MWANZA:INSURANCE clients have been urged to report claims to their insurers orally within 48 hours and in writing within seven days after an incident occurs.
The Tanzania Insurance Regulatory Authority (TIRA) Manager for the Lake Zone, Mr Richard Toyota said insurance clients need to report the claims on time so that procedures could be followed and enable payment on time.
He was speaking during a community insurance awareness campaign in Mwanza city. Mr Toyota insisted that reporting incidents promptly aligns with the guidelines under Sections 6(2)(e) and 11(b) of the Insurance Act, Chapter 394, which require policyholders to provide accurate information to their insurers when a claim arises.
Moreover, as per national laws, he said incidents must also be reported to relevant authorities such as the Police Force or specific agencies based on the nature of the incident.
Giving an example, he said fire incidents must be reported to the Fire and Rescue Force. Mr Toyota said to address public knowledge gaps, TIRA developed claims handling guidelines in 2022, where those guidelines are mandatory for all insurance service providers to implement and follow.
He underscored the importance of adhering to the claims reporting process, describing it as the foundation for claim assessment and settlement. He noted that the person reporting the claim does not necessarily need to be the policyholder, it could be their representative.
He said once a claim is reported, the insurer will guide the policyholder or their representative on the necessary steps, including submitting required documents relevant to the type of incident.
Mr Toyota further explained that the guidelines aim to improve claims handling systems within the insurance sector, which is crucial for fostering public trust in insurance services.
“These guidelines establish clear timelines for managing insurance claims, starting from the initial incident report to final payment”, he said.
He said those guidelines also adhere to best practices in claims handling, as outlined in Section 131(3) of the Insurance Act.
“They apply to registered and licensed insurance institutions, policyholders, beneficiaries and other stakeholders,” he added.
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Mr Toyota highlighted the roles of those institutions, which include implementing systems to manage claim processing timelines, enhancing customer experiences by adhering to the timelines and promoting economic and social well-being.
“These measures also aim to strengthen public confidence in insurance services”, he said. He clarified that insurers are legally required to settle claims within 45 days from the date a settlement agreement is signed.
However, he noted that the law does not specify timelines for certain stages of the claims process, such as obtaining police reports, court judgments, or death certificates.
Delays in these stages often depend on how quickly claimants are able to secure the necessary documents. “The introduction of these guidelines offers a long-term solution.
In the past, insurers were not required to adhere to specific timelines for processing claims, unless the claimant and insurer had already agreed on the compensation amount and method,” he explained.
He also stressed that TIRA’s Lake Zone office will continue its efforts to educate the public on the importance of insurance, aiming to encourage more people to enrol in insurance services for their financial security and overall well-being.
