DEFINITION OF CLAIM OF POLICY
A claim of policy, also known as a factual claim, is the process whereby a policy holder gives a formal notification to an insurance company about the damage or loss they suffered. The policy holder will typically claim that these are covered by their policy, prompting the company to take action and review the claim.
The insurance company has the right to review your claims to ensure that the loss or damage you suffered meet the risks covered by your policy, and that your claim satisfies the policy’s terms and conditions. Therefore, it is important that you attach evidence to prove that your claim is genuine, and in line with your insurance policy.
If your claim of value is accepted, your insurer will almost always take the necessary courses of action based on the policy provisions.
While defending a claim based on policy provisions might not in itself be entirely cumbersome, effecting payments for the value claim may prove to be quite challenging.
Always note that it is only in the policy where it’s explicitly stated who is right or wrong, between you, the policyholder and the insurer. In the event that the policy fails to solve this challenge, you may be required to take action by providing facts and consulting with your legal counsel.
While this is the less desirable road to tread, a large number of claims of policy tend to require some level of action before the claims are met.
Thankfully, there’s a process towards ensuring the payment of your claims.
HOW TO EFFECT PAYMENT OF CLAIMS
For you to effect the payment of your claims under an insurance policy, there are a few guidelines you always should or ought to follow, and they are as follows:
1. NOTIFICATION OF INCIDENT, DAMAGE OR LOSS
Upon the occurrence of a loss or damage under an insurance policy, the burden is on you to notify the insurance company by sending facts and inference as it pertains to such loss or damage immediately.
If you experience such loss or damage resulting from theft or burglary, you must also report to the local police within your location. You would be required to obtain a police report as the same would be used as evidence when defending a claim.
2. PROTECTION OF DAMAGED PROPERTY
You should take photographs of the damage before undertaking any repairs to alleviate the damage or loss. It is important to note that all material evidence must as much as possible be kept in its original state so that the insurer’s claims assessor or surveyor can detect the damage done.
When executed effectively, there’s a higher chance of getting a judgment claim as per the information contained in your claims of policy document.
3. REPAIR OR REPLACEMENT OF DAMAGED PROPERTY
As the insured, you are to forward any quotation for repairs to the company to allow for considerations of your claims before you proceed with any repairs.
If necessary, you can also go ahead with repairing the damaged property to prevent further/continuing damage. However, such expenditure must be documented in pursuance of your claims. It is important to note that only claims which meet the initially agreed upon claims of policy document, and fall within the stipulated guidelines such as time may be considered.
4. SURVEYING OF DAMAGE
The insurance company may undertake inspections to survey the damage themselves with the claims of policy document as a guide. Where detailed and comprehensive surveying is needed, they can assign a surveyor/loss assessor to work with you to access the damage and ascertain your claims at your convenience.
5. PREPARATION OF CLAIMS DOCUMENTS
To accelerate the pace of the claims process and make certain that the claims are not arrived at erroneously, you are required to prepare and submit to the insuring company and the surveyor/claim assessor the following documents:
- Notice of loss or damage;
- Accident report with pictures of the damage;
- Expenses and cost of loss with supporting documents like receipts.
- Copy of police report.
- Any other document as may be required by the insurance company.
6. PAYMENT IS ARRANGED
After repairs have been completed and lost/damaged items are replaced, you will be contacted regarding the payment of your claim. The duration of time required before you are paid your claim is dependent on the complexity of the damage.
There are still some processes you have to undergo after filing your claim. Take note that every claim has its peculiarity, and some claim processes may differ faintly according to the policy. Therefore, it is advised that utmost care and attention be given while you take steps to effect the payment of your claim. It is important nonetheless, in any claim of policy processes, that you ensure all the necessary documentation of the damage and claims documents are prepared to avoid any inefficiencies and misunderstanding.