A GUIDE TO INSURANCE CLAIMS 
                                                                                 
                                                                                IRA UGANDA  
                   
                   
                   
                             What is an Insurance Claim? 
                             An Insurance Claim is a formal request by a policy holder to an 
                             insurance  company  for  settlement  or  compensation  benefit 
                             following the occurrence of a loss event. 
                             When Making an Insurance Claim. 
                             Making an insurance claim is simple and stress-free especially 
                             if you get the details right. 
                             Here are the simple steps to follow when filing a claim. 
                              
                             Step 1- Immediately Notify your insurance provider 
                             Inform your insurer the details of your claim and ask them what 
                             they require from you. The insurance provider will usually need 
                             legal documentation, police records, witness statements among 
                             other things they may need.  
                             Please note that this is not to make the process difficult or 
                             burdensome for you. It is simply to make sure that your claim 
                             is genuine. 
                             Also, in case you buy your insurance policy through a broker, 
                             they often assist with the claim process by offering you support 
                             and advise and working with the insurance company to get your 
                             claim sorted. 
                             As you notify the authorities, Find Out the following below; 
                                  -   Whether the damage is covered under the terms of your 
                                      policy 
                                  -   How long you have to file a claim whether your claim 
                                      exceeds your deductible (the amount of loss you agree to 
                                      pay before insurance kicks in)   
                                  -   How long it will take to process the claim 
                                  -   whether you’ll need estimates for repairs 
                              
                                                                            
                   
                   
        
          Step 2- Prepare all the necessary documentation required 
          Having all the documents in place ensures a quick and efficient 
          processing  time.  It  is  important  you  keep  copies  of  all  the 
          documents and bills related to the incident. Write down detailed 
          notes following conversations about the incident for example 
          indicating the time, date and the people you spoke to during the 
          incident. 
          NB: Sometimes your insurer may require additional documents 
          to enable them process your claim. Make sure you avail all the 
          necessary documents. 
          Step 3  
          After your claim has been acknowledged and registered by your 
          insurer, get a reference or claim number from the insurer so that 
          you can track the claim.  
          Step 4 
          After filing the claim, an assessor may be appointed to assess 
          the  loss  or  damage  and  confirm  that  the  claim  is  valid.  An 
          assessor will typically take into account the whole sum insured 
          to determine the amount to be paid for the specific damaged or 
          lost item by insurance company. 
           
           
                            
        
        
        
        
        
        
        
        
        
        
                            The Claims Process and Service Standards for Insurers 
                         Activity                                     Indicative Timelines 
                 Step 
                 No 
                 1.      Claim Intimation                             *As per policy Conditions 
                 2.      Claim        acknowledgement            &  *Within 3 working days from intimation 
                         acquisition  of  documents/contact 
                         with the claimant 
                 3       Site     Visit/or     appointment       of  *Within 3 working days of the claim. 
                         assessor/adjusters                           *5  working  days  for  complex  claims 
                                                                      since they require approval by IRA 
                                                                       
                 4       Making        settlement      offer     or  *5  working  days  from  receipt  of  final 
                         communicating repudiation of claim  adjustment/investigation                  report     or 
                                                                      where  no  adjustment/investigation  is 
                                                                      required,  date  of  receiving  the  final 
                                                                      supporting documents. 
                                                                      *Discharge  voucher  to  be  submitted 
                                                                      together with adjustment report. 
                 5       Settling Claim                               *Up to Shs10 million: within 10 working 
                                                                      days after receipt of discharge voucher. 
                                                                      *Above Shs10M to Shs50M: Within 15 
                                                                      working days after receipt of discharge 
                                                                      voucher. 
                                                                      *Above Shs50M: Within 20 working days 
                                                                      after  receipt  of  discharge  voucher  or 
                                                                      upon receipt of cash call payment from 
                                                                      reinsurers whichever occurs first. 
                                                                       
                                                                       
                                                                      Note: To avoid delays, insurers should 
                                                                      do cash calls to reinsurers immediately 
                                                                      on receipt of the final adjuster s’ report.