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Step-by-Step Guide to Filing a Professional Liability Insurance Claim

Posted on 20 Aug, 2024

Professional liability insurance is a type of insurance that covers experts, entrepreneurs, and consultants. It compensates the insured if a customer/client files a lawsuit due to an actual or claimed error or wrong advice. This insurance covers the insured's professional liability and compensates him/her against legal action. Thus, everyone who delivers a fee-based service to clients should avail of this insurance. It is also known as "errors and omissions insurance" and covers legal bills, settlements, and judgments up to the Limit of Indemnity (i.e., sum insured).

 

Professionals and entrepreneurs can find it challenging to file professional liability insurance claims. This guide will take you through a step-by-step process to file a professional liability insurance claim effectively.

Professional liability insurance

Professional Liability Insurance Claim Process

Following a defined process is important when anything happens that might result in a claim. This is a step-by-step guide for effectively handling the claims procedure for professional liability insurance —

Review Policy Documents: Read the terms and conditions of your insurance policy coverage and the process for filing a claim.

Notify the Insurance Provider: You can contact them via phone, email, or in person at the closest branch office. Timely notification is essential to start the claim procedure. Report the incident to the appropriate authorities, such as the police, in case of theft, injury, or death. You must submit this official report with your claim form, so ensure you get one.

Gather Evidence: Collect all relevant evidence. This might include any supporting material for your claim, such as witness statements and photographs. 

Contact the Claim Handler: Speak with the claim manager that your insurance provider has designated. Give him/her thorough details on the event along with any other pertinent information. The claim handler will send you a claim information form to complete. Fill out this form accurately and submit it with the required paperwork (Aadhar Card, PAN Card, Registration Certificate, proof of address for the incident site, etc.).

Claim Registration and Surveyor Inspection: The insurance provider will assess and register your claim once you provide the required information. After that, they will issue you a reference number for tracking and future contact. The insurance company may assign a surveyor or a team of surveyors to examine the incident scene and verify your claim. Cooperate with the surveyor and give any papers and information requested.

Finalising the Claim: The insurance company will calculate the compensation amount based on the policy conditions, the surveyor's evaluation, and the resolution of any legal actions. You must maintain consistent communication with your insurance company to monitor the status of your professional liability insurance claim. 

Documents Required for Claim Process

To file an insurance claim, you need to provide several documents. These include:

  • A completed and duly signed claim form

  • Legal notices, if served by the client

  • Registration certificates for professionals or institutions (like hospitals)

  • Detailed client information to assess financial loss

  • Correspondence related to the claim (emails, letters, legal documents)

  • Identities of the claimant and any other involved parties

  • Copies of PAN Card, Aadhar Card, GST Registration Certificate

  • Address proof of the insured location

  • Any additional documents required by the insurer

Cases Where You Can’t Claim Professional Liability Insurance

Although this insurance policy is intended to shield policyholders from allegations of negligence or error, specific scenarios are not covered under professional liability insurance:

  • Any losses brought on by illegal or deliberate wrongdoing are not protected.

  • This insurance does not cover claims pertaining to violations of employee rights, such as harassment or wrongful termination.

  • Workers who sustain illnesses or injuries while doing their duties are not covered.

Exclusions can vary by profession, with policies tailored to specific professional risks. For example, a contractor’s liability policy might exclude injury coverage, while a medical professional’s policy would include it.

Wrapping Up

Professional liability insurance is necessary for professionals like doctors, attorneys, and architects, as it protects against claims resulting from professional blunders that might have severe repercussions. Even without financial loss, organisations that provide professional services/advice risk being sued. This insurance policy ensures businesses and professionals are supported during challenging times. Small business owners should prioritise obtaining this insurance to mitigate risks and maintain financial stability.

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This contains only an indication of the cover offered. For complete details on risk factors, terms, conditions, coverages and exclusions, please read the sales brochure carefully before concluding a sale.ICICI trade logo displayed above belongs to ICICI Bank and is used by ICICI Lombard GIC Ltd. under license and Lombard logo belongs to ICICI Lombard GIC Ltd. ICICI Lombard General Insurance Company Limited, ICICI Lombard House, 414, Veer Savarkar Marg, Prabhadevi, Mumbai – 400025. . IRDA Reg.No.115. Toll Free 1800 2666. Fax No – 022 61961323. CIN (L67200MH2000PLC129408). customersupport@iciclombard.com. www.icicilombard.com. (Marine Insurance, 4010 , IRDAN115P0010V01200607)