INSURANCE CLAIMS PROCEDURE

It is a normal policy condition that in the event of any occurrence that may give rises
to claim, you should notify us immediately and provide us with full information as
soon as possible thereafter.

The “Golden Rule” to follow in the event of an occurrence that may give rise to a
claim is:

“NOTIFY US IMMEDIATELY AND ACT AS IF YOU ARE UNINSURED AND ON

THIS BASIS MINIMISE THE LOSS”

MOTOR
In the event of an accident take all the details of the location and the cause of the
accident. Where a Third Party is involved, NEVER ADMIT LIABILITY but
exchange your particulars and those of your Insurers with the driver of the Third
Party vehicle.

In all cases of bodily injury, report to the Police immediately.

 Remove the vehicle to a place of safety. (This can be done without prior
authority).
 Notify us of the accident as quickly as possible.
 Complete a Claim Form and send it to us.
 Submit to us an estimate of the cost of repairs (Comprehensive Policies Only). Do
not authorize repairs without the prior consent of the Insurers.
 Where the accident has been reported to the Police, obtain a Police Abstract
Report and forward it to us.
 Advise us of any Third Party claims and forward to us any correspondence
received from the Third Party unacknowledged.

BURGLARY
 Inform the Police and make an official Report to them. Ascertain the amount you
have lost and notify us as quickly as possible.
 Complete a Claim Form and submit it to us.

MONEY
 Report the loss to the nearest Police Station.
 Ascertain the amount of the loss and advise us as soon as possible.
 Complete a Claim Form and forward it to us.

GROUP PERSONAL ACCIDENT

 Advise us of injury to or death of any of the insured people immediately.
 Complete a Claim form and forward this to us.
 Submit Medical Bills to us and advise the date of return to duty.
 In the event that the benefits are calculated on a multiple of annual salary, advise
us of the salary of the employee concerned.
 Obtain a Doctor’s Report and submit this to us.

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 In case of death, obtain a Death Certificate and forward this to us quickly.

WORK INJURY BENEFITS INSURANCE

 Claim form duly completed immediately after accident
 Complete four copies of form DOSH 1 (Parts I & II) sent to Director
 Eye witness statement
 Copy of Accident Register
 Copies of wages receipts for three months
 Copy of wages register for the year of accident
 Two medical reports from the Doctor attending the injured employee, one to
Labour Officer and one to us.
 Medical invoices, Receipts and other medical notes
 Photocopy of National ID of the injured workman
 Death Certificate of the deceased employee
 Copy of limited grant obtained by the dependants
 Photocopies of the dependants or those who hold limited grant
 A copy of the order of the competent Authority certifying the names of
dependants
 Any other document needed for substantiatiation of the claim
 If the employee prefers settlement as per assessment, the Labour Officer will
make the assessment and when this is returned send it to us immediately under
the following forms.
 LD Form 102(Revised) for agreement as to compensation to be paid by the
employee
 Form LD 105/1 – Notice of accident by or on behalf of the workman
 Form LD 180 (Revised) – Assessment by the Director / Provincial Officer
 Settlement receipt given by the employee to the Provincial Officer / Director

PUBLIC LIABILITY
 Advise us immediately of any event likely to give rise to a claim.
 Complete a Claim form and forward this to us as quickly as possible.
 All correspondence received from the claimant should be forwarded to us
unacknowledged.
MARINE
Advise us of the loss and then forward to us the following documents as soon as
possible.
 Original Certificate or Cover Note.
 Original or non-negotiable Bills of Lading
 Invoice(s) and Packing specification.
 Port Documents.
 Consignment Notes.
 Survey Report.
 Correspondence exchange with Third Parties.
Note: As there is normally some delay before receiving a reply from the Carrier, do
not wait for this but submit other documents and send carrier’s Reply when received.

FIRE AND CONSEQUENTIAL LOSS

 Notify us immediately.
 Complete a Claim form and send it to us.

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 Obtain an estimate of repairs and advise us.
 Do not start repairs without authority from Insurers.

ALL RISKS
 Notify us immediately.
 Complete a Claim Form quickly and send it to us.
HOUSE OWNERS AND HOUSEHOLDERS
 In the event of burglary or theft, report to the nearest Police Station.
 Take immediate action to minimize the loss.
 Complete a Claim Form and forward it to us together with an estimate of repair of
any damage as soon as possible.
BOILER EXPLOSION AND MACHINERY BREAKDOWN
 Advise us immediately.
 Complete a Claim Form and send it to us together with a detailed repair estimate
as soon as possible.

FIDELITY GUARANTEE
 Advise us, immediately you discover, or have reason to believe, that there has
been an act of fraud or dishonesty involving one or more of your employees.
Carry out a thorough investigation of the theft and/or fraudulent act and inform
the Police authorities for the necessary action to be taken.
Withhold any moneys due to the fraudulent employee(s) and submit a detailed
claim for the net amount of the loss to us within 3 months of the date of discovery.
Note: The onus is on the employer to prove the loss, therefore fully documented
 Evidence must be made available to the Insurers.
 The Police must be informed.
 If you enter into an agreement with an employee to repay the loss then cover is
automatically nullified in respect of that employee.

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