Fidelity Guarantee Insurance Claim Process
Scope of Cover and Documents required for Claims
The term “Fidelity Guarantee Insurance” embraces policies indemnifying employers against financial loss on account of forgery, defalcation, embezzlement and fraudulent conversion by employees. The object is to provide protection in respect of the default of an individual acting in capacity such as Cashier, Accountant, Store-keeper etc.
Scope of Cover
- Commercial Fidelity Guarantee Policy provides indemnity against loss of money or goods as a result of acts of Fraud or dishonesty on the part of employees.
- The cover may be required in respect of a single employee or a number of employees. There are three types of policies normally issued for this class of business viz. Individual Policy, Collective Policy and Floating Policy.
- It is necessary to obtain the Private Reference and/or Former Employer’s Report forms in addition to completed Employer and Employees application form, as appropriate.
Documents Required for Claims:
- Intimation to the insurance Company about the loss and obtaining the claim form.
- Intimation to Police authorities regarding the embezzlement and lodging of FIR.
- Details of Date of Discovery of Loss.
- Auditors report as to the quantum of loss.
- If the audit is by an Internal Audit team then their report as to the quantum of loss.
- Details of departmental Enquiry held with regard to the employee/employees who have caused the loss.
- Detailed statement of Witnesses who have corroborated about the loss.
- Documentary evidence about the value of property stolen through Invoice, Bills, Receipts Cheque counterfoils etc as the case may depend.
- The details of terminal benefits due to the employee and details of set off of the same .
- Final Investigation report from the Police authorities.
- Letter of Indemnity in favor of the Insurance Company where there is right of recovery.
In the event of Claims being repudiated by the Insurance Company the following options are available as a recourse:
- Make a representation to the Insurance Company/TPA.
- If no reply is received within 15 days on making such representation make a representation to the Grievance Cell of the Insurance Company.
- If No Reply is received or if the reply is not satisfactory then make a representation to the Insurance Ombudsman who has Quasi Judicial powers to hear the case and make adjudication.
- If still not satisfied the next option is to go to court.