Sometimes insurers don’t want to pay your claim. Why?
Because if they don’t have to, they probably won’t. Them paying does not depend on their mood but on what they are legally bound to do, which is determined by the contract that they have with you: it’s called your policy.
As ever, it takes 2 to tango and in this case it is not different. Both parties have duties and obligations. We thought we will quickly run your through some of them so that hopefully next time you claim, you actually will get paid.
What the insurer needs to do……….
An insurer needs set aside a certain amount of their income to reserve for claims. How much that is, is regulated, monitored and enforced by MAS, the financial industry regulator. Insurance companies also have to abide by the Personal Data Protection Act. This regulates the collection, use and disclosure of personal data.
More importantly, the insurer also has a duty to defend you when third party liability claims are raised (i.e. you get held liable by someone else), even if coverage under the policy is in doubt and may eventually not exist. The Insurer should act promptly and fairly in dealings with you and when investigating and negotiating any claim or defending and your interest.
The most important obligation of course is to pay claims based on the benefits, time periods and exclusions agreed in your policy.
What you need to do……..
Be honest! You must provide true and honest information when you buy insurance and at renewal. You need to disclose any important information that could influence the insurers decision to accept your insurance or not. Fail to do so and there is a big chance that your policy will be cancelled or voided. Even claimed funds that have already been paid can be asked back. The insurer will not refund your premium either.
Act normal! The fact that you are insured, should not change your behaviour and you are required to act carefully. If Insurers find you have been reckless or negligent, they will consider discontinuing your cover and not pay claims.
Keep stuff up to date! You also have to keep all your information up-to-date. Any change in circumstance, such as change in address, business activity (for Corporate Clients) that is relevant should be reported immediately.
Pay on time! In Singapore, you are only covered after premium has been paid to your insurance broker or the insurer. Regardless of how well and how many premiums you’ve paid for in the past, once you are late paying for your policy the insurer is no longer obliged tokeep their end of the deal. (Only a life insurance policy with cash values could be an exception).
Communicate and cooperate! Tell the insurer asap if something happens to give them the opportunity to investigate and determine any action to limit a loss. You also have the obligation to cooperate, think of giving access to your premises, attending hearings and trials (in case of third party liability claims) and providing additional evidence.
Keep the pics, notes and receipts! You may be asked to submit evidence that substantiates your claim. In case of larger or complex losses, insurers may actually decide to appoint an independent party (called loss adjuster) to determine the cause and the extent of the loss.
If despite all good intentions, you and your Insurer cannot come to an agreement about certain issues such as the amount of a claim, you can go to FIDReC (the Financial Industry Disputes Resolution Centre), for affordable dispute resolution.
We hope you will stay out of trouble. We know it may be tedious, but when you have a moment; read your policy. If you have bought it through us you can download it after logging into your account. It may be a good investment.
If in doubt about anything, just give us a call or chat with us online!