Wednesday 23 July 2014

No premium no cover: Insurers get five days to pay claims

By Sola Alabadan

The subsidiaries of Nigerian insurance companies in Ghana including Equity Assurance, WAPIC, Regency Alliance, IEI Ghana and NEM Insurance, have been directed to pay all genuine claims within five working days in order to raise public confidence and trust in the insurance industry. The directive also applies to all other insurance companies in Ghana.

The National Insurance Commission, Ghana came up with this new guidelines on claims management for non-life insurers in keeping with the 'no premium no cover policy'. The policy stipulates that the receipt of an insurance premium shall be a condition precedent to a valid contract of insurance and that there shall be no cover in respect of an insurance risk, unless the premium is paid in advance.

The guidelines which takes effect from August 1, 2014 mandates insurers to pay all genuine claims within five working days once the claimant has submitted all required documents, and the insurer has admitted liability and issued the discharge form.

While the insurers are to determine liability within five working days, where liability is not admissible, the insurers are also required to inform the claimant in writing within five working days upon determination of liability, stating the reasons for rejecting the claim.

After the acceptance of the insurer's settlement by the reinsurer, the reinsurer is obliged to pay its proportion of the claim in respect of facultative placements within five working days.

Going forward, the insurers are also required to educate the policyholders to report claims in a timely manner, as well as draw the people's attention to the fact that prompt reporting of the loss is crucial for the preservation of evidence that may be required in determining admissibility and the quantum of the claim.

Where a claim is reported late, the insurers were directed not to repudiate such without ascertaining the reasons for the late notification.

Besides, the insurers are mandated to have a documented system and procedure for receiving, registering and resolving complaints in each of its offices.

While it is also the duty of insurer to update the complainant regularly on the process of the claim, if the complainant is dissatisfied with an insurer's response, the insurer is required to advice the complainant to report to the regulator and provide the contact details of the regulator to the complainant.




Source Daily Independent

No comments: