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 evaluate the professional skills acquired as part of the training provided in the company.

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

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

It helps the student to 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 Actual activity ☐ Simulated activity x
First name: Sophia CONTRACT IMPLEMENTED: Personal insurance
TYPE OF CLAIM: Death
Activity regarding: Death
□ Property and liability insurance     ⌧ Personal insurance     □ Other contract, specify
Name of the company (and possibly the principal insurer):  GIA LECOURBES INSURANCES

Context of the activity: Mrs. PIERROT MANINA’s wife sent us the death certificate issued in her husband’s name by mail
STUDENT:  PROFESSIONAL(S):
Management: 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 phone: 03 33 44 22 11
Mobile phone: 07 66 77 88 99
Email: geraldineepierrot@gmail.com (email address of his daughter as he is under guardianship)
Contact: By mail
Driver’s license: License B
Status and seniority of the client: Member since 2014
Contract involved in the claim: Life insurance
Policy type supporting the activity: Multisupport RES contract
Life insurance contract, with investment options in an euro fund or unit-linked funds
Monsieur PIERROT’s contract: 100% on the euro fund subscribed on 17/02/2014
Value at his death: €32,745.32
Other contracts in portfolio: The wife of this client holds a life insurance policy that is active

Payment Status of Premiums/Contributions as of: Active 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 life annuity • In the event of the policyholder’s death: payment of a capital to the designated beneficiary(ies)

Limitations of coverage:

The capital to be paid is predefined (within limits imposed by the insurer based on the premiums paid).

Main exclusions: An exclusion clause is a provision by which the insurer excludes coverage for certain events or damages. … An exclusion is considered “indirect” when the insurer does not state it in the contract but it is a consequence of a positive definition of the guarantee

Claims Management


Circumstances of the event causing the claim


– On December 1, 2019, Mr. PIERROT’s wife sent us the death certificate issued in her husband’s name by mail so that we could process the file
– Search for the contract in the database to notify the death of Mr. PIERROT MANINA
– Send a letter to the wife informing her that following the death of our policyholder, she was designated as the beneficiary of the contract. In this letter, I explained the procedure to follow to access the capital owed to her. I also informed her that she had two options:
Request the payment of the capital into her bank account;
Or request the payment of the capital into 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 fiscal and patrimonial information and their choice of payment.


Guarantee/acceptance conditions of the 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 on deadlines do not apply to life insurance.
“The provisions mentioned in 1°, 3°, and 4° of this article are not applicable to life insurance.”


Expert’s mission


No expert is assigned


Possible used agreement


No agreement is used


Settlement procedure


Steps of the settlement procedure:
• Receipt of the death certificate;
• Analysis of the beneficiary clause;
• Tax review;
• Settlement.
The death certificate was received by mail.
Mr. subscribed to a multisupport RES contract on 17/02/2014. At the time of his death, his contract was worth €32,745.32. In his membership application, he chose Clause Type 1: “spouse, or if not, children, or if not, heirs.” We know that his wife is still alive, so according to the selected clause, he will be the total beneficiary (100% of the capital) of the contract.


Calculation of the indemnity


Regarding taxation:
• Mr. was not yet 70 years old. Therefore, 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. Consequently, the insurer must determine the taxable amount, which is calculated not on the capital gains but on the total amount of death benefits paid, that is €32,745.32. However, his contract will not be taxed for two reasons:
• The value of his contract is below the €152,500 exemption.
• As the heir is his spouse, the TEPA law provides that, in this case, the life insurance contract is not taxed in the event of the policyholder’s death.
The indemnity payable to the insured’s spouse and beneficiary of the contract is the amount of the contract, namely €32,745.32.
Information to retain in the database
The contract will be classified as closed once the transfer has been made.


Impact of the claim on the premium or contribution or on the termination

Self-evaluation


Achievement of objectives, critical analysis of communication, conduct of the interview, and the (proposed) actions, corrective actions)
Communication with the insured
Reception of the claim declaration / 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, and the settlement delays
We explained the settlement process, in accordance with article l.132-8 CA modified by the law of December 7, 2007 and the ordinance of December 1, 2016. We clarified that to receive the transfer, she needed to fill out a “Better Know You” form to provide complete and current personal, professional, patrimonial, and economic information. Once this questionnaire was completed, we would indemnify her with the due amount, €34,667.88.
Possible commercial rebound
When we process a settlement of this nature, we offer the beneficiary to transfer the capital received into an existing contract or to subscribe to a new one with the due amount as the first premium, with no transfer fees. The insured beneficiary decided to transfer the capital into their multisupport RES contract.

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Kevin Grillot

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