This is a very important process. Claims is actually the insurance product. One of the ways, an insurance company’s service is tested is the clarity and the efficiency with which claims are serviced.
Simple reality of life is accidents happen. Such events are more often than not emotional. Claim process need not be anxious moments if adequate pre-cautions are taken at the time of claims processing. We assist all our clients through the claim process. Commercial establishments often have professionals (such as qualified insurance professionals, lawyers) dealing with the claims and often know how to deal with these things. Our retail customers often have a lot of questions. Based on our experience, we have compiled general guidelines or good practices to follow in the event of claims for the following products.
- Please have your policy details easily accessible and in hand.
- One of the very important things is not to delay reporting the claim. All claims should be intimated to the insurance company immediately. We as your insurance broker will assist you in this process.
- Unless there is a life threatening situation, there may be a need to leave things untouched for the moment briefly as in some situations the insurance company may appoint a surveyor to come and inspect the damage. This is very critical and if not handled properly will impact the veracity of the claim.
- If immediate repair is required, contact us, your insurance broker immediately.
- Please keep all original documents such as repair invoices, and/or purchase receipts. You may need to submit this along with the claim form.
- You may need a claim form.
- Please also always keep the replaced parts etc. as the insurance company may want to take that or otherwise dispose it. ”
Most medical insurance policies whether purchased in the individual capacity or as a Group through your employer will be administered directly at the service provider. Most Medical insurers will have an approved list of medical service providers you can go to directly for medical advice and insurance services. You may need to pay a co-pay for the OPD type medical visits.
In case it is a planned procedure, the medical service provider will contact your insurance company or its appointed Third Party Administrator and the procedure is likely to be smooth as per insurance policy’s coverage.
In case you choose to go to non-network practitioner, you have to submit the original bills along with the claim form. The amount, if covered under your insurance policy, will be re-imbursed to you. In such cases to avoid claims being rejected, it is useful to call the insurance company first and ask them for specific coverage details based on your current requirements.
Please keep all original invoices and prescriptions as you may be required to submit it to the insurance company along with the claim form.
In case you still encounter claims being rejected, please check if it fits one of the most common reasons for medical claims being rejected and address the relevant issues accordingly. If the claim is not covered under the policy, nothing much can be done. Most common reasons why the medical claims are rejected are :
- Treatment sought without prior authorization
- Improper claim filing (missing information, illegibility)
- Claims not filed within time limits
- Treatment not covered by policy
- Procedure deemed medically unnecessary
Motor Insurance Claims – Accident
- In the case of an accident, please call the police to the site and have them prepare an initial report. Please note that all communication is bi-lingual, both in Chinese and in English. Please understand the documents very well before signing on anything. It is within your rights to ask for an explanation in English before you accept any documentation or sign it.
- In case repairs are needed or you need to tow the vehicle and comprehensive insurance is in force, please call the call centre of the insurance policy issuer. If you are a member of AA, you can call them for assistance as well. Please note that repairs can commence only after inspection has been done by a duly appointed surveyor of the insurance company.
- Take full details of any third party involved (name, address, telephone number, registration number and if possible insurance details).
- Please intimate the claim immediately to the insurance company or to us.
- Please have your policy details handy together with details of the vehicle driver or person last in charge of the vehicle (date of birth, details of any previous accidents, convictions etc).
- You may need a claim form. It always helps to put down the details surrounding the accident in as much detail and as much accuracy as possible.
- In case of a third party being involved, always forward any correspondence from the third party to ourselves or the insurer without being requested for such documents.
Motor Insurance Claims – Theft of Vehicle
- Notify the police immediately and record the crime number.
- Please intimate the insurance company immediately. Please note that in case you are intimating the claim on the insurance company hotline, it is possible that they may not be able to assist you on the phone immediately.
- Please have your policy details handy, together with details of the vehicle driver or person last in charge of the vehicle (date of birth, details of any previous accidents, convictions etc).
- You will need a claim form.
- If your vehicle is recovered and the damage is repairable, you should contact the insurer’s call centre who should put you in contact with an approved repairer.
- If your car is stolen and not recovered, you should enclose with the claim form, your V5 registration form, purchase receipt, keys, service records and MOT certificate.
- We, as your insurance broker will help you through the claim process. Kindly let us know immediately.