|
INTRODUCTION TO
OCEAN MARINE CLAIMS
EXAMINER
AN EDUCATION &
TRAINING COURSE
held
at
American Institute of Marine
Underwriters
14 Wall Street, 8th Floor, Suite 820
New York, NY 10005
(see course schedule for exact dates) Fee: Member $550 Non-Member $1000
Click here for
registration form
COURSE
DESCRIPTION
This three-day course is designed
for the Claims Professional who is primarily responsible for the
investigation and settlement of claims made by policyholders and
third-parties. You will learn the methods, procedures and
standards used in handling claims adjusting of hull and machinery,
cargo, liability and recreational marine insurance.
Who Should
Attend:
Insurance company claims personnel,
agents and brokers, transportation shippers and carriers, maritime
attorneys, risk managers, independent surveyors, claims adjusters,
average adjusters, salvors, subrogation and recovery employees.
Continuing
Education Credits:
State Insurance Departments
New Jersey 15 Credits
Connecticut 14 Credits
New York 15 Credits
PART I
CLAIMS
EXAMINER DUTIES AND RESPONSIBILITIES
1.
The Marine Claims Professional
A.
Job Knowledge
¨
Technical
–
Cargo
–
Cargo Subrogation
–
Hull – Brown Water / Blue Water
–
Personal Injury
–
Excess P & I
–
Liability
–
Excess Liability
–
Bumbershoot
–
Reinsurance
¨
Legal
–
Litigation Management
–
State Federal Regulations
–
Privacy and Compliance
–
Adjuster Licensing
B.
Planning & Organizing
¨
Prioritize workflow
¨
Manage Diary System
¨
Respond to incoming telephone calls,
faxes and mail
¨
Meet deadlines
¨
Risk information
¨
Time management
C.
Problem Solving / Creativity
¨
Analyze coverage
¨
Proper investigation
¨
Vendor Selection – Surveyor, Attorney
and Experts
¨
Business strategy for case handling
¨
Document thought process in file notes
D.
Decision Making
¨
Gather and analyze information and
documentation
¨
Develop plan for claim resolution
¨
Make a timely decision and proceed
E.
Judgment
¨
Technical expertise
¨
Best practices
¨
Market conditions
¨
Awareness of the total picture
F.
Adaptability
¨
Understanding the needs of customers
¨
Be open to new resources if they will
improve our business results
¨
Understand and support business goals
G.
Initiative
¨
Diary
¨
Reserving
¨
Claim management
¨
Risk information
¨
Sharing information / reports
H.
Entrepreneurship
¨
Being pro-active
¨
Make things happen
¨
Being resourceful
I.
Communication Skills
¨
Internal / External
¨
Verbal / Written
¨
Clear / Concise / Professional
J.
Interpersonal Skills
¨
Communication
¨
Attitude
¨
Respect
¨
Enthusiasm
K.
Accountability for Results
¨
Take ownership of your work
¨
Take pride in your work
1.
Policy Coverage
A.
Conveyances, duration, valuation,
geographical limits, goods insured, terms of sale, shipment
reporting methods.
2.
Types of Loss – Measure of Indemnity
A.
Particular Average
B.
General Average
C.
Sue and Labor Expenses
D.
Goods on consignment fees and expenses
E.
Increased value policies, business
income loss
F.
Total loss
G.
War claims and S.R. & C.C.
3.
Loss Investigation
A.
Assign surveyors
B.
Warranties
C.
Policy defenses – expressed and
implied
D.
Legal counsel
4.
Loss Adjustment
A.
Replacement cost vs. actual cash value
B.
Depreciation
C.
Deductible
D.
Claim calculation, freight costs,
selling price, valuation
E.
Special loss clauses due to type of
commodities
5.
Subrogation
A.
Time limitations
B.
Carriers defenses
C.
Limitation, COGSA/Warsaw/Domestic
transit
D.
Amounts recoverable
6.
Examples of Cargo Claims
PART III
HULL CLAIMS
1.
Notice of Loss
A.
Policy Coverage and Verification
¨
Policy Period – Date of Loss
¨
Schedule of Vessels – Vessel Name and
Value
¨
Assured Name
¨
Coverage and Perils
¨
Deductible
¨
Claims Lead and Following Clause
B.
Setting up the Claim File
2.
Types of Losses and Damages
A.
Losses
¨
Particular Average
¨
General Average
¨
Collision Liability
¨
Salvage
¨
Sue & Labor
¨
Total Loss
B.
Damages
3.
Loss Investigation and Assignment of
Experts
A.
Appointing the Surveyor
B.
Appointment of Attorneys
C.
Appointing the Adjuster
4.
Loss Adjustment and Documentation
A.
Review sample Adjustments
B.
Discuss sections within the Adjustment
¨
Items of claims and Common Charges
C.
Documentation Necessary to Support a
Claim
5.
Examining the Adjustment and Claims
Settlements
A.
Warranties
¨
Expressed – Implied
¨
Seaworthiness – Trading
B.
Burden of Proof
C.
Assureds Allegation
D.
Proximate Cause
E.
Reasonable Cost of Repairs
F.
Surveyors Approvals
G.
Unrepaired Damage
H.
Payment on Account
I.
Consistency
J.
Without Prejudice
K.
Payments
¨
Loss Payee
¨
Pay Orders
PART IV
MARINE
LIABILITY CLAIMS
1.
Policy Coverage
A.
Liability for:
¨
Death or injury to:
–
Crew
–
Shore workers
–
Marine workers / non-seamen
–
Offshore workers
–
Passengers
–
Third parties
¨
Property damage
–
Other vessels
–
Land or shore facilities
¨
Not “first party” losses
B.
Insuring agreements
¨
Indemnity v. liability policies
¨
Excess liability
–
Following form
–
manuscript
¨
Coverage for contractual indemnity
¨
Additional assured status
¨
Waivers of subrogation
¨
Duty to defend
¨
Other insurance clauses
C.
Frequent Exclusions
¨
Punitive damages
¨
Radioactive exposure
¨
Water craft exclusion
¨
Fines and penalties
¨
Crew exclusion
D.
Limitations
¨
“As owner” deletion
¨
“Limitation of liability” deletion
2.
Insured & Policy Forms
A.
Types of Insureds:
¨
Vessel
–
Owner
–
Employer
–
Dual capacity
¨
Wharfingers
¨
Terminal Operators
¨
Stevedores
¨
Marina
¨
Boat dealer
¨
Voyage & time charterers
¨
Pleasurecraft
¨
Shipyards
¨
Offshore operators, drilling companies
and service contractors
B.
P & I Clubs
¨
Nature of insurance – shipowner’s
mutual
¨
Typical assureds
–
Ocean or blue water ships
–
Liners
–
“tramps”
–
integrated tug and barge (“ITB’s”)
¨
Certificates of entry
¨
Fixed premium
¨
Typical clubs
–
U.S.
–
England
–
Scandinavia
C.
Types of policy forms
¨
Taylor SP-23 P & I
¨
Taylor SP-38 P & I
¨
Employers A & B with MEL Endorsement
¨
Marine CGL
¨
Marine Package Policy
¨
Builder’s Risk
¨
Excess
¨
Marine excess
¨
Bumbershoot
¨
Difference in conditions
3.
Types of Claimants
A.
Seamen
¨
The Merchant Marine Act of 1920 (Jones
Act) 46 USC
§688
et seq.
¨
Seamen status
¨
Theories of recovery for injury or
death of seamen against an employer / vessel
–
Negligence
–
Warranty of seaworthiness
–
Maintenance and cure
¨
Borrowed employee
¨
Theories of recovery against third
parties
B.
Marine Workers
¨
Longshore and Harbor Worker’s
Compensation Act
–
905(a) compensation benefits
–
905(b) negligence action
–
905(c) prohibitions
C.
Offshore workers
D.
Third Party:
¨
Passengers
¨
Business invitees
¨
Bystanders
E.
Property damage
¨
Other vessels
¨
Fixed or shore structures
¨
Mooring facilities
4.
Loss Investigation and Adjusting
A.
Prompt notice and time limits
B.
Defence costs
C.
Surveyor, consultant, expert or
investigator fees
D.
Setting Reserves
E.
Bad Faith
¨
State adjuster requirements
¨
State statutory penalties
F.
Reservations of Rights
¨
Reservation of rights letter
¨
Non-waiver agreement
¨
Waiver of rights
G.
Declinations of Coverage
H.
Settlement of Claims
¨
Written agreements
¨
ADR
¨
Settlement conference before judge or
magistrate
I.
Decision to litigate
¨
Considerations
–
Excess judgments
–
Defense costs
¨
Third party recoveries / subrogation
J.
Reporting requirements
¨
Internal communication
¨
Communication with counsel
¨
Communication with consultants,
surveyors and experts
PLEASURECRAFT
CLAIMS
1. Policy
Coverage
A.
Physical damage, liability, P & I
Coverage, Exclusions and general conditions.
2.
Types of Loss
A.
Property Damage
¨
Coverage problems
¨
Surveyors
¨
Damages
¨
Stolen and sinking vessel claims
¨
Sue and Labor expense
¨
Salvage claims
B.
Liability Losses
¨
Passenger injury claims
¨
Crew member claims
C.
Recovery
3.
Loss Investigation
A.
Valuation
B.
Defense
C.
Bad Faith
D.
Federal and State laws
E.
U.S. Coast Guard
F.
National Fire Protection Association
G.
American Yacht and Boating Association
H.
Legal Counsel & lawsuits
I.
Denial of Coverage
J.
Reservation of Rights
K.
Payments
Special Assistance
In Compliance
with the American’s with Disabilities Act, AIMU will make all
reasonable efforts to accommodate persons with disabilities at its
meetings. Please call James M. Craig at (212) 233-0550.
Refunds/Cancellations/Substitutions
Refund requests will be honored if received in writing by 15
days prior to scheduled start date. All refunds will be subject
to a processing fee of $25. Cancellations received after the
refund deadline, “no shows” are subject to the full registration
fees. Substitutions may be made by notifying the conference
registrar in writing or in person at the on-site registration
desk.
Program Features
Continental
Breakfast
Lunch
Handouts &
Lecture Notes
For Additional Program Information Contact Us At:
Phone: (212)
233-0550
l
Fax (212) 227-5102
Email:
aimu@aimu.org l Web:
www.aimu.org
|