The purchase or sale of insurance involves a contract which gives rights but also imposes obligations to both parties.
Therefore, knowing your rights and fulfilling your responsibilities is central to getting your claim paid in the shortest possible time.
There has been a lot of cynicism about insurers in regard to the manner in which they handle issues of claims.
Before apportioning blame to either the insurer or the policy holder, it is important to first appreciate how insurance works.
Insurance is an agreement between you and an insurance company whereby the latter guarantees to compensate you for a specified loss, damage, illness or death as the result of an unforeseen event.
The insurance company agrees to compensate you if you make a claim and in return you agree to pay your premium to the insurance company.
Premium is the price paid by policyholders to insurance companies in return for insurance coverage.
Before entering a contract, it is important to exercise due diligence and care. Remember, you have a right to be informed fully details about the product that is being offered, the main features and benefits, any exclusion in the policy, how long the cover will last and whether you have any cancellation rights.
You have a right to be treated fairly, to timely complaint resolution, and to privacy.
With rights, however, come responsibilities including, for example, the expectation that you will provide complete and accurate information to your insurer, pay the agreed premiums make claims in agreed schedules and provide the requisite supportive documentation.
Duty of policy makers
Policyholders should honour what they have committed themselves to.
They should be aware of obligations to fulfill terms of agreements and take responsibility for non-fulfillment of those terms.
Consumers not satisfied with the contract terms should refuse to accept them, instead of hastily entering into agreements and going back on them afterwards. At the end of the day, it is your money.
Don’t commit yourself before fully understanding what you are committing it for.
Bearing the above in mind, we can now apportion blame for the mass pessimism about insurers in regard to claims.
Whereas insurers may have a share of it, sometimes a greater share goes to the policyholders.
If you have a problem with any insurance player, first assess carefully what was promised at the time of purchase and in the terms of the contract to see if you have a justified case.
Sometimes the problem is outside the scope of the policy while in other cases, it’s due to the non-fulfilment of your obligations.
Always be truthful in your statements and avoid exaggerating and omitting facts that are relevant to the situation.
Otherwise, the Insurance Regulatory Authority of Uganda (IRA) has important roles to play in ensuring that your rights are protected.
If you have a complaint that your insurerbrokeragent has failed to resolve, you may seek redress from the Authority.
The writer is the assistant director of market research and development with the Insurance Regulatory Authority of Uganda.
SOURCE: Daily Monitor