Claims
The claims department at an insurance company is the section that manages the settling and adjusting of claims. This department is an essential part of any insurance company's operations and is one of its core functions.
Some activities they are responsible for include:
- Receiving notice of claim from insureds.
- Adjusting and evaluating whether a loss is covered or not.
- Determining the amount of money or other compensation to be paid to the insured for insured losses.
- Investigating claims to determine whether fraud has occurred.
- Other tasks involving the handling and processes of claims received
Their role is to guide the policyholder along the claims process, investigate the claim for legitimacy and the extent of the damage, and eventually approve or deny a claim based on the insured’s claim filing paperwork, their coverage, and other factors.
See Coverages See All Products
Claims
The claims department at an insurance company is the section that manages the settling and adjusting of claims. This department is an essential part of any insurance company's operations and is one of its core functions.
Some activities they are responsible for include:
- Receiving notice of claim from insureds.
- Adjusting and evaluating whether a loss is covered or not.
- Determining the amount of money or other compensation to be paid to the insured for insured losses.
- Investigating claims to determine whether fraud has occurred.
- Other tasks involving the handling and processes of claims received
Their role is to guide the policyholder along the claims process, investigate the claim for legitimacy and the extent of the damage, and eventually approve or deny a claim based on the insured’s claim filing paperwork, their coverage, and other factors.
See Coverages See All Products Accident or Sickness Claim Form 2024.
| Claims Documents | Death Claims (Accidental Death, Unprovoked Murder or Assault, Burial Benefit) | Disablement / Dismemberment Claims | Accidental Medical Reimbursement / Daily Hospital Allowance |
|---|---|---|---|
| Accomplished MAAGAP Claim Form | X | X | X |
| Two (2) valid government ID | X | X | X |
| Photocopy of the issued Certificate of Insurance | X | X | X |
| Copy of the Policy Report | X | X | X |
| Original Official Receipts | X | X | |
| PSA copy of the certificate Birth Certificate | X | ||
| PSA copy of the certificate of Marriage, if married | X | ||
| Post Mortem certificate, for murder cases | X | ||
| Copy of Driver’s License with covering OR (if the accident happened while the insured is driving a motorcycle or a vehicle) | X | X | X |
| Photo of affected part of the body (whole body & close shot of the affected body part) | X | ||
| Radiology report | X | ||
| Hospital medical records – for amputation & operation by attending physician | X | ||
| Medical Certificate with degree of disability or dismemberment / Attending Physician Certificate, if claim form is not accomplished | X | X | |
| Hospital Statement of Account (SOA) | X |
Coverages
Motor Car Claims
Requirements for Filing a Claim:
- Own Damage
- ⁃ Insurance Policys
- ⁃ Official Receipt of premium payment
- ⁃ Car Registration and Official Receipt (MVRR)/ Delivery Receipt and Sales Invoice (for Brand New)
- ⁃ Duly notarized Original Owner's/Drivers Affidavit or Duly Accomplished Accident Report Form/ Police Report (Original or certified true copy)
- ⁃ Driver's License and Official Receipt
- ⁃ Stencils of Motor and Chassis Number of Insured Vehicle
- ⁃ Repair Estimates
- ⁃ Photographs of damaged vehicle
- Third Party Property Damage to Vehicle
- ⁃ Same as the Own Damage Requirements
- ⁃ Stencils of Motor and Chassis Number of Third Party Vehicle
- ⁃ Certificate of No Claim
- Third Party Other Than Vehicle
- ⁃ Colored pictures of the damaged property
- ⁃ Estimated cost of repairs of the damaged property
- ⁃ Proof of Ownership
- ⁃ Other Requirements that the attending adjuster may require in connection to the claim
- Third Party Bodily Injury / Compulsary Third Party Liability (CTPL or VTPL)
- ⁃ Original Medical Certificate
- ⁃ Receipts of Medicine (original)
- ⁃ Hospital Bills
- ⁃ Birth Certificate (if minor)
- ⁃ Other Requirements that the attending adjuster may require in connection to the claim
- Third Party Death Claim
- ⁃ Death Certificate
- ⁃ Funeral Receipts
- ⁃ Marriage Contract (if married)
- ⁃ Birth Certificate (if minor or single)
- ⁃ Other Requirements that the attending adjuster may require in connection to the claim
- Carnap
- ⁃ Original Insurance Policy
- ⁃ Original Endorsement, (if any)
- ⁃ Original OR of premium payment
- ⁃ Original Car Registration and Official Receipt
- ⁃ Original Assured's Affidavit of Loss
- ⁃ Complaint Sheet (original or certified true copy)
- ⁃ Alarm Sheet (original or certified true copy)
- ⁃ Original Certificate of Non-Recovery
- ⁃ Outstanding balance from the bank (if mortgaged)
- ⁃ Purchase Invoice/Delivery Receipt (if necessary)
- ⁃ Original/Spare Keys
- ⁃ Car Manual
***Other Requirements that the attending adjuster may require in connection to the claim
Non-Motor Car Claims
Our Non-Motor claims unit handles all claims relating to non-motor insurance cover, such as;
- Personal, Family & Group Personal accident
- Foreign Travel
- Workmen's Compensation
- Fire & Allied Perils
- Goods & Cash in Transit
- Public Liability
- Engineering & Construction
- Marine & Aviation Policies
As soon as you discover loss or damage to your assets, kindly report it to us and our competent and well trained claims staff will assist you through the process.
Generally, when an accident occurs, you should comply with the following;
- Report the incident to the police or fire service (in case of fire)
- Contact us immediately and complete a claim form for the specific cover
- Take all steps to protect the damaged property for inspection by us
- Do not settle or negotiate to settle, admit or repudiate any claim without our consent
- Submit all relevant documentary evidence in respect of the loss to us
- Submit all claims, writs or letters from third parties to us unanswered
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