Why Insurance Claims Delay in Ghana — A Deep Look Behind the Waiting Game

By InsureGhana Editorial Team

Insurance is built on one promise: that claims will be paid when loss strikes. Yet across Ghana, policyholders often wait weeks — sometimes months — for their claims to be processed. Behind these delays lies a web of procedural, cultural, and systemic factors that shape how insurers operate and how customers experience protection.

“There’s a misconception that insurers are only interested in collecting premiums and reluctant to pay claims. That is not true,”
— Kingsley Kwame Brako, Chief Executive Officer, Ghana Insurers Association (GIA), MyJoyOnline, 2025.

According to the GIA, Ghanaian insurers collectively pay out over GHS 8–10 million daily in claims. So why do delays persist — and what can be done to fix them?

1. Paperwork and Outdated Workflows

Despite digital advances, many insurers still depend heavily on manual documentation. Claims are printed, scanned, couriered, and reviewed by hand. A 2022 BMJ Digital Health study on Ghana’s National Health Insurance Scheme (NHIS) found that electronic claim systems process requests significantly faster than manual ones — yet adoption across private insurers remains slow.
Every missing signature or duplicate file adds days, sometimes weeks, to the queue.

“Digitisation isn’t only about software. It’s about redesigning workflows so fewer hands touch a claim.” — InsureGhana Analyst Comment.

2. Policy Confusion and Information Gaps

Most delays begin long before the claim is filed. Ambiguous policy wording, unclear exclusions, and poor education at the point of sale create information asymmetry.
“Many clients file claims without full understanding of coverage or required documents,” notes a brokerage executive quoted by Ghana Business News (Sept 2025).
This often forces insurers to return claims for additional evidence — a time-consuming loop that frustrates both sides.

3. Staffing and Technical Capacity

Claims assessment is a specialist function, yet many insurers operate with lean or under-skilled teams. A 2024 study in the African Journal of Business Studies observed that firms with “clear claims-processing rules and adequately trained staff” consistently achieved faster turnaround times.
In Ghana, increasing claim volumes — particularly from motor and health policies — outpace available expertise.

4. Fighting Fraud Without Punishing the Honest

Fraudulent claims remain a growing concern.

“Fraudulent claim is hectic… we have to spend a lot of money verifying every claim because you can’t trust what people are bringing,”
— Insurance Executive quoted by ModernGhana (2023).

While such scrutiny protects the system, excessive or indiscriminate verification slows down legitimate claims. The solution lies in risk-based fraud controls: fast-tracking low-risk cases while investigating suspicious ones in depth.

5. Financial and Regulatory Pressures

When insurers face liquidity or solvency strain, there can be a subtle incentive to delay large payouts. The National Insurance Commission (NIC) requires all insurers to maintain a formal claims manual and publish documentation requirements. Yet, regulatory oversight alone cannot fix the underlying operational inefficiencies.
Transparent reporting of average claim turnaround times — paired with sanctions for chronic delays — would strengthen consumer confidence.

6. The Trust Deficit

Delays erode the very trust that insurance depends on. The perception that “insurers don’t pay” lingers even though data shows otherwise. Public education, responsive communication, and real-time status updates could help bridge this trust gap.

“Prompt claim settlement is the best marketing an insurer can ever do.” — InsureGhana Editorial View.

The Way Forward

1. Digitise and Standardise: Adopt integrated claims platforms across insurers, brokers, and healthcare providers.
2. Simplify Policy Language: Use plain-English contracts and checklists at the point of sale.
3. Invest in People: Train claims officers in customer communication and digital tools.
4. Balance Fraud Control with Speed: Deploy analytics to flag anomalies instead of manual over-checking.
5. Strengthen Transparency: NIC should publish periodic claim-processing performance reports.

If these steps are pursued jointly by insurers, regulators, and brokers, Ghana can move from slow settlements to swift, transparent, and trusted claims — restoring public faith in insurance as a true safety net rather than a bureaucratic maze.

References

1. Ghana Insurers Association: “Insurers pay GHS 10 million daily in claims.” MyJoyOnline, July 2025.
2. Benefit-Cost Analysis of Electronic Claims Processing, BMJ Digital Health, 2022.
3. “Ghanaians advised to employ brokers for prompt claims.” Ghana Business News, Sept 2025.
4. “Fraudulent claims making insurance sector hectic.” ModernGhana, June 2023.
5. National Insurance Commission, Annual Report 2019, Accra.
6. African Journal of Business Studies, Claims Process Efficiency in Emerging Markets, 2024.