When you become aware of a claim or an intimation of a possible claim against you, you need to notify the LPIIF immediately in writing. You will also need to compete the necessary claim form (click here for claim form) and send it to the Claims Manager at claims@LPIIF.co.za.
In addition to the completed claim form, you need to provide the LPIIF with as much information as possible about the claim by providing a comprehensive background report, on your practice’s letterhead.
The LPIIF policy does not provide any rights to third parties (such as clients) to submit claims. The relationship is between the LPIIF (as insurer) and the practitioner (as insured). It remains the practitioner’s responsibility to notify the LPIIF of any claims and to apply for indemnity under the policy.
It also remains your responsibility to notify your top-up insurer should you have additional cover over and above the layer provided by the LPIIF. Please consult the LPIIF professional indemnity Master policy (“the LPIIF policy”) regarding the amount of cover and excess applicable to your practice.
What to do in the event of a claim or intimation of a claim
- Refer your client to another practitioner. You cannot assist your client with their claim against you as there will be a conflict of interest.
- You may provide your client with a copy of his/her file, but you must retain at least one complete copy to submit to the LPIIF. It is important to provide the LPIIF with the entire file content: this includes all correspondences, pleadings and all notes made thereon, including file, consultation, telephone, research as well as notes on “post it” stickers (if available).
- Do not admit or deny liability, negotiate, settle a claim or incur any costs or expenses in connection with a claim, without the prior written consent of the LPIIF, as you will be in breach of the LPIIF policy. Your right to indemnity under the LPIIF policy cannot be ceded, assigned or encumbered in some other way for the benefit of a third party.
- On receipt of your notification, the LPIIF will determine whether or not the claim falls within the indemnity afforded under the policy. (Please consult the LPIIF policy regarding the exclusions).
- If the claim is not covered under the LPIIF policy, the claim will be formally rejected.
- If the claim is covered under the LPIIF policy, the claim will be allocated to one of the legal advisor within our team (who are all admitted attorneys).
- The claim will be registered on the system in the appropriate insurance year and the standard first letter, together with additional requirements will be forwarded to you.
- Indemnity is conditional upon the practitioner complying with all the requirements set out in the policy as well as any additional requirements from the legal advisor.
- If an actual claim has been made against your practice (either by letter of demand, summons or application), the legal advisor may request the claimant’s attorney to hold over further proceedings to allow the LPIIF to investigate the claim. You may also be requested to file a notice of intention to defend or notice of intention to oppose.
- If the claimant’s attorney is not willing to hold over further proceedings, the legal advisor may request you to assist him or her with the filing of further notices and/ pleadings to provide them with more time to investigate the claim.
- You are obliged to co-operate with the LPIIF at all times. A failure to co-operate or provide assistance may lead to the withdrawal of indemnity.
- After a thorough investigation by the claims team, the LPIIF may, after consultation with you, either settle the claim with the claimant or defend the action on your behalf.