Annex activity sheet E42 BTS Insurance

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ANNEX VI – Activity Sheet E42

The activity sheet E42 is an important document for BTS Insurance students to monitor and assess professional skills acquired within the framework of the training provided in the company.

It is generally completed by the student, under the supervision of their company mentor. It must describe one or more professional activities carried out by the student, related to the missions assigned by the company.

This sheet contains several sections, which allow a detailed description of the activity performed. It should notably specify the nature of the activity, the context in which it was carried out, the resources used to perform it, the results obtained, the difficulties encountered, and the solutions provided.

It helps the student become aware of their skills and professional achievements. It also allows the company to track the student’s progress and to assess the skills acquired.

 

E42 – CLAIM MANAGEMENT

Activity Sheet No. 1
Name : DUPONT Real activity ☐ Simulated activity x
First Name : Sophia CONTRACT IMPLEMENTED : Personal insurance
TYPE OF CLAIM : A death
Activity related to: A death
□ Property and liability insurance         ⌧ Personal insurance     □ Other contract, specify
Name of the company (and possibly the appointing insurer): INSURANCES GIA LECOURBES

Context of the activity: Mrs. PIERROT MANINA’s wife sent us the death certificate by mail, made in her husband’s name
STUDENT : PROFESSIONAL(S):
Manager Ms. Luce
CLIENT/INSURED :
Mr. PIERROT MANINA

Activity description :


Client File


Client : Mr. PIERROT Géralde
Age : 61 years
Gender : Male
Marital status : Married
Professional situation : Retired
Landline : 03 33 44 22 11
Mobile : 07 66 77 88 99
Email : geraldineepierrot@gmail.fr (email address of his daughter as he is under guardianship)
Contact : By mail
Driver’s license : B category
Client status and seniority : Member since 2014
Contract involved in the claim : Life insurance
Policy supporting the activity: Multisupport RES Contract
Life insurance contract, with the possibility of investment in an euro fund or unit-linked accounts
Mr. Pierrot’s contract: 100% in the euro fund subscribed on 17/02/2014
Value at the time of his death: €32,745.32
Other contracts in the portfolio: The wife of this client holds an active life insurance contract

Payment status of premiums/contributions as of: Ongoing contract

Specific Conditions


Main due date : 01/02

Guarantees : INDIVIDUAL LIFE INSURANCE CONTRACT OF MULTISUPPORT TYPE NO. 2222. The Power Future contract offers: • In the event of the policyholder’s survival at the end of the contract: payment of a capital and/or a lifetime annuity • In the event of the policyholder’s death: payment of a capital to the designated beneficiary(ies)

Coverage limits :

The amount to be paid is defined in advance (within the limits imposed by the insurer depending on the contributions).

Main exclusions : A guarantee exclusion is a clause by which the insurer excludes certain events or types of damages from coverage. … An exclusion is called “indirect” when the insurer does not specify it in the contract but it results from a positive definition of the coverage

Claims management


Circumstances of the event causing the claim


– On December 1, 2019, Mrs. Pierrot sent us the death certificate made in her husband’s name by mail, so that we could process the file
– Search for the contract in the database to notify Mr. PIERROT MANINA’s death
– Send a letter to the wife, informing her that following the death of our policyholder, she was designated as the contractual beneficiary. In this letter, I explained the procedure to follow to access the capital due to her. I also informed her that she had two options:
Request the payment of the capital to her bank account;
Or request the payment of the capital onto her ongoing life insurance contract.
Her choice will be recorded on the beneficiary questionnaire, which, from December 10, 2019, must be completed by the beneficiary, providing their tax and patrimonial information along with their choice of payment.


Guarantee conditions / eligibility of declaration


According to Article L113-2 of the Insurance Code, the insured has 5 working days to declare a claim, except that for insurance the last paragraph states that the provisions regarding deadlines do not apply to life insurance.
“The provisions mentioned in items 1°, 3°, and 4° of this article are not applicable to life insurance”


Expert’s mission


No expert is commissioned


Convention possibly used


No convention is used


Settlement procedure


Steps of the settlement process:
• Receipt of the death certificate;
• Analysis of the beneficiary clause;
• Tax control;
• Settlement.
The death certificate was received by mail. Mr. subscribed to a multisupport RES contract on 17/02/2014. At his death, his contract was valued at €32,745.32. In his membership application, he chose the Type 1 clause: “spouse, failing that children, failing that heirs.” We know that his wife is still alive, so according to the clause he subscribed to, he will be the full beneficiary (100% of the capital) of the contract.


Calculation of the compensation


Regarding taxation :
• Mr. was not yet 70 years old. Consequently, the contract is not subject to Article 757B of the CGI.
• Mr.’s contract falls within the scope of Article 990-I of the CGI. Therefore, the insurer must determine the taxable amount, which is calculated not on the capital gains but on the total amount of death benefits paid, i.e., €32,745.32. However, his contract will not be taxed for two reasons:
• The value of his contract is below the exemption threshold of €152,500.
• Since the heir is his spouse, the Tepa law provides that in such cases, the life insurance contract is not taxed upon the death of the policyholder.
The indemnity due to the spouse of the insured and beneficiary of the contract is the amount of the contract, that is €32,745.32.

Information to keep in the database
The contract will be classified as completed once the transfer has been made.
Impact of the claim on the premium or contribution or termination

Self-assessment


Achievement of objectives, critical analysis of communication, conduct of the interview, (and) proposal(s), corrective actions)
Communication with the insured
Receipt of the claim/report request by email
Following the receipt of the death certificate, we contacted the beneficiary, who was the wife. We sent her a letter expressing our condolences and informed her, in the same letter, that her husband had designated her as the beneficiary of the contract.
Explanation of the settlement procedure, the amount of the indemnity, the settlement deadlines
We explained the settlement process, in accordance with Article L.132-8 CA amended by the law of December 7, 2007 and the ordinance of December 1, 2016. We specified that to receive the transfer, she needed to fill out a “Get to Know You Better” form to collect complete and up-to-date personal, professional, patrimonial, and economic information. Once this questionnaire was completed, we would pay her the due amount, i.e., €34,667.88.
Potential commercial rebound
When we process a settlement of the same nature as this one, we offer the beneficiary to transfer the capital to an existing contract or to subscribe to a new one with the due amount as the first contribution, with no deposit fees. The insured beneficiary decided to transfer the capital to his RES Multisupport contract.

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