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B) How to Make an Insurance Claim

The exact process really depends on the type of Insurance Policy that you have purchased and the nature of the claim. The general process is set out below.

Because Insurance is based on the principle of Indemnity – or reimbursement of  covered losses, most claim scenarios happen after the Insured Person has incurred some kind of loss or expense and is therefore seeking reimbursement for that amount.
(i) Inform your Insurance Broker of the Claim.

(ii) Your Insurance Broker will send you a Claim Form to complete, sign and return to them together with the original copies of all required supporting documents such as receipts, medical reports, police reports, etc.

**It is important to note that failure to complete or sign the Claim Form, or failure to submit the original copies of all required supporting documents will result in delays in the processing of the claim. This in turn delays any claim pay out that might be made.
(iii) Complete the Claim Form and submit it to your Insurance Broker together with the original supporting documents. If you have any questions or are unsure about how to complete the form, call your Insurance Broker.

(iv) Your Insurance Broker will submit your Claim Form to the Insurance Company together with all supporting documents.

(v) Depending on the nature of the claim, the Insurance Company may require a loss adjuster to review the damage. If this is the case, the loss adjuster will review the damage and then issue a report to the Insurance Company.
(vi) The Insurance Company will inform your Insurance Broker of the result. Depending on the findings of the loss adjuster, your insurance policy’s wording, the Insurance Company’s policies and their final decision, the Insurance Company may decide to issue you partial or full reimbursement, or they may decide to deny your claim.

(vii) Claim Denials happen when it is determined that the loss arose out of an event that was not covered in your insurance policy – e.g. the event took place before the insurance policy took effect, or the event itself was excluded from the policy.

A good Insurance Broker will assist throughout this process, particularly in the follow up with the Insurance Company regarding their decision.