Claims And Conflict Of Interest

The claims industry is not immune from Conflicts of Interest, and independence is amongst the key criteria which needs to be considered when appointing a consultant to prepare a claim.

For example a conflict of interest may arise if the consultant accepts engagements from both the Insurer and Policyholder. A Policyholder needs to be satisfied that the presentation of their claim is free from any working relationship the consultant may have with the Insurer.

A conflict may also arise if the consultant is also the Policyholder’s auditor. Both the Policyholder and Insurer need to be content that the claim presentation is free from any need to retain a larger audit role.

One event can often lead to a series of claims affecting many parties e.g. one fire may affect a tenant, landlord, customer and supplier. The consultant must be aware of the relationships and avoid situations that may cloud their judgement. The Pan Pharmaceuticals product recall that occurred in Australia in April 2003 is a prime example. It would be difficult to prepare the claim for Pan as well as its affected customers.

See Also: - Choosing a Claim Preparer

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Author

Published with permission of Claim Solutions Pty Ltd 

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Insurance Policy

Country: - Australia

Policy Description: - Various

Insurer: - Various

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External Links

 

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