What documents are required for insurance claim processing when liability has been fully established

An insurance claim is a formal request made by a policyholder to an insurance company for compensation based on the terms and conditions of the insurance one buys for cover.

The claim is submitted when the insured or individual experiences a loss or damage covered under the policy, such as an accident, illness, or property damage.

The insurance claims processing involves the following steps:

1. Notification of Claim: Report the loss or damage to the insurer, providing relevant details and documentation.

2. Claim Investigation: The insurer evaluates the extent of damages or losses.

3. Documentation Submission: Submit necessary paperwork to the insurance company.

4. Claim Evaluation: The insurer assesses the validity of the claim.

5. Claim Settlement: Payout is determined and made according to policy terms.

Dos and Don’ts in the event of a claim?

Non-motor insurance comprise of several lines example public liability, professional indemnity, personal accident etc. Each non-motor insurance claim has its own specific claims procedure and conditions. Generally, when an accident occurs the insured should comply with the following :

1. Report to the police.

2. Contact your broker/insurer and fill the specific claim form.

3. Do not settle or negotiate to settle, admit or repudiate any claim without the consent of your broker/insurer.

4. Forward all relevant documentary evidence in respect of the loss.

5. Forward all claims writs of summons or letters from third parties to your broker/insurer through insureghana.com.

MOTOR

A. Own damage

• Report the loss to the insurer and fill the accident report form.
• Attach a copy of the driver’s license.
• Furnish the insurer with an estimate of the cost of repairs from either the insurer’s recommended garage or a repairer of your choice.
• Provide pictures of the damaged vehicle, clearly showing the registration number of the accident vehicle.
• Allow damaged vehicle to be inspected by the insurer’s surveyor before the commencement of repairs.
• Police report would be required, depending on the circumstances leading to the loss.

B. Property damage claim

• Letter of claim
• Police Report
• Furnish the insurer with an estimate of the cost of repairs from either the insurer’s recommended garage or a repairer of your choice.
• Provide pictures of the damaged vehicle.
• Provide driving license of the insured’s driver.

C. Injury cases·

• Letter of claim
• Police Report
• Medical report
• Original receipts of Medical Bill incurred (To justify the cost being claimed for)
• Sworn Affidavit.

Two (2) passport-size pictures of the injured victim endorsed by the doctor who treated the victim.

D. Deceased (death) cases

• Letter of claim
• Police Report
• Death Certificate/Burial permit/Post-mortem report
• Letters of Administration
• Personal Particulars of the deceased
• Sworn Affidavit
• Endorsed passport size pictures of Administrators (2 each).

In all cases, the insurance company will issue a discharge form, which states the agreed quantum (amount), to the insured or claimant for execution and forwarded back to enable us process the cheque.