, it is necessary to determine whether to pay or refuse to pay according to the scope of liability and exemption reasons listed in the clause. When determining responsibilities, the following points should be noted:

1. Whether the accident occurred within the validity period of the insurance. The insurer is not responsible for compensation for accidents that occur before or after the validity of the insurance.

2. Whether the insured has formally filed a claim with the insurer within two years since he knew or should have known about the accident. If it is more than two years, the insurer shall not be liable for compensation, except that the litigation activities occur within the effective claim period and the closing time exceeds the effective claim period.

3. Whether the location of the accident is within the scope of the project entrusted by the insured as stated in the policy.

4. The cause of the accident belongs to insurance liability or extended coverage.

(2) Compensation calculation

1. Compensation processing method. The compensation treatment of property management liability insurance is based on the provisions of property management liability insurance clauses, and within the compensation limit stipulated in the policy, the court or relevant government departments determine the amount that the insured should pay according to law or the parties negotiate with the insurer. Under normal circumstances, accidents that have been confirmed to be within the scope of insurance liability should be resolved through consultation in time. If no agreement can be reached or there is a big disagreement, it will be resolved through legal channels, and the court decision will serve as the final basis for the insurer's compensation.

2. Compensation calculation. In the case of determining the insurance liability and verifying the loss, the insurer may calculate the indemnity according to the compensation treatment method stipulated in this article, as follows:

The amount of compensation for personal injury or property loss to a third party and the total amount of arbitration and litigation expenses with the prior written consent of the insurer shall not exceed the compensation limit for each accident or the additional insurance limit listed in the insurance policy schedule, and the compensation limit for personal injury or death shall not exceed the compensation limit for each person. The excess shall be borne by the insured.

(1) The property losses of the third party shall be determined according to the amount determined by the court or arbitration award, or the compensation shall be calculated according to the list of property losses and the liability of the insured in the accident. If there is a deductible, it is necessary to deduct the deductible for property losses in each accident, which is an absolute deductible.

(2) Compensation for personal injury or death of a third party shall be paid for the insured's responsibilities in the accident according to the amount determined by the court or arbitration award, or according to documents such as disability, death certificate and medical fee receipt issued by relevant departments, and referring to national laws and relevant regulations of relevant government departments.

(3) The compensation for litigation costs with the prior written consent of the insurer generally includes litigation fees, defense fees, attorney fees, evidence collection fees, etc. , according to the amount decided by the court or the actual arbitration fee.

After the insurance liability accident, the compensation for the necessary and reasonable expenses paid by the insured to reduce or reduce the liability for personal injury or property loss to a third party shall be calculated separately from the compensation for personal injury or property loss to a third party and the litigation expenses, and can be calculated according to two compensation limits per accident, and each limit shall not exceed the compensation limit per accident. The compensation for this expense should be based on the premise that the expense is really necessary and reasonable.

(3) Compensation for double insurance

When a claim within the scope of insurance liability occurs, if other insurance covers the same liability or any part of the liability, the insurer will pay the relevant compensation in proportion to the liability limit.