MOTOR CLAIMS STAKEHOLDERS WORKSHOP The workshop was held on 9th September 2010 at Sarova Panafric Hotel. One hundred and twenty participants attended the workshop. The following topics were presented: 1. Overview of Motor Insurance Claims by Mr M Mukoma - Convenor, Motor Technical Committee. 2. Motor Claims Malpractices - Motor Assessors’ Perspective by Mr Mirichu Nderitu - Motor Assessors Association of Kenya (MAAK). 3. Motor Claims Malpractices - Motor Investigators’ Perspective by Mr Mike Munyoki - National Association of Kenya Investigators (NAKI). 4. Motor Claims Malpractices - Motor Repairers’ Perspective by Mr Nasir Karmali - Kenya Automobile Repairers Association (KARA). During the plenary session, participants were asked to list the various malpractices done by the stakeholders. Their contributions are below:- 1. INSURERS MALPRACTICE COUNTER MEASURE 1. Poor underwriting practices in risk Garages should seek dialogue with evaluations underwriters on effect of not paying in 2. Collusion of staff e.g. soliciting good time. Should seek alternative commissions survival 3. Lack of integrity in creating panels Proper underwriting 4. Delayed payments and adjustments of Adhering to IRA guidelines fees without consultations Integrity 5. Backtracking on agreements Treat service providers equally 6. Invoices not paid on time Honour agreements 7. Accepting inflated sums insured Payment on time to avoid 8. Windscreen claims on vehicles with inconveniencing garages who take out 9. pre-existing cracks loans and are charged interest on 10. Lack of integrity (release letters not defaulting properly worded) Valuation should be done 11. Back dated insurance covers Letters should be clear and avoid 12. Laxity to follow up on documentation ambiguity on what is clear, payment 13. Not being strict on claim notification should be done duration Stop giving certificates to intermediaries 14. Too much involvement in filing claim Strict underwriting contract forms by service providers Stop deciding which late notified claims 15. No explanation of what is on the unless with proper reason proposal form Only allow insured to fill in claim form 16. Valuations Education of the insured 17. Intermediaries Insurers should insist on mandatory 18. Motor claims staff colluding with service valuation for all vehicles providers to allocate work selectively No insurance through a phone call or 19. Hiding/misplacement of files logbook 20. Sleeping on cheques Should be done by an independent 21. Receiving Kitu Kidogo valuer 22. Not taking into account Agents and brokers should not play any recommendations of assessors role in the motor claim process. 23. Pushing service providers to sign SLAs No filing of claim forms or choosing they have not agreed on garages for insureds 24. Leaking confidential information to Staff monitoring have a system of parties who should not have it allocating work by rotation 25. Deduction of fee without consultation Senior management should be involved with service providers and review the process 26. Asking for documents not in the hands Intentionally to induce the service of service providers e.g. DL provider to part with something 27. Delayed payment of service to service Should implement systems of fees providers settlement, not individualized The delayed fees should also be reported to senior management. 2. ASSESSORS MALPRACTICE COUNTER MEASURE 1. Incompetent assessors Hire qualified assessors 2. Exaggerated reports Assessors should give regular updates on 3. Unqualified assessors or investigators jobs they are handling Have NAKI 4. Assessors compromised by garages or members on panel insured’s to inflate repair costs They should all be members of MAAK or 5. The assessors/investigators contacts NAKI 6. Rogue/unqualified assessors not able Reasonable time in settlement of service to do proper job - report providers fees to empower them 7. Assessors who do not visit garages Rogue assessors to be removed from but just get photos from garages - do MAAK register report Should not be released to the brokers or 8. Assessors doing reports which have insureds not been agreed and signed by the The assessors reports should be garages confidential and should not be disclosed 9. Use of non MAAK members to the brokers 10. Lack of proper i.e. inspection report – Report cases to Association for no photos disciplinary action 11. Lack of follow up on repairs by Employees of MAAK members should assessors also be vetted 12. Variations in estimates between pre- MAAK & KARA to meet and agree on the insurers and accident assessment way forward 13. Assessors offering inducement to Use MAAK members insurance claims employees Not the work of assessor to monitor 14. Assessors do reports in favour of repairs unless required garages for fear of being locked out Rotation as much as possible 15. Delay in submission of report SLA 16. Deliberate inflation of repair costs in order to write off 17. Authorizing inclusion of parts that are not necessary 18. Borderline cases: assessors get compromised by garage not to write off even if necessary 19. Rare models - lack of guidance on how to handle these cases 20. Divulging information on the assessment to the insured before work is completed 21. Allowing parts that will not be replaced for the purpose of making 22. Use of digital photos 3. INVESTIGATORS MALPRACTICE COUNTER MEASURE 1. Substandard reports Need qualified staff/training 2. Delayed reports Improvement of payments 3. Being compromised on fraudulent Integrity/payments claims Trainings /have NAKI members on panel 4. Prescribe possible solution Appoint investigators in good time 5. Incompetent investigators Vet investigators integrity 6. Delayed reports Look for all available evidence and 7. Investigators colluding with claimants submit it 8. Unsupported conclusions in reports Work with NAKI members that cannot be supported in courts Report to NAKI for disciplinary action 1. scenes of accident 2. Leaking information to third parties 3. Coming up with information that cannot be authenticated for purpose of getting work from other companies 4. GARAGES MALPRACTICE COUNTER MEASURE 4. Theft of parts/vandalization Proper storage 5. Delay in completion of repairs – Cooperation by towing personnel underwriters loosing on car hire Pay cash in lieu extensions Advise underwriters immediately 6. Putting damaged parts and removing Integrity by parts collectors after assessment Disciplinary by Associations 7. Payment of commissions Government involvement 8. Inflated costs. The market price should prevail 9. Competence of garages. Only vehicles below 3 years should be 10. Submitting invoices not fully repaired at dealers workshops to attract supported as required higher discounts 11. Exaggeration of claims/damage/repair Some are not capable of undertaking cost large jobs especially on chassis repairs. 12. Causing more damage on the vehicle Vehicles should be towed to garages that is not accidental with the equipment. KARA to assist 13. Paying brokers commission Fully supported invoices, re-inspection 14. Garages influencing claims staff to reports, purchase receipts, parts have them as choice repairers collection notes 15. Paying inducements to interested Garages should seek dialogue with parties underwriters on effect of not paying in 16. Panel beating instead of replacing good time. Should seek alternative with new parts. survival Stop this/garage panel Tell brokers to negotiate for higher commission with IRA Proper control systems by underwriters Cut out the brokers Timely payment of garages Use of KARA members only Assessor to monitor and give a report. A stakeholders meeting will be held to discuss the report.
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