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Claims

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We all dread it when the inevitable happens and we have to lodge a claim with the insurance company, it is inconvenient and a very stressful process. With the help of our team, we shall walk you through the crucial steps that will lead to processing your claim

Important note for all claims:

  • Report all claims to us as soon as possible
  • Obtain a police abstract
  • Quick submission of all the required documents/information
  • Ensure that you provide full details of the of loss/damage. If possible, take & produce photographs of the scene before it is disturbed to support the loss /damage
  • Ensure that you take measures to minimize the loss
  • Where a third party is involved NEVER ADMIT LIABILITY

Motor Claims (Own Damage / Liability)

  1. Note details of the location, date, and time of the accident and possible cause of the accident
  2. In all cases of bodily injury, report to the Police immediately and note to get names and details of as many witnesses as possible and obtain an inspection report.
  3. In cases involving property damage, take details of the third party (Name, contact details, Description of their vehicle, their Insurers)
  4. If the vehicle is not drivable, arrange for the vehicle to be towed to an approved garage/repairer.
  1. Please obtain a repair quotation from an approved Garage/Repairer (Comprehensive Policies Only). If you do not know of any, please contact us and we will provide you with a list of approved repairers by the Insurer. Don’t authorize repairs without the consent of the insurers. 
  2. Assessment will then be arranged at the Repairer’s premises
  3. Share the duly completed Claim Form and return to us with clear and legible copies of your Driver’s License, copy of the log book, and Police Abstract.
  4. Advise us of any Third Party Claims and forward to us any correspondence received from the Third Party, without acknowledging the same.

Motor Claims

(Windscreen)

Complete a claim form and forward it to us with the following documents.

  1. Original replacement receipt with ETR
  2. Photo of the damaged windscreen before and after replacement
  3. Copy of logbook. 
  4. Copy of driver’s valid driving license. 
  5. Replace the damaged windscreen

Fire & Perils /Fire Consequential Loss Claims

  1. Report all claims to us as soon as possible
  2. Submit all the required claim documentation at the earliest
  3. If possible, establish the estimate of the loss/damage or provide a breakdown of the loss /damage
  4. We will ensure that a Loss adjuster is appointed depending on the loss estimate
  5. Ensure that you take measures to minimize the loss
  6. Ensure that your Accounting Records are intact as without such records, claim settlement could be prejudiced
  7. Don’t authorize repairs without the consent of the insurers

Machinery Breakdown Claims

  1. Notify us immediately in case of accidental electrical or mechanical breakdown of a machine.
  2. Obtain the technical report on the cause of damage and submit it together with repair/replacement estimates
  3. Submit all the required claim documentation at the earliest
  4. Partial Loss: The damaged part is replaced with no depreciation charged
  5. Total Loss: Item is replaced

Property Loss or Damage Claims

  1. Report all claims to us as soon as possible
  2. Submit all the required claim documentation at the earliest
  3. Obtain replacement quotations for all damaged or stolen items and attach copies of original purchase invoices or replacement invoices. Don’t authorize repairs without the consent of the insurers
  4. If the claim involves stolen jewellery, then please include recent Valuation Certificates.
  5. All crime-related losses must be reported to the nearest Police Station and a Police Abstract must be obtained.
  6. If items are damaged by lightning, water, fire, etc. then a Damage Report must be included with the claim documentation stating that the items are damaged beyond economical repair and/or repairable and what the cause of damage was. If the items can be repaired, the repair cost must be given on the Damage Report.
  7. All damaged items must be retained until the claim is settled as the Insurance Assessor may want to view the items or collect the salvage.

Marine Claims

  1. Advise us of the loss as soon as possible.
  2. If you discover any loss or damage whilst off-loading, and if possible, wait for a Loss Adjuster to be present, if not please take pictures showing loss or damage.
  3. Whenever goods are received but contents are not checked e.g. cartons, mark the Inland Consignment note to read ‘Contents not verified or checked’.
  4. Whenever you receive goods which may be damaged or there are obvious shortages, insist that a Transporters Representative be present whilst the goods are checked.

The following documents are normally required:

  1. Marine Certificate
  2. Original or Non-negotiable Bill of Lading.
  3. Original Invoice(s) and Packing List.
  4. Inland Transporters Consignment.
  5. Port Documents E.g. Release Order, Port Charges, Port-Examination Voucher, if issued, etc.
  6. Survey Report.
  7. Correspondence exchanged with Third Parties.

For major losses, Insurers directly appoint Surveyors or Loss Adjusters who provide the following services:

  1. Inspect and determine nature/extent of loss
  2. Investigate and determine cause of loss
  3. Assist in loss mitigation and salvage disposal
  4. Assess quantum and negotiate claims settlement
  5. Obtain evidence of loss e.g. photographs, expert reports and documents
  6. Initiate recovery against liable carriers or bailees
  7. Issue detailed Survey/Adjustment report to Insurers.

Fidelity Guarantee Claims

  1. Notify us immediately if you discover a loss / have reason to believe there has been an act of fraud or dishonesty involving one or more of your employees.
  2. Report to the police/authorities for further investigation to be carried out.
  3. Withhold any salary/wages due to the fraudulent employees.
  4. Submit all the required claim documentation at the earliest including, a duly completed claim form, Appointment letter, Reference letters, Police abstract, Termination letter, Copy of ID for the suspect and other relevant documentation to support the claim.

WIBA Claims

  1. Notify the Director of Occupational Safety & Health Services within 24 hours in writing for any Fatal Injuries and within 7 days in case of other Injuries if the employee has been away from work for more than 72 hours
  2. Advise us of the Injury as soon as possible.
  3. Ensure that an Incident Report has been made and signed by the Supervisor and at least two witnesses when the incident is still fresh in their minds.
  4. For all Companies with more than 20 employees, a Health and Safety Committee must be constituted. Whenever an employee is injured, the Committee must submit a Report.
  5. Submit all the required claim documentation at the earliest

Claim Documentation

An Injury not leading to Permanent Total Disability:

  1. Claim Form
  2. DOSH I which acts as a claim form.
  3. DOSH II which should be completed by the attending doctor, acts as the medical certificate
  4. Original Medical Bills
  5. Medical Receipts
  6. Copy of certified pay slip for one month prior to the date of the incident
  7. Copy of national identity card
  8. Statement by the injured party/ employee
  9. Statement by a witness.

Claim Documentation

An Injury leading to any degree of Permanent Total Disability:

  1. This is processed six months after an injury.
  2. The documents stated above will have already been submitted and medical expenses and Temporary Total Disability bit of the claim paid.
  3. The injured should obtain a medical certificate and forward the same to both the DOSH office and to the insurers.
  4. The DOSH office will compute the benefits payable on a form called DOSH WIBA 4 form and if the claimant is in agreement with the computations, then they sign three (3) copies of DOSH WIBA5/A. These forms are provided to the claimant at any DOHSS office.

Claim Documentation

If the injury is fatal please provide the following additional documents

  1. Death Certificate
  2. Post-mortem Report
  3. Death Permit
  4. List of Beneficiaries

N.B DOSH form parts I & II- are obtained from the labour office. An incident report and copy of the claimant’s payslip need to be submitted to the labour office to get these documents done DOSH form part II will indicate the benefit payable for TTD.