How to File an Insurance Claim in Kenya.

Filing an insurance claim in Kenya is not quite easy particularly when it occurs following an accident, hospital emergency or sudden loss. A lot of individuals purchase insurance policies and do not even know the claims process until the time they require it. Regrettably, ignorance results into late payments, rejection of claims and frustrations in terms of finances.

This article offers a step-by-step guide on how to file an insurance claim in Kenya, what documents you need, what are the most frequent mistakes that people make, and what questions people frequently have. No matter what type of claim is involved, be it motor insurance claim, a medical claim, life insurance claim, or property insurance claim, this guide will enable you to go through the process confidently.

Insurance Claim Process in Kenya.

Insurance is to help you come out of crisis. It is however not until you have succeeded in making a claim that you can truly realize the true value of an insurance policy. The Insurance Regulatory Authority (IRA Kenya) indicates that inability to adhere to appropriate claim procedures is one of the key reasons why claims are denied.

Being aware of the process is helpful because it helps you:

• Minimize inappropriate claim denials.
• Get to settle and compensate faster.
• Get to know your policyholder rights.
• Select good insurance firms in Kenya.

Procedure: How to Make an Insurance Claim in Kenya.

Step 1: Read your Insurance Policy.

Always refer to your insurance contract before you file a claim. Key things to check include:

• Coverage limits – What is covered in your policy?
• Exclusions – Not covered (e.g. drunk driving on motor insurance).
• Timelines – Deadlines on the reporting and submissions.

Example: In the case of a motor vehicle insurance claim, in Kenya, the insurance companies demand that you notify them about an accident within 24 hours.

Step 2: Notify of the Incident As Soon As Possible.

The time aspect is important in insurance claims. You should always notify your insurer immediately the incident has happened.

• Motor Insurance Claim in Kenya – Report to the police, get a police abstract and inform your insurer.
• Medical Insurance Claim – To get cashless medical cover, you should notify the hospital and your insurance company immediately. To get reimbursements, retain all medical bills and receipts.
• Life Insurance Claim– Inform the insurer of death and beneficiary details using a death certificate.
• Property Insurance Claim – Report the damage to the authority (fire department /police) and report to your insurer.

Step 3: Assemble All the necessary documents.

Every kind of the insurance claim in Kenya demands accompanying paperwork. Losses of documents are usually problematic and may result in delays or rejection.

Motor Insurance Documents:

• Police abstract,
• Claim form,
• Driving license copy,
• Logbook
• Accident photos.

The Medical Insurance Documents:

• Hospital bills.
• Discharge summary.
• Doctor report.
• Claim form.
• SHA statement.

Life Insurance Document:

• Death certificate.
• Claim form.
• ID copies of beneficiaries
• Policy document.

Property Insurance Documents:

• Fire or theft report.
• Valuation report.
• Photos of damage.
• Claim form.

Hint: It is always wise to copy all the documents sent.

Step 4: Complete the Claim Form

A claim form will be issued by the insurance company. Complete it honestly and verify information like dates, names and description of an incident. Fraudulent data may result in dismissal of claims and even black listing.

Step 5: Claim Assessment

When you have submitted your documents, the insurance company will send an assessor or a loss adjuster to confirm the claim.

• Assessors of motor vehicles examine the level of damage.
• Medical insurance companies call the hospital to verify treatment.
• Life insurers check death certificates.
• Adjusters are sent to inspect damage by property insurers.

Step 6: Claim Approval, Settlement.

Upon verification, the insurance company makes payment or makes service arrangements. Timescale of settlements will differ depending on the claim type:

• Motor Insurance Claim– 7 to 30 working days.
• Medical Insurance Claim – Cashless cover is immediate; payment is made within 14- 30days.
• Life Insurance Claim– Normally 30-60 days upon document verification.
• Claim on Property Insurance – 30 to 90 days as per investigations.

Top mistakes that people do when making insurance claims in Kenya.

• Late reporting – Most of the people take long before they can report to their insurer leading claim is rejection.
• Late submission of documents– The absence of abstracts, receipts or IDs slows down approvals.
• False information – Insurers may put you on the blacklist because of false information.
• Disregard of policy exclusions – e.g. motor insurance will not cover accidents caused by unlicensed drivers.
• Failure to follow up – A large number of claims fail to materialize because the claimant failed to follow-up on the claims.

Insurance claims in Kenya: some recommendations on how to get faster approval.

• You should always purchase insurance cover with licensed insurance companies in Kenya that are approved by IRA.
• Make your premiums on good time–lapsed policy claims are denied.
• Keep good records of receipts, hospital bills or photos of accidents.
• Keep in touch with your broker or insurer.
• A copy of your policy document should be kept so that you can refer to it at any time.

Insurance claims in Kenya Frequently asked questions.

What is the duration of the insurance claim in Kenya?

• Motor Insurance: 7-30 days
• Medical Insurance: Instant (cashless) or 14-30 days (reimbursement)
• Life Insurance: 30-60 days
• Property Insurance: 30- 90 days based on investigations.

What are the reasons why insurance claims are rejected in Kenya?

• The incident was reported out of time.
• Inconsistent information or false information.
• Missing documents.
• Exclusions of policies in your plan.
• Failure to pay insurance premium.

Is it possible to put in an insurance claim online in Kenya?

Yes. Most insurers like Jubilee Insurance, Britam, CIC group and APA insurance enable you to claim online using their websites or mobile apps.

What is the insurance claims regulation in Kenya?

The Insurance Regulatory Authority (IRA Kenya) regulates the insurance companies in order to ensure equitable settlement of claims and guard the rights of the policyholders.

What are the most preferred insurance companies in Kenya in faster claims?

The most reputable insurers with effective settlement of claims are:

• Jubilee Insurance (life insurance and medical insurance)
• Britam Insurance (general and life insurance)
• CIC Insurance Group (motor insurance)
• APA Insurance (property, motor, medical)
• Madison Insurance (life insurance and medical insurance).

Submitting an insurance claim in Kenya does not necessarily have to be a stress. By possessing the appropriate knowledge, that is, knowing your policy, reporting on time, presenting correct documents and following up, you will save unnecessary delays and fully enjoy the benefits of your insurance cover.

Whenever selecting an insurer, ensure that the companies with good reputation on regards to settling claims quickly are the top priority rather than the low premium companies. Keep in mind it is not the cost of an insurance policy that gives an insurance policy a true test but the reliability of the insurance when you need it the most.