Insurance Claim Procedure (How to Guide)



insurance umbrella

Life is full of the unexpected and unfortunately, accidents do happen. The thought of filing an insurance claim afterwards can be daunting. If the incident wasn’t bad enough, now you have to relive it in explicit detail in the hope that your insurance company will help you out.

The good news is that insurance companies have tried to make lodging a claim as easy as possible. The internet has made filing insurance claims a lot easier.

Insurance companies have different procedures and different methods when it comes to filing an insurance claim. The insurance claim procedure is heavily dependent on what you are claiming for and the policy that you have. The steps you follow for car insurance might be completely different from those involved in pet insurance.

There is however a general process that most insurance companies follow when it comes to filing claims.

How to File Insurance Claims

Before we get into the steps, it’s important to understand what an insurance claim is. An insurance claim is a request made to an insurance company by the policyholder. This claim formally notifies the insurer that the policyholder has suffered a loss or damage and claims coverage or compensation against their policy.

Here is a general step-by-step guide on the insurance claim procedure.

how to file an insurance claim word cloud

Step 1: Contact your Insurer

Learning your insurance policy off by heart is impractical and basically impossible. Luckily most insurance companies have consultants that will be able to tell you all about your policy. If anything does happen, the best first step is to contact your insurance company.

A consultant will be able to tell you exactly what to do and exactly what your policy entails. For example, if you’re involved in a car accident, most insurance companies offer 24-hour towing at no extra charge.

It’s also important to note that insurance companies have specific terms and conditions that they want you to follow otherwise they might reject the claim.

Step 2: Damage report for insurance (Take note of the details)

Insurance companies need to know exactly what happened. You need to specify exactly what you are claiming. Be sure to take note of who, what, when, where and how. Even the smallest detail can be of use to your insurer.

It’s also important to make sure you are very clear when explaining what happened. The details need to be accurate and consistent if you want to receive a settlement.

Insurance companies also like to see photographs. So make sure you have photos that will be useful in providing a clear picture of the incident.

taking notes insurance claim

Step 3: Contact the police

In South Africa, most insurance companies will ask for a case number (which you can only get from the police). In some cases not contacting the police is a violation of your policy. If a law has been broken, the police need to be informed (such as in a house robbery).

A police report helps to clarify exactly what happened. It’s useful to get all the details down on paper so that when the insurance company starts asking questions, you have all the answers and the evidence to back it up. Not having the details can be one of the main reasons for rejecting an insurance claim.

It also helps you to remember when it happened and who was involved. A police report can really help to speed up the claims process.

police man in uniform

Step 4: File a standard insurance claim

Most insurance companies will allow you to submit an insurance claim on their website, via a phone call with an insurance agent or via email. Insurance companies like MiWay, Sanlam and Discovery all have apps that allow you to file claims with minimal hassle.

The insurance company will want to see any supporting information, such as proof that you own the item (in the case of a house robbery). This is where you’ll use all the details you made sure to remember and submit your case number.

You submit all this information and then you should get a response from the insurance company with your claim number. Usually, insurance companies communicate via SMS or email to give the customer updates on the claim.

Step 5: Don’t wait too long

For the best results, it’s best to file the claim as soon as possible. This way the incident will be fresh in your mind and you’ll have all the evidence you need.

It is also important to note that most insurance companies have a cut off period from when you can submit your claim. For example, First for Women insurance requires you to submit your claim within 30 days of the incident while other companies allow up to a year.

Step 6: Keep all your documents

Insurance companies like to dot their i’s and cross their t’s. They will need all the information about the incident and might ask for it more than once. If you’re making a claim, it’s important that you keep everything.

file insurance documents

Procedures for Claiming: Whether or Not to Claim?

Deciding to claim is linked with your excess and the type of policy that you have. Your policy will determine whether it’s worthwhile to claim.

At some point during the insurance claim procedure, your insurer will also tell you about any excess you need to pay. Depending on the claim type you might have to pay the excess upfront before the company will proceed with the claim. This is when you can decide it’s worthwhile to claim.

Most insurance companies work on a no-claim bonus. Your monthly premiums are linked to whether or not you claim. If you do decide to claim your monthly premiums may increase. Some insurance companies give their policyholder cashback for not claiming.

What Next?

Once you’ve submitted your claim, it is up to you to decide whether claiming is worthwhile both in the short term and in the long term. If you choose to claim, the insurance company will then validate the claim and, once approved, issue payment to the insured or to someone else on behalf of the insured.

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