Insurance Claim

As we have discussed in our various articles, the whole essence of insurance is the reimbursement or the provision of indemnity by the insurance company to the policyholder. This indemnity is what is known as insurance claim. Our main focus in this article is to discuss what insurance claims means, its types and others.

Meaning of insurance claim

Insurance claim means a request from a policyholder to his insurer for the provision of reimbursement or indemnity against the losses covered by the terms of the insurance policy. The filling of an insurance claims comes after the occurrence of the risk or risks as covered by the terms of the insurance policy. Thus, where the incident of insurance happens, you must formally file for the claims with your insurance company. The filling of the claims represents a notice to the insurance company that the event upon which they undertook to indemnify you has occurred and that they should pay you the claims amount as contained on the policy or replace or repairs depending on the terms of the policy or your agreement with the insurance company.

Similarly, medical bills, income replacements, alternative accommodations etc may also constitute part of the claims payable by your insurer. And these reimbursements provide relief in such circumstances.

Processes of filling an insurance claim

There are certain procedures to be taken by a policyholder in the event for filling a claim. Some of these procedures are;

Notify your insurer

The first step in filling for an insurance claim from your insurer is the process known as raising a claim. This is the period where you first put your insurer on notice of the occurrence of the incident covered by your insurance policy. Thus, when the risk covered by your policy occurs, you must first report to your insurance provider.

File your claims.

After informing your insurers about your accident, there is also the need to file your claims. This involves filling the claims forms at your insurer’s office or claims website. However, to this, you will need to prepare all the paperwork you may need in filling for the claims. These documents may include but not limited to;

  1. All photographs of the incident and damage to your bike
  2. Information from all parties
  3. Any and all applicable medical bills
  4. The police report
  5. Documents in relation to expenses like receipts medical bills, towing bills and other expenses
  6. Any other relevant document which your insurers may require.

Reviews of claims

It is not out of place for your insurance company to review the claims you have made. They will usually send an assessor in the event of an accident or other happenings. They may equally likely visit scene of the incident for the full appraisal of the level of damage or loss. The essence of this step by the insurance company is to determine the value of the damage and how much they will pay you.  It is therefore good for you to sincerely work with such an assessor.

Make your own research.

Not minding that the assessor determines final claim, it is still proper for you to make your independent findings. This research will enable you to find out the monetary value of the damage and others.  Your research may equally extend to knowing your limits and coverage options for insurance policy.

Approval of claims

After the review of your claims by the insurance company and it meets the terms and conditions set by the terms of the policy, your insurer will approve the claim. Once your claims are approved, your insurer pays same to you. However, in the event of life insurance claims, your beneficiaries will receive the insurance benefits

Receive your claim.

After the review and approval of your claims by the insurance company, the next step is to receive your claims. And usually, the amount of your payment or indemnity will depend on the terms of your policy and level of coverage. So, this will determine the level of coverage and what you will receive as an indemnity or what your beneficiaries will receive as insurance benefits in the event you have subscribed to life insurance policy.

Types of insurance claims

There are various types of insurance claims and we are going to examine some of them here;

  1. General insurance claims.
  2. First party insurance claims
  3. Car insurance claims
  4. Health insurance claims
  5. Homeowner claim
  6. Natural disaster claim

General insurance claims

This is a type of claim that arises from or related to a significant inaccuracy in any representation or any breach of the terms of the insurance policy.

First party insurance claim

This is the claim filed by the holder himself. When a policyholder suffers illness or sustains an injury or damages with respect to the object of insurance, he will file the claims arising from such occurrence with the insurer for the payment of indemnity or for replacement or for reimbursement. This is what is called first party insurance claim. In other words, when the policyholder files a claim under his policy with his insurance company..

 Car insurance claim

This is the type of claims filed with respect to car insurance coverage. Car insurance claims maybe with respect to car accident injuries, injuries to third parties, replacements or cost of repairs etc.

Health insurance claims

This is a claim with respect to health insurance.  The types of health claim may include but not limited to medications, surgeries, hospital stays, emergency medical cares, ante natal cares, deliveries etc.

Homeowner claims

Most often, homeowners protect themselves against damage to their homes as a result of fire, flood etc. the types of claims filed to seek the provision of indemnity in the happening of the events insured against is called homeowner insurance claim.

Natural disaster claim

This are claims with respect to natural disasters like hurricanes, earthquakes, windstorms, and other natural disasters.

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