Third Party Claims
This document describes the process to be used for allocating and processing Third Party Claims Appeals.
Appeals Process (NMC NE contract)
Details of Process / Guidance
Upon receipt of a letter repudiating (denying liability) for a claim, the claimant may wish to clarify Amey’s position and enter into further correspondence with the Third Party Claims Team.
In the event that Amey maintain their stance, and the claimant wishes to progress the matter, they may write to the Third Party Claims Team requesting that the matter be appealed. The Third Party Claims Team will write to the claimant acknowledging receipt of the appeal within 7 days, and identify a suitable senior independent manager within the business to carry out the review. The Third Party Claims Team will compile the information already gathered (claim form, receipts, photographs etc.), and any additional information provided by the claimant through subsequent correspondence, and make this available to the independent manager for review.
The independent manager will conduct a “desk-top” investigation within 14 days, reviewing the circumstances, and available evidence, to establish whether Amey have complied fully with our contractual and legal obligations in relation to the claim. The independent manager will report their findings back to the Third Party Claims Team, whereby Amey’s final response on the matter will be communicated to the claimant within 7 days.
Amey has an appeals process whereby an Independent Manager will review the circumstances and available evidence to ascertain if Amey have complied fully with their Contractual obligations in relation to the claim. The Manager will inform the Claimant of their finding on completion of the review.