Claims management

CLAIMS MANAGEMENT

Our methodology

Our claims handling protocol guarantees effective, timely and decisive attention to any company's claims.

Start-up, direction and strategy

Data collection of the incident or complaint.
Preliminary study of the cause of what happened and initial determination of responsibilities.
Creation of an incident or claim file, based on the declaration of the claim by the injured party.

Registration

Opening of a specific file for each incident or claim report and its follow-up.

Registration of the case in the computer system and assignment of a unique file number that identifies it and facilitates its administration and follow-up, as well as that of all the documentation related to the case.

Identification of the Claim with the Policy

Exhaustive analysis and verification that the events referred to in the notification of loss are covered by the guarantees and coverage provided by the policies.

Study of the actions to be taken in the event of non-existence of coverage, looking for compensation alternatives and proposing modifications to the policies, if necessary.

Verification of the effectiveness of the payment of the corresponding premiums and that the regularizations of inventories, declarations and liquidations have been properly carried out.

Immediate communication to the Insurance Company of the policy involved in the loss and/or to the delegation of the Insurance Compensation Consortium, if the circumstances admit it, of the occurrence of the loss within a maximum period of 7 days after having become aware of it.

In order to facilitate the reception and sending of claims communications, clients will be provided with a claims communication model adapted to their activity and to the different risk areas, which gathers the basic information of what happened in a structured and easily assimilated form by all parties.

The notification to the Insurance Compensation Consortium shall be formulated in the form established for this purpose, accompanied by the pertinent documentation.

The client will be advised on the most convenient way to present the notification of the loss and to prepare the documentation supporting the claim to the insurers, taking into account the actions that the insured must take into account in order to minimize and avoid the extension of the damage, the preservation of remains, vestiges and any evidential material of what happened and preparing the inspection visit of the experts appointed by the insurers.

In order to structure this initial claims, incidents and claims management process, the client will be provided with all the necessary information on how to act, including both communication forms appropriate to each circumstance and informative documents on how to proceed in the event of the occurrence of an event included in our scope of action and, as we will see below if deemed appropriate, an action protocol between the parties detailing the most appropriate information flows and processes for the particular management of incidents and claims that may occur.

Follow-up

Just as a rapid intervention and an adequate initial approach to the claim are fundamental for the proper development of the claim, the appropriate follow-up of its development by specialists in this type of management is decisive in order to achieve the effectiveness of the policies contracted and the defense of the insured's interests.

During this phase, in close collaboration with the insured and the insurer, as well as with the experts and lawyers appointed to intervene in the case, the different causes and circumstances inherent to the claim will be discussed, which will determine the necessary documentation and the most appropriate actions for its satisfactory resolution.

The objective to achieve this is the modification and updating of the data, following all the necessary procedures until the final resolution of the same, carrying out a periodic review of the file and coordinating the corresponding actions of Grupo Galilea S.A. with all the parties involved.

This review and update of each file will be carried out with the frequency recommended by the particular characteristics of each case. For this purpose, a computerized alarm system has been established as a basic element of our quality procedures, which, with a maximum period of 2 months, obliges each claims executive to review and update its situation.

To keep the Insured and the Insurer promptly informed.

All documentation that is requested or sent will be previously analyzed and studied in detail, trying to restrict it to the strictly necessary, orienting it according to the circumstances of each case and channeling it through the fastest ways to the person who should receive it, using the standardized models by Grupo Galilea S.A. in its internal quality standards.

Likewise, Grupo Galilea S.A. will keep complete physical and computer files of the information related to each claim at the disposal of the parties, as well as comprehensive data of all the claims of its client.

A periodic review of the status of open files will be carried out. The aim is to avoid any kind of delay in the settlement of claims, in close collaboration with the executive responsible for the account, in order to detect possible gaps, lack of coverage, underinsurance and any other inconvenience hindering the insured's compensation.

Based on the periodic review of each client's accident rate, the appropriate corrective measures will be taken in order to develop work, prevention and protection methods that will serve as control tools. This allows us to make the best possible decisions when modifying insurance contracts in future renewals, in the contracting of new coverage or in the modification of existing coverage.

Indemnification and Settlement

In accordance with the particular conditions of the policies subscribed, Grupo Galilea S.A. shall endeavor in defense of the insured's interests to obtain from the insurers the fair indemnity, subject to the agreements reached between the parties in each of the claims as regards the amount and the form chosen for the indemnity (payment in any form, restitution or repair of goods, provision of services, etc.).

Grupo Galilea S.A. will take care of making effective in the shortest possible time the indemnity agreements between the parties, following up the issuance of the appropriate expert reports and their content. The necessary documentation is managed to formalize the payment with the transmission of settlements, checks and any other required document, assuming the processing of recoveries when so established and controlling the effectiveness of the payments.

Closure and reopening of the claim

Once the appropriate verifications have been made regarding the payment or once the steps to obtain the indemnity have been completed without success, with the agreement of the insured party, the file will be closed both in the physical file and in the computer system. All the information on each particular case will be recorded and filed at the disposal of the parties for a period of time determined by the client's requirements.

The file may be reopened with an indication of the circumstances that make its reopening advisable and the transfer of the reopening notification to the parties in order to initiate any additional management that the case may require, initiating the procedure again at the appropriate stage of development.