Demystifying insurance claims – 5 steps of the insurance claims process

 By Philomena Serwaa BOAFO

The Ghanaian insurance industry is faced with many misconceptions, and studies have shown that it is one of the many contributing factors to low insurance uptake in the country. Very often, you will hear people say, “oh, those people, they only know how to take the money. When it’s time for them to pay, they will give you stories”.

These misconceptions continue because people have little knowledge about the right process of filing a claim, so they end up frustrated by the process. In this article, I am going to help make your lives better. I will take you through all the insurance claims processes you need know in simple steps.

THE CLAIM PROCESS

For every insurance company, the “moment of truth” is the time of claims payment. It is the period where customers test the promises made at the time of purchase. When unexpected events occur and result in damages or losses, insurance claims become a crucial aspect of seeking financial recovery and support for clients.

An insurance claim is a formal request from a customer to an insurance company for a payment based on the policy’s terms. The insurance company reviews the claim for its validity and then pays the insured or requesting party (on behalf of the insured) once it is approved.

Upon approval, the insurance company provides compensation according to the terms and conditions outlined in the policy. The timely and accurate filing of insurance claims is essential, as it allows policyholders to obtain the necessary resources to rebuild, repair, or recover from the covered incident. A paid insurance claim serves to indemnify a policyholder against financial loss.

In a highly competitive insurance market, differentiation through new and more effective claims management practices is one of the most important and effective ways for insurers to maintain market share and profitability.

Like many other processes, insurance claims also has a process or procedure to follow. Are these processes that cumbersome? Certainly not! Let’s demystify the insurance claims process step by step.

Step 1 – FILING THE CLAIM

After the incident, get in touch with your insurance provider as soon as possible. Provide your insurer with the information you’ve gathered. You can also connect with your broker or agent (Hollard2U).

Your intermediary is your primary contact when it comes to your insurance policy – they should understand your situation and how to proceed once you give your them a detailed list of all the items that were damaged or lost, and any photos or videos that help to explain the circumstances.

Your insurance provider will assign you a Claims Adjuster. A Claims Adjuster is your point of contact throughout the process. They will guide you through the next steps and help you understand what to expect. Your insurance company will require you to fill out a claim form. This form provides essential details about the incident and the damages or losses you’ve incurred. Be honest, accurate, and complete in your responses. Submit any supporting documentation alongside the claim form.

At Hollard, Claims can be reached on the dedicated line 0302 240392 for all claims and our reliable staff will connect you to a Claims Adjuster. Alternatively, you can reach our Customer Experience Centre on our toll free on 0800 444 999.

Step 2 – CLAIM INVESTIGATION

After the claim form is filled and submitted to the insurer. The Claims Adjuster will conduct investigations to confirm the happening of the event and to determine the amount or quantum of loss or damages covered by your insurance policy. They will also identify any liable parties, and you can help the process by providing any witness or contact information for other involved third parties. The investigation might involve an on-site inspection, reviewing the documentation, or discussions with involved parties.

Step 3 – POLICY EVALUATION

Once the investigation is complete, the Claims Adjuster will carefully review your policy to determine what is and isn’t covered under your policy and inform you of any applicable deductibles/excess that may apply to your case. Deductibles/excess is the first portion of a loss which the customer will bear or contribute.

Step 4 – ASSESSMENT OF DAMAGE

To accurately evaluate the extent of the damage, your Claims Adjuster may hire Surveyors, Engineers, or Contractor Loss Adjusters to lend their expert advice on the incident. Once the evaluation is complete, your Claims Adjuster will provide you with a list of preferred vendors/garages to help with repairs. You are not obligated to hire these vendors/garages but opting for them can save you a great deal of time and research. We have approved trusted garages at Hollard, and they offer post-repair services at no extra cost.

Step 5 – CLAIMS PAYMENT

Before or After repairs have been completed and/or lost or damaged items have been replaced, your Claims Adjuster will contact you regarding the settlement of your claim and payment. The insurer will then issue you with a repair authorisation letter or discharge voucher to be signed to enable payment. The period of time it takes to receive payment will depend on the complexity and severity of your claim. At Hollard, we pay same-day claims for motor insurance for amounts up to GHC5,000.00, and this straight-through process is hassle-free like our normal claims processes.

Every claim is different, and although the claims process can vary slightly according to the situation, your Claims Adjuster will devote the time and attention it takes to resolve your case.

Philomena Serwaa is Deputy Head of Claims. Hollard Insurance is committed to ensuring every claim is handled as fairly, professionally and carefully as possible. If you have questions or concerns during the claims process, you can always contact us at [email protected] or by phone on  020 2222392 to get the answers you are looking for.

Watch out for my next article that will guide you on tips for a smoother claims payments.

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