When an unfortunate event occurs, you'll need to be familiar with the insurance claim process in order to mitigate those headaches as much as possible. Here are claims procedures for various classes of insurance.
- Notify us immediately.
- Complete a Claim form quickly and send it to us together with a purchase invoice & pro-forma invoice for a computer similar to the one lost/damaged. If loss was as a result of a burglary, inform the police. In the event of a major computer claim the Loss Adjuster may require an Engineers’ report.
- Notify us immediately
- Download and complete the claim form and send it to us(Claims@canopykenya.com)
- Obtain an estimate of repairs and advise us
- Do not start repairs without authority from Insurers
- In the event of burglary or theft, inform the police and make an official report to them. Ascertain the amount you have lost and notify us as quickly as possible. Complete a claim form and submit it to us. A loss adjuster may be appointed and he may request you to provide a valued inventory of stock held at the time of loss.
Motor – (Private, Commercial, Motor Cycle)
In the event of an accident take all the details of the location and the cause of the accident. Where a Third Party is involved, NEVER ADMIT LIABILITY but exchange your particulars and those of your Insurers with the other party involved, note the exact location and immediately report to the police within 48 hours.
- In all cases of bodily injury, report to the Police immediately and note to get names and details of as many witnesses as possible.
- Do not enter into discussions concerning negligence of either party involved, or take any action to be construed as an admission of liability. Simply do not admit liability.
- Remove the vehicle to a place of safety and if vehicle is extensively damaged have it towed to a garage where the Insurers Assessor can assess it.
- Notify us of the accident as quickly as possible.
- Complete a Claim Form and Send it to us together with a copy of the driver’s licence and a police abstract report. Your broker will advise on the excess amount applicable.
- Submit to us an estimate of the cost of repairs (Comprehensive Policies Only). DO NOT authorise repairs without the prior consent of the Insurers.
- Advise us of the Third Party Claims and forward to us any correspondence received from the Third Party, unacknowledged.
- In the event of theft of a motor vehicle you will be required to submit the original logbook of the subject vehicle, Copy of certificate of incorporation, vehicle service records and Copy of Insured’s PIN certificate.
Machinery Breakdown Insurance
- Notify us immediately in case of accidental electrical or mechanical breakdown of a machine.
- Complete a claim and submit to us
- Obtain the technical report on the cause of damage and submit together with repair/replacement estimates
- A loss adjustor will be appointed to inspect the damage and validate the repair estimates
- Partial Loss: The damaged part is replaced with no depreciation charged
- Total Loss: Part is replaced
- Notify us immediately.
- Complete a claim form and send it together with a replacement invoice. Inform the police and obtain an abstract report
- You should report the loss to the nearest police station
- Ascertain the amount of loss and advise us as soon as possible. You will be required to forward to us a duly completed claim form, Transaction receipts or banking slips and statements from one or two senior employees.
- Be careful about policy warranties particulary escort warranty and daily banking warranty
- Ensure documents requested by investigator are forwarded through Canopy.
- Advise us, immediately you discover, or have reason to believe, that there has been an act of fraud or dishonesty involving one or more of your employees.
- Carry out a thorough investigation of the theft and/or fraudulent act and inform the police authorities for the necessary action to be taken.
- Withhold any moneys due to the fraudulent employee(s) and submit a detailed claim for the net amount of the loss to us.
- Note The onus is on the employer to prove the loss, therefore fully documented evidence must be made available to the Insurers. The police must be informed. If you enter into any agreement with the culprit to repay the loss then cover is automatically nullified in respect of that employee. A loss adjuster is normally appointed.
WIBA/Group Personal Accident
Following an incident leading to a claim, the following documents should be obtained. Copies should also be sent to the area Occupational Health and Safety Officer for records.
An Injury not leading to Permanent Total Disability:
- DOSH I which acts as claim form.
- DOSH II which should be completed by the attending doctor, acts as the medical certificate
- Original Medical Bills
- Medical Receipts
- Copy of certified pay slip for one month prior to the date of incident
- Copy of national identity card
- Statement by the injured party/ employee
- Statement by a witness.
DOSH form part I & II- are obtained from labour office. An incident report and copy of the claimant’s payslip need to be submitted to the labour office to get these documents done DOSH form part II will indicate benefit payable for TTD. An Injury leading to any degree of Permanent Total Disability:
This is processed six months after an injury.
- The documents stated above will have already been submitted and medical expenses and Temporary Total Disability bit of the claim paid.
- The injured should obtain a medical certificate and forward the same to both the DOSH office and to the insurers.
- The DOSH office will compute the benefits payable on a form called DOSH WIBA 4 form and if the claimant is in agreement with the computations, then they sign three (3) copies of DOSH WIBA5/A. These forms are provided to the claimant at any DOHSS office.
If the injury is fatal please provide the following additional documents:-
- Death Certificate
- Post-mortem Report
- Death Permit
A claim may arise out of either the WIBA policy as highlighted above and once the relevant documents are obtained, the issue of negligence is argued in Court. However, demand letters and court summons from the claimant’s representatives must be sent to us/Insurers immediately upon receipt.
Upon happening of an event, take all reasonable steps to protect the injured person or property. Advise us immediately of the event, complete a claim form and forward it to us immediately. No correspondence should be entered into with a third party except acknowledging receipt of the claim which should read as follows: -
"Without Prejudice" we acknowledge receipt of your correspondence concerning an incident at ..........................................
This is receiving our attention.
All correspondence received from the claimant or his representatives should be forwarded to us unacknowledged. Where possible provide witnesses statements.
- Do not give any interview or make any statement to a Loss Assessor or other person investigating any accident or damage unless such person is acting on behalf of your Insurer or Principal.
Goods In Transit (Git), Marine Insurance &Carriers Liability
Should insured goods be delivered in a damaged condition or if there is any reason to suspect damage, the attention of the Carrier's or Shipper's Representative should be immediately drawn to same and the delivery receipt claused accordingly. In the event of suspected damage, it is suggested that the receipt be claused "Goods believed to be damaged. Accepted subject to survey in store".
A letter of claim should be immediately lodged with the Carrier or Shipping Company's Agent.
Canopy should be advised by telephone of any loss or damage and an estimate of repair or replacement cost provided. This notification will enable the Broker to arrange for the Underwriter's Surveyor to call.
A claim form should be prepared and sent to CANOPY together with the following :‑
Documents required in marine claim
- Original Marine Insurance Certificate
- Air Waybill
- Shipper’s Invoice/Packing List
- Arrival Cargo Advice – Provide details/quantity/weight of cargo landed.
- Customs Entry Form C63
- Arrival/Transfer Manifest/Check Weight Docket
- Release or Delivery Order
- Owner’s Risk Consignment Notes/Delivery Notes from carriers
- Survey Report
- Letter of Indemnity
- Claim Form
For major losses, Insurers directly appoint Surveyors or Loss Adjusters who provide the following services:-
- Inspect and determine nature/extent of loss
- Investigate and determine cause of loss
- Assist in loss mitigation and salvage disposal
- Assess quantum and negotiate claims settlement
- Obtain evidence of loss e.g. photographs, expert reports and documents
- Initiate recovery against liable carriers or bailees
Issue detailed Survey/Adjustment report to Insurers.
Note: As there is normally some delay before receiving a reply from the Carrier, do not wait for this but submit other documents and send Carrier's Reply when received.
In the event of burglary or theft, report to the nearest police station.
Take immediate action to minimize the loss
- Notify us as soon as possible
- Complete a claim form and forward it to us, together with an estimate of repair of any damage, as soon as possible.
- Loss adjustor is normally appointed to assess the extent of the damage.