Appraisal Of The Insurance Companies Approach To Claim Settlement

Appraisal Of The Insurance Companies Approach To Claim Settlement

Chapter One

Background Of Study

The saying “ HAD I KNOWN ”, is a frequent question of the mortal race. The expression can be convinced or conceivably excluded if mortal beings can prevision or fantasize what would be in future. Life itself is full of pitfalls and misgivings pullulate. Every individual faces pitfalls, either of particular nature or business nature.

A businessman for case faces the threat of his goods being damaged by fire while his dependant may suffer loss of income through his death. Inversely, a manufacturing establishment runs the physical threat of possible loss of goods by fire or theft or similar other specialized threat as loss of trade as a result of government programs, loss of trade of trade due to change in fashion, loss of profit as a result of fire outbreak. A auto proprietor for case stands to face the possible theft of his auto and damage through accident. sweats can be made to avoid some of these pitfalls. Accidents can be avoided if proper preventives are taken. An existent can avoid aeroplane disaster or crash by not engaging in air trip no matter how careful bone can be, some form of peril still hangs around.

Some pitfalls are essential in nature or life itself and can not be avoided. For case, men are mortal and must die, when complete avoidance is insolvable, man attempts to reduce or conceivably assumes pitfalls. A thatched roof house is a lesser fire threat than one with tiled roof. numerous people accept the small threat of erecting house of standard construction than that of thatched roof. Then the threat has not been avoided but reduced. threat supposition may also arise out of ignorance or may indeed be an purposeful art where the degree of expose threat is slight or possible loss is minimum. Assumption is indeed possible where a deliberate provision has been made for consequences of loss passing. numerous individualities would still prefer to shift or spread the threat where possible. It’s then that Social Economic Services rendered by Insurance companies will be appreciated. Insurance has been described as a social device by which the Insured agrees to transfer all or part of his pitfalls to the Insurer who agrees to compensate him when the threat ensured against happens on the payment of the decoration. The introductory part of insurance is to produce a common pool into which the individual or association contribute decoration commensurable with the degree of threat for which insurance is sought. The members of the pool who are unfortunate to suffer loss are compensated with the benefactions of others in the pool. In this way, the larger society is made to be made to be responsible for furnishing compensation for the unfortunate many who ineluctably dodge fiscal losses through the operation of certain mishap.

It’s thus obligatory on the part of the insurer to compensate the ensured( their customer) whenever, is loss on the item ensured against as long as the ensured abides to the conditions stated in the contract or policy. therefore, the ultramodern society retain insurance as the system of working the threat associated with their conditioning, in that it helps to soften the fiscal blow that would have redounded. When the public feels that this function isn’t being carried out the assiduity may suffer or face a possible collapse.

Statement Of Problem

The major reason for the establishment of insurance company is to give a bumper for individual or association that has or may suffer some mischance at a price called decoration. occasionally when loss occurs and claims presented, they’re delayed or declined and when paid it doesn’t restore the ensured to his former fiscal position. This has formed the mastermind of disagreement between the ensured and the insurer. These I suppose affect the station of assuring public and development of the insurance assiduity in Nigeria. It’s thus the purpose of the study to find out why claims are delayed or not paid at all and the part played by the assuring public that affect in claim being settled or declined. The study also finds out if approach to claim agreement affect station of the assuring public and to what extent it affect the development of the insurance assiduity.

Ideal/ Purpose Of Study

The ideal of this exploration work is to look into the performance of the Nigerian insurance assiduity viz a viz the procedure and approach to claim agreement. individualities hold different opinion about this assiduity and the general print is that the insurance assiduity has failed to win the confidence of the assuring public. frequently times, people make comment similar as “ unintentional to settle claim but always willing to collect decoration and use its small prints in the policy to decline its liability ”. It’s the belief about the assiduity is allowed to continue and not corrected that the assiduity will completely collapse and the after effect will be over bearing on the frugality. When we consider the significance of insurance in the profitable development of any nation, it’s thus the intention of the experimenter to find out if this allegation is true or else, proffer result and make recommendation that will help to break these problems.

The purpose of study among other effects is to-

– Find out if insurance companies are staking on the ignorance or ignorance of the assuring public.

– To find out what the perception of the public is towards insurance companies.

– To find out if there are laws that make it insolvable for them to settle claim that are genuine.

– To find out what makes it delicate for insurance companies to settle claim when they arise.

– To find out the effect of rate slice on the insurance companies.

Exploration Question

Having defined the background to the problem and purpose of study, it’s thus anticipated that practical answers will be handed to the following questions at the end of the study.

