Claims Explained

An insurance policy is a promise of assistance when things go wrong provided you fall within the policy’s terms and conditions.

If you are lucky, you may never have to make a claim against your insurance policy. However, when things go wrong and you are involved in an unexpected accident, disaster or experience loss that is covered by your insurance policy you can make a claim with your insurer.

What is a claim?

When you make a claim on an insurance policy, you are formally notifying the insurance company that you have suffered a loss or damage that is covered by the policy and you are requesting action.

The insurer will review your claim and see if the event or circumstances are risks covered by the policy.

As the insured, you will need to provide proof it is a genuine claim and the insurer will need to be certain the claim satisfies the terms and conditions of your insurance policy.

If your claim is accepted, the replacement, repair or payout (in case of life insurance) is made to the insured or beneficiary by the insurance company.

The insurer will work out the value of the claim and provide the appropriate benefit specified in your insurance contract.

The claims process

The claims process is generally the same across the board. The policy holder is expected to go through a few steps in the process. However, each insurance class may have a few differentiating factors, for example, motor insurance will require that assessment is done to determine whether to repair or replace the vehicle. On the other hand medical insurance is slightly different.

The first thing you must do is contact your insurance company as soon as practical after the event happens, especially if the loss is due to theft or a serious accident.

You may choose to review your policy document to establish if you have a valid claim and that the event is not on the list of exclusions for your policy. Your insurer will do this anyway once you lodge a claim.

If you have all the information that the insurance company requires, making a claim becomes straight forward.

At the time of notifying the insurance company of your claim, you could also ask for them to explain to you the claims process as well as the documents they will require. This could make your claim process smoother.