Regulations for Underwriting and Claim Adjustment Procedures under Compulsory Automobile Liability Insurance Article 17
After receiving the claim form, the insurer shall conduct the followings if necessary:1.Send a staff to investigate the facts and whether the driver is licensed or covered by the insurance; meanwhile, the staff shall photograph, draft the scene to be used as the basis of claim settlement. If the scene has been disturbed, the accident report made by the civilian or military police authorities shall be regarded as the basis of claim settlement .2.Verify the facts of accident with the witness and the civilian or military police authorities, take testimony or copy the scene map as well as the statement record.3.Investigate the death or injury condition of the injured party and the amount of medical expense.4.Request the claimant to assist the insurer in preserving the subrogation right if the damage is caused by the insured due to the violation of Article 29 of the Act.5.Request the insured to assist the insurer in preserving the subrogation right if the damage is caused by the deliberate intent or negligence by the third party.6.Manage to acquire evidence and fact if there is any false representation or fraudulent act by the insured or the claimant.7.The claims adjuster should ascertain the apportionment of liability and record it in the adjustment report in order to facilitate the statistic process.8.After verification, the claims adjuster shall immediately fill out the accident investigation report specifying the cause of accident and the existence of other insurance.
中文原文 強制汽車責任保險承保及理賠作業處理辦法第17條
保險人受理理賠申請後,應視事實需要辦理下列事項:
一、派員調查事實真相,並查詢駕駛人有無駕照及投保情形;同時應加以拍照、繪圖,以作為理賠之依據。
如現場已破壞者,依警憲機關之肇事處理報告,作為辦理之依據。
二、向證人及警憲機關查證事故內容,索取證言或洽抄現場圖、筆錄。
三、查訪事故人員傷亡情形及醫療費用之多寡。
四、損害係由被保險人違反本法第二十九條規定所致者,應請請求權人協助保全保險人之代位權。
五、損害係由第三人之故意或過失行為所致者,應請被保險人協助保全保險人之代位權。
六、如發現被保險人或請求權人有不實報告或詐欺行為,應設法取得事實證據。
七、理賠人員查明肇事責任後並將肇責比例記載於理算書上,以利統計作業。
八、理賠人員查證後應立即填寫出險調查報告,並載明肇事之原因及其他保險情形。
一、派員調查事實真相,並查詢駕駛人有無駕照及投保情形;同時應加以拍照、繪圖,以作為理賠之依據。
如現場已破壞者,依警憲機關之肇事處理報告,作為辦理之依據。
二、向證人及警憲機關查證事故內容,索取證言或洽抄現場圖、筆錄。
三、查訪事故人員傷亡情形及醫療費用之多寡。
四、損害係由被保險人違反本法第二十九條規定所致者,應請請求權人協助保全保險人之代位權。
五、損害係由第三人之故意或過失行為所致者,應請被保險人協助保全保險人之代位權。
六、如發現被保險人或請求權人有不實報告或詐欺行為,應設法取得事實證據。
七、理賠人員查明肇事責任後並將肇責比例記載於理算書上,以利統計作業。
八、理賠人員查證後應立即填寫出險調查報告,並載明肇事之原因及其他保險情形。