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Comcover Insurance Policy

Part 3. General Information

3.1 Reporting incidents for a Claim

1. Early notification of a claim or an event or loss that is likely to give rise to a claim is crucial to the ability of Comcover to protect the Fund Member's interest and minimise any subsequent loss
2. It is imperative that a Fund Member notifies Comcover Member Services of an incident that could lead to a claim of a liability nature against it, even if, at the time of notification, there has been no demand from a third party.

3.2 Incidents and Claims including those below the Fund Member's excess

1. All incidents of a liability nature should be recorded by Fund Members for their own risk management purposes and be notified to Comcover Member Services
2. For non-liability incidents that are clearly below the excess, members should record those as part of their own risk management program
3. For non-liability related incidents that are approaching the excess, Fund Members should record these as part of their own risk management program and report them to Comcover Member Services as they may exceed the excess and become a claim
4. For non-liability related incidents that exceed the excess, Fund Members should record these as part of their own risk management program and report them to Comcover Member Services for processing as a claim.

3.3 Incident and Claim reporting procedures

1. Fund Members should take the following action when they have information that there is a claim against them or that an incident has occurred that might give rise to a claim

1. notify Comcover Member Services
2. preserve any evidence
3. complete claim form documentation
4. provide supporting documentation and information
5. refer all communication concerning the matter to Comcover Member Services
2. Notification in the first instance can be by telephone, e-mail, facsimile, in person or by post. It is important to ensure that sufficient information is given to Comcover Member Services regarding the claim, or possible claim
3. The following information needs to be given to Comcover Member Services
   1. name and telephone number of Fund Member contact officer
   2. the policy number
   3. name and address, if known, of the third party(s) involved in the incident
   4. the time, date and location of the incident
   5. the name of the Fund Member employee or other persons involved
   6. a full description of the incident
4. details of the claim made, or likely to be made against the Fund Member
5. names and addresses of witnesses
6. A claim form should be completed and forwarded immediately to Comcover Member Services, or at least, within 5 days of an incident occurring; a claim being made against the Fund Member; or where the Fund Member becomes aware of circumstances that are likely to give rise to a claim against it
7. When completing the claim form, the Fund Member should provide supporting information, including
   1. any originating application, writ, summons, demand or other correspondence from third party(s) and file notes of any telephone conversations with third party(s)
   2. employee statements. The statement should be confined to the facts and not express an opinion on negligence/liability
   3. witness statements
   4. photographs of the incident site (if relevant)
   5. details of any other party(s) (not employees or affected third parties) who may have contributed to the incident
   6. any other relevant information
8. The Fund Member should retain copies of all of the above documents and open its own file in relation to the claim.

3.4 Points to remember

1. Refrain from making any statement to possible claimants or witnesses to an incident, or taking any action, that could be construed as an admission of liability
2. Where possible and appropriate, take all necessary steps to prevent further public access to the site where the incident took place (or any other actions to prevent further loss) until it can be visited by an assessor and made safe
3. Where possible and appropriate, take all necessary steps to provide assistance to a prospective claimant and reduce the likelihood of legal action (e.g. provide reassurance, first aid, ambulance).  A conciliatory attitude at this stage can help settle any claim that is ultimately commenced against the Fund Member
4. Request all staff (or other persons associated with you such as contractors) who witnessed the incident to prepare written notes, or better still statements, dealing with the facts of the incident as observed by them.  No attempt should be made to attribute blame
5. Where property is lost or stolen take all reasonable steps to recover the property.  If the loss is caused by theft, report the loss to the police immediately
6. Report details of a motor vehicle accident that:
   1. damages the motor vehicle or property belonging to another party
   2. injures people
7. Report the motor vehicle accident to the police as required by State and Territory motor traffic legislation
8. Report the theft of a motor vehicle or its contents
   1. If the vehicle is damaged, leave the vehicle at the premises of a repairer of your choice where it can be examined by an assessor (minor repairs will be attended to immediately).

3.5 Indemnities, Guarantees, Warranties and Letters of Comfort

1. The Australian Government’s policy on issuing indemnities, guarantees, warranties and letters and comfort is to accept such risks only when the expected benefits, financial or otherwise, are sufficient to outweigh the level and cost of risk which the Government would be assuming. As a matter of principle, risks should be borne by those best placed to manage them
2. Sound risk management is fundamental to the effective management of exposures that result from the issue of indemnities, guarantees, warranties and letters of comfort. Agencies should have both an overall corporate risk management strategy and a separate, more specific and detailed risk management plan to apply to the management of indemnities, guarantees, warranties and letters of comfort
3. Risk management involves assessing and accepting risk in a way that minimises the long term cost to the Commonwealth. The strategies for managing these exposures are aimed at
   1. managing the relationship with the indemnified party so as to reduce the likelihood that the contingency is triggered, and
   2. managing the aggregate risks from an agency perspective including by
      1. Establishing an awareness of the environment the agency is operating in
      2. Identifying the risk to be managed
      3. Analysing the risk, which involves consideration of the possible consequences of the risks and the likelihood that those consequences may occur
      4. Treating the risks (such as they retained, reduced, eliminated. controlled or transferred), and
      5. Monitoring and reviewing the risks on a periodic basis
4. Ideally, contracts entered into by Fund Members should, wherever possible, provide for insurance and indemnity from vendors, contractors and sub-contractors indemnifying the Commonwealth or Fund Member. As noted above, the Australian Government’s policy on issuing indemnities to other parties is to accept such risk only when the expected benefits outweigh the potential losses
5. Before issuing an indemnity, potential losses should be assessed commensurate with the level of risk identified. Indemnities can only be issued by a duly authorised person
6. If it is necessary to provide an indemnity, Comcover may be able to provide insurance protection for some aspects of the indemnity. One relevant consideration will be whether members have followed Finance Management Guidance No 6 – Guidelines for Issuing and Managing Indemnities, Guarantees, Warranties and Letters of Comfort, September 2003.

3.6 Co-operating with Comcover Member Services

Comcover Member Services has performance obligations under its contract with Comcover.  The Fund Member must do everything possible to co-operate with, and assist, Comcover Member Services in meeting these obligations.

3.7 Risk Management

1. One of the key functions of Comcover is to support the Australian Government's aim of achieving greater transparency and accountability in the management of the Australian Government's risks.  The coverage of insurable risks provided by Comcover is but only one element in the overall management of risk (both insurable and non‑insurable) by Australian Government agencies
2. Risk management is a central element of any corporate governance framework, whether for private or public sector organisations.  Systematic risk management is essential for Australian Government agencies.  Its implementation requires a considerable commitment by chief executives and senior management as well as investment and ownership by all staff in Australian Government agencies
3. A sound corporate governance framework, with a well integrated risk management strategy, will provide the essential discipline and structures needed by modern government organisations.  Effective risk management will help in managing the risks confronting Australian Government agencies so that full advantage can be taken of opportunities while minimising the adverse impacts of risks
4. Comcover is committed to working in partnership with Fund Members, to help them develop a risk management culture within their organisation.  Fund Members will have access to a wide range of risk management support  through Comcover Member Services, including risk management training and networking opportunities, support to Boards, Executives and Senior Managers, professional risk management expertise and agency specific advice
5. While Comcover is happy to offer advice and support on managing agencies' risks, it is important to recognise that the ultimate responsibility for risk management continues to rest with agency chief executives and their senior management team.  Chief executives need to take a close interest in and responsibility for their agency's risk management strategies and the implementation of the strategies, if their agencies are to effectively identify and respond to the wide and increasing variety of risks that now have to be faced by organisations.

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