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ORM Property Claims. Blanket Property Boiler & Machinery Employee Bonds Crime Policy Bridge Property Damage. P.O. Box 91106 70821-9106 James.Lea@LA.gov. First party claims involve our Insured Agencies and Employees.
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ORM Property Claims Blanket Property Boiler & Machinery Employee Bonds Crime Policy Bridge Property Damage
P.O. Box 91106 70821-9106 James.Lea@LA.gov
First party claims involve our Insured Agencies and Employees. ORM is contractually obligated to cover 1st Party losses, unless the premiums are not paid. Third party claims involve individuals who are making a claim against one of our User Agencies. ORM is obligated to defend and indemnify claims against the User Agencies. 1st Party Vs. 3rd Party Claims
What to do after a property loss or accident • Notify ORM Claims Department using telephones, facsimile, electronic mail, or by traditional correspondence; • Mitigate your damages, or try to prevent additional damage to property; • Preserve evidence & establish a chain of possession involving as few people as possible; • Photograph the damages when possible; and • Notify police and other authorities when appropriate.
Employee Bond Policy • Discovery Period for Loss: We will pay only for covered loss discovered no later than one year from the end of the policy period. • Duties in the Event of Loss: After you discover a loss or a situation that may result in loss of, or loss from damage to, Covered Property you must: • Notify us as soon as possible. • Submit to examination under oath at our request and give us a signed statement of your answers. • Give us a detailed, sworn proof of loss within 120 days. • Cooperate with us in the investigation and settlement of any claim.
Blanket Property Policy • Duties In The Event Of Loss Or Damage • You must see that the following are done in the event of loss or damage to Covered Property: • Notify the police if a law may have been broken. • Give us prompt notice of the loss or damage. Include a description of the property involved. • As soon as possible, give us a description of how, when and where the loss or damage occurred.
Blanket Property Policy cont. • Take all reasonable steps to protect the Covered Property from further damage, and keep a record of your expenses necessary to protect the Covered Property, for consideration in the settlement of the claim. This will not increase the Limit of Insurance. However, we will not pay for any subsequent loss or damage resulting from a cause of loss that is not a Covered Cause of Loss. Also, if feasible, set the damaged property aside and in the best possible order for examination. • At our request, give us complete inventories of the damaged and undamaged property. Include quantities, costs, values and amount of loss claimed. • As often as may be reasonably required, permit us to inspect the property proving the loss or damage and examine your books and records.
Blanket Property Policy cont. • Also permit us to take samples of damaged and undamaged property for inspection, testing and analysis, and permit us to make copies from your books and records. • Send us a signed, sworn proof of loss containing the information we request to investigate the claim. You must do this within 60 days after our request. We will supply you with the necessary forms. • Cooperate with us in the investigation or settlement of the claim. • We may examine any insured under oath, while not in the presence of any other insured and at such times as may be reasonably required, about any matter relating to this insurance or the claim, includingan insured’s books and records. In the event of an examination, an insured’s answers must be signed.
Boiler & Machinery Policy • Duties In the Event of Loss or Damage • You must see that the following are done in the event of loss or damage: • Give us a prompt notice of the loss or damage. Include a description of the property involved. • As soon as possible, give us a description of how, when and where the loss or damage occurred. Allow us a reasonable time and opportunity to examine the property and premises before repairs are undertaken or physical evidence of the “accident* is removed. But you must take whatever measures are necessary for protection from further damage.
Boiler & Machinery Policy cont. • Permit us to inspect the property and records proving the loss or damage. Also permit us to take samples of damaged property for inspection, testing and analysis. • If requested, permit us to question you under oath, at such times as may be reasonably required about any matter relating to this insurance or your claim, including your books and records. In such event, your answers must be signed. • Send us a signed, sworn statement of loss containing the information we request to settle the claim. You must do this within 60 days after our request.
Boiler & Machinery Policy cont. • Cooperate with us in the investigation or settlement of the claim. • We may examine any insured under oath, while not in the presence of any other insured and at such times as may be reasonably required, about any matter relating to this insurance or the claim, including an insured’s books and records. In the event of an examination, an insured’s answers must be signed.
Crime Policy • Discovery Period for Loss: We will pay only for covered loss discovered no later than one year from the end of the policy period. • Duties in the Event of Loss: After you discover a loss or a situation that may result in loss of, or loss from damage to, Covered Property you must: • Notify us as soon as possible. • Submit to examination under oath at our request and give us a signed statement of your answers. • Give us a detailed, sworn proof of loss within 120 days. • Cooperate with us in the investigation and settlement of any claim.
How to File a Claim • Fax, phone or email reporting is preferred. • ORM’s website does not contain any Property Loss reporting form, but the CGL form can be used instead. • We need to know who, what, when, where and how. • Each line of insurance coverage, or type of claim is different, and has different reporting requirements.
Most claims are based upon the date of loss. Most claims expire or prescribe 12 months after the date of loss. Most losses can be reported anytime during this 12 month prescriptive period, but should be reported as soon as possible. Employee bond claims are based upon the date of discovery. The employee bond policy requires that the claim be reported within 90 days of the discovery date. The suspect employee must be identified when the loss is reported. Date of Loss Vs. Discovery Date
How Claims Are Processed • The very first activity that an adjuster should accomplish upon receiving a new claim is to verify coverage. In the private world, that means finding the policy number, and making sure it has not been cancelled. If there is any doubt about coverage, a reservation of rights letter may be issued to the Insured.
Prompt Set-up of Claims • ORM Policies & Procedures require that all new claims be entered into our computer system and acknowledged to the User Agency within 72 hours of receipt.
STARS • Previously, we could establish a claim number without entering the claim into the computer, but now all claim references are determined by our computer system, STARS.
Independent Adjusters • Over the years, our procedures for investigating claims have changed, especially in regard to the use of Independent Adjusters. Twenty years ago, we were required by our Excess Carriers to use certain independent adjusters under specific circumstances. During the past several years, we have assigned fewer and fewer claims to independent adjusters.
Purchasing Rules • Simply because ORM will be the funding source, does not mean that a User Agency can ignore Purchasing Rules that govern their particular Agency. ORM Claims Adjusters never generate Purchase Orders, and never authorize any repairs. Only the “owner” or “custodian” of the damaged property can authorize repairs.
Proof of Ownership • In the past, it was easy to document ownership, acquisition cost, and date of purchase by providing a copy of the Property Control print-out on each “Content” item, but now only those items that initially cost more than $1,000 are required to be tagged and entered into Protégé. Now we often have to use old Purchase Orders or Vendor Invoices to document ownership and original cost details.
All damaged items should be labeled or tagged with the correct ORM claim number before being sent to Louisiana Property Assistance Administration (LPAA) for disposal as any salvage received from auction is supposed to benefit ORM, and thereby reduce the net claim amount, which in turn reduces the User Agency’s future premiums. Salvage
SLABS • If a building is severely damaged, we utilize the State Lands & Buildings System (SLABS) to determine the value of the building. This is why we ask for the Building ID number.
Depreciation • All moveable property, as opposed to real property, is subject to depreciation. Theft of, and damage to computer equipment involves a large portion of our claims. Nearly all computer equipment depreciates over a three year period, or 33% each year. DOTD seems to use a 20 year depreciation scale for mobile equipment, but we rely upon vendors and dealers to develop current market values.
Vendors-Reimbursements • If a User Agency wants to be reimbursed for repairs or replacement of damaged property, the Agency must provide proof of payment; However, if the Agency wants ORM to pay the vendor, we simply need payment instructions from the Agency. Of course W9 tax forms are now required before ORM can issue any payments.
