Claims management is the carrying out of the entire claims process with particular emphasis on the monitoring and lowering of claims review, investigation and negotiation. A claim is a request to be reimbursed (or compensated) filed by the insured and addressed to the insurer.
Effective claims management is a critical factor in achieving satisfactory underwriting results. The procedure for handling claims varies according to the type of cover, amount of claim, and whether it is a personal or commercial claim.
SIC maintains in-house investigators, engineers and surveyors to handle most of the claims, in order to detect any fraud or abuse in the processing of claims.
Furthermore, in-house lawyers aid claim management procedures and law enforcement investigations in an attempt to reduce insurance fraud and litigation.
A. Injury Cases
- Police report
- Medical report
- Original receipts of Medical bills incurred (To justify the cost being claimed for)
- Personal particulars
- Affidavit
- 2 passport-size pictures of the injured victim endorsed by the doctor who treated the victim
B. Deceased (Death) Cases
- Police Report
- Death certificate/Burial permit
- Letters of Administration
- Personal particulars of the deceased
- Affidavit
- Endorsed passport size pictures of Administrator (two each)
C. Property Damage Claim
- Police Report
- An estimate of the cost of repairs
- Pictures of the damaged vehicle
- Photocopy of the driver’s licence
In the event of any occurrence which might give rise to a claim the Insured shall:
- Immediately notify the Company by telephone or telegram as well as in writing, giving an indication as to the nature and extent of the loss or damage;
- Insured should take all steps within his power to minimize the extent of the loss or damage;
- Insured should preserve the parts affected.
- Furnish all such information and documentary evidence as the Company may require.
- The Company may at their own option repair or replace what is damaged or pay in cash for the loss or damage.
- The Company shall not be liable for the cost of any repairs undertaken by the Insured without the Company’s’ written permission.
- The Company shall not be liable for loss or damage of which no notice has been received by the Company within 14 days of its occurrence.
- Upon notification of a claim being given to the Company, the Insured may carry out repairs of any minor damage or replace items, which have sustained any minor damage, but in all other cases a representative of the Company shall have the opportunity of inspecting the damage before any alterations are effected.
- If a claim is in any respect fraudulent, or if any false declaration is made or used in support thereof, or if any fraudulent means or devices are used by the Insured or anyone acting on his behalf to obtain any benefit under this policy, or if a claim is made and rejected and no action or suit is commenced within three months after such rejection or, in the case of arbitration taking place as provided for herein, within three months after the arbitrators or umpire have made their award, all benefit under this policy shall be forfeited.
- Whenever a claim arise and the same loss, damage or liability is covered by any other insurance, the Company shall not be liable to pay or contribute more than their rate able proportion of any claim for such loss, damage or liability. The Insured shall be obliged to inform the Company of any other insurance covering the same insured property.
- Injury/Death - up to 3 years from the date of accident
- Damage - up to 6 years from the date of accident
NOTE: Write a letter of claim directly to us as soon as practicable but within the above stated period.
- Where an unlicensed person was driving
- Where there was no insurance cover at the time of the accident
- Where there is change of ownership of the vehicle insured
- Statute barred claims; that is, where the claim was not submitted within the period stated in 3 above
- Using the vehicle without the Insured’s consent
- Using the vehicle for unauthorized purposes
- Using the vehicle whilst the driver is drunk
- The police report is needed to help establish liability
- Always report accidents to the PoliceReport to us and complete an accident report form
- Submit a photocopy of the driver’s license
- Submit all claims, writs and letters unanswered to us
- Do not admit liability, or make any payment or offer of payment without our consent
- Do not effect repairs before we inspect the damage vehicle.
- The policy holder (Insured)
- Any one whose property has been damaged by the insured vehicle
- The injured victim (s
- The Administrator of a deceased’s estate
- Parents or guardians in the case of minors
NOTE: Insured do not request claimants to engage the services of a lawyer; engaging the services of a lawyer is a matter of your choice
