Making a Claim / Notifying a Circumstance

We act as agent for the Insurer, Suncorp Metway Insurance Limited, in receiving and managing claims and notifications.
   
When to notify
 
Whenever a complaint of breach of professional duty is made against you
    • whether the complaint is made by a client or non-client
• whether the complaint is made in writing or verbally
• whether you believe the complaint to be justified or not.
  Whenever in the course of your practice you become aware of any act or omission of yours, your employees or your sub-consultants might give rise to a claim against you - even if no complaint has been articulated against your practice.
   

The claim / notification process
  Claims and Notifications must be reported in writing. This is done by completing a Notification of Circumstances (‘NOC’) form, which can be obtained from your broker or account manager or may be downloaded from www.plannedins.com.au. Attach any supporting documents to the NOC form.
  Do not make any statement on the NOC that could be construed as an admission of fault. Confine your notification to statements of fact, and leave expressions of opinion for later discussion with a Claims Manager.
  If the matter is urgent, immediate telephone advice can be obtained from one of our legally qualified Claims Managers.
  Return the completed NOC form by fax or post to:
    Planned Professional Risks Underwriting Agency
236 Balaclava Road
North Caulfield 3161
(PO Box 2257 Caulfield Junction)
Fax: (03) 9500 2274
  Receipt of your notification will be acknowledged in writing. A Claims Manager will then evaluate the notification, and contact you by telephone or in writing as is necessary, to obtain further information that may be required, and advise you as to the steps to be taken in the management of the matter.
    Some rules to note and observe
  If you fail to notify at the appropriate time, you may forfeit your entitlement to indemnity. If you are in doubt as to whether a circumstance is notifiable, speak to your broker or to us about it. The golden rule is – IF IN DOUBT, NOTIFY.
  Early notification enables us to determine what, if any, steps can or ought be taken immediately to protect the interests of both the Insured and the Insurer. This is critical to reducing the overall cost of claims.
  Open a separate file for your correspondence and communication with us. Do not place these documents on your project file.
  Your dealings with us are private and confidential, and NOT your client’s business:
    • DO NOT tell your client that you have notified your Insurer. Many claimants are opportunistic, and may press on with a claim, or exaggerate the claim, when they know an Insurer is involved.

• DO NOT provide your client with copies of communications passing between you and us, and do NOT identify your broker or Insurer by way of ‘cc’ on any correspondence you send to your client.
  When you become aware of a claim or a circumstance that might give rise to a claim, you must not subsequently do anything that could increase the amount of a claim, or prejudice your Insurer’s rights. To avoid potential problems in this regard:
    • Keep us fully informed of developments, and seek our consent BEFORE taking steps in the management of any matter you have notified.

• Do NOT volunteer documents from your project file to your client, loss adjusters or other third parties without first consulting us. Claimants are often ‘fishing’ for information to use against you.

• Do NOT sign any statements prepared by your client’s solicitor or barrister without our prior approval. Neither should you attend meetings with them without first checking with us, and never go to such meetings on your own.

• If you have continuing contractual obligations (e.g. as contract superintendent or assessor) do not ignore those duties – if in doubt, seek advice from us or from your own solicitor.

• Do not make embarrassing notes or comments on original documents you receive from others. They will most likely be subject to the rules of discovery, and could later be used against you.
 


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