– Does ignorance of the public have nay effect on the capability of the insurer to settle claim?

– Does the assuring public involve interceders in their insurance affair or contract?

– Should emphasis be laid on police report before claim agreement?

– Why is the issue of under agreement common?

– Is there a shift from comprehensive to third party motor?

– How effective is their approach in claim agreement?

Significance Of Study

Claim administration is the core of insurance business; an effective and prompt setting service is the stylish of advertising for an insurance company.

But since claim agreement has been a subject of contestation this study will help-

– The insurer claim. Setting superior value and effective agreement of claim. The insurance company can change their client prospects and make them the machine energy of invention by harkening to their careful analysis, complaints compliment and evaluation of their services delivered.

– The study will also be applicable to academicians who may wish to know themselves of data and information about claim agreement situation in enugu, it’ll also enlighten the public at large on insurance matters. More so the study will serve as a dimension to putup experimenters and will give them the bases for validating and disapproving the finding of this study.

Compass And Limitation Of Study

The compass of this study covers Nigeria but because of time and difficulty in reaching all the insurance companies in Nigeria, the experimenter close to cover only the registered insurance companies in Enugu state.

LIMITATION- in carry out a exploration work experimenter is bound to encounter some difficulties which act as limiting factor. The following are the limitation in this study.

The cost of carrying out a exploration work is getting veritably grandly especially during this period of harsh profitable reality which places a lesser burden on the experimenter’s limited coffers.

In order to carry out an in- depth study on any subject matter time is absolutely needed.

The experimenter was constrained in carry out in- depth study on major matter due to complete factors affecting the disposal of time.

The position of some of the repliers caused some communication problem for experimenter and this her to calculate on the service of practitioner during interviews.

Getting response from marketable vehicle possessors was an uphill task.

These were shy accoutrements hence, the experimenter was faced with difficulties, in sourcing applicable material for this study.

The experimenter has calculate on substantially on material from oriental insurance co. The nature of this content was veritably general and wide. The experimenter has to constrict it down to vehicle insurance claim since it’s the most common, mandatory and formed the base on which conclusion about insurance is drawn.

Description Of Terms

POLICY this is a document which gives the term and condition of insurance contract. It’s popularly called insurance policy and it’s given to the ensured by the insurer after his offer has been accepted and his decoration paid. This shows an substantiation being contract between the ensured and the insurer.

decoration- is the financial consideration passing from the ensured to the insurer for their undertaking to pay the sum ensured in the event of the threat ensured against passing. It’s a necessary element in conformation of an insurance contract.

Offer FORM- This is a document drafted by the insurer and which seeks answers to main material aspects of the threat. It’s a questioned designed to evoke material information pertaining to the threat to be ensured. It’s completed by the person who wants to enter into insurance contract.

CLAIM FORM- This is a form in which the insured countries the circumstances of the circumstance of the damage or loss for which he sought the form given to him by the insurer.

CLAIM- This is an operation by the policy holder to exercise the right to compensate or profit under the policy.

LOSS ADJUSTERS This is an independent establishment whose services are employed by the insurance company if there’s redundant claim by the ensured to assess similar claim. After their assessment, their judgement is final and they’re paid for similar services by the insurance company.

NOTICE OF RENEWAL- A policy meant for one time for case, 2000- 1st January 2001 is anticipated to lapse at the end of one time. So before it setbacks, a renewal is transferred to the ensured reminding him to come and renew his policy because any claim on lapsed policy isn’t entertained.

ALMOST GOODFAITH- Due to its fiduciary nature it’s needed by this doctrine that all parties to an insurance contract should expose material fact concerning the contract that they want to enter into whether needed or not.

PROXIMATE CAUSE- The active effective cause that sets in stir a chain of events which brings about a result without intervention of any force stated and working laboriously. From new and independent source in PawsayV. Scottish union and public( 1907).

donation- is the right of an insurer to call upon others analogous but not inescapably inversely liable to the same ensured to partake the cost of an reprisal payment(J.I.Stell, rudiments of insurance study course II text, London, chapter 5 runner 5)

SUBROGATION- Is a contract that beholds reprisal contract. It’s to help the ensured from entering further than reprisal.

INSURABLE INTEREST- Legal to ensure arising out of fiscal relationship between the ensured and subject matter of insurance enforceable at law.

reprisal- Is the control principle of justice. Brett n CastellenV. Preston( 1883). Indemnity is a medium of pulling the ensured back to the former position he enjoyed incontinently before the loss.

threat- Is the chance of loss. threat is also the query as to the circumstance of an profitable loss.