The Nigerian insurance industry has long been plagued by a trust deficit, with many policyholders struggling to receive timely payouts on legitimate claims. This has led to widespread skepticism and a perception that insurers deliberately create obstacles to avoid settling claims. However, a shift in regulatory focus, spearheaded by the National Insurance Commission (NICOM) and its Commissioner for Insurance, Olusegun Omosehin, promises to change this narrative. Omosehin has publicly emphasized the need for a change in attitude within the industry, urging insurers to “find reasons to pay claims” and prioritizing claims settlement to restore public trust. This directive has been reinforced through various initiatives, including publicizing consumer complaints about unpaid claims and making claims payment a central theme in industry meetings. The regulator’s commitment, coupled with the stated willingness of industry players to align with this new direction, offers hope for improved claims processing and a more positive experience for policyholders.
Despite this positive regulatory push, the onus still lies, in part, with policyholders to navigate the claims process effectively. Data from NAICOM reveals the significant scale of unpaid claims, amounting to billions of Naira and millions of dollars, affecting policyholders across various insurance types, particularly life, group life, and motor insurance. These unpaid claims represent not just financial hardship but often deep emotional distress, as illustrated by the case of Bose Abidemi, a beneficiary entangled in a five-year battle with an insurer over a life assurance claim following her uncle’s death. Her experience, and that of a Lagos-based entrepreneur whose motor insurance claim was denied due to a technicality, underscores the challenges policyholders face even when their claims are valid. These stories highlight the need for policyholders to be proactive and well-informed to ensure a smoother claims process.
A key factor in ensuring prompt claims settlement is a thorough understanding of one’s insurance policy. Coronation Life Assurance, a leading insurance provider, stresses the importance of policyholders familiarizing themselves with the details of their coverage, including limits, exemptions, and any timelines for filing claims. This knowledge empowers policyholders to manage expectations, anticipate potential issues, and avoid surprises during the claims process. Similarly, the US-based Gunn Law Group emphasizes the importance of scrutinizing policy documents for misrepresentations or gaps in coverage before an incident occurs. This proactive approach can prevent disputes and ensure that policyholders are adequately protected in the event of a claim. Asking questions and seeking legal advice when necessary are crucial steps in this process.
Beyond understanding the policy, proper documentation is paramount in supporting a claim. Insurers require concrete evidence to validate claims, and lacking the necessary documentation can lead to delays or outright rejection. Examples of essential documents include medical reports, death certificates, valid identification, and any other documents specified by the insurer. Having these documents readily available can significantly expedite the claims process. Furthermore, maintaining honest and transparent communication with the insurer is crucial. Providing accurate and complete information without embellishment or omission builds trust and avoids raising suspicion, which can lead to further investigation and delays.
The insurance industry operates on a foundation of trust, and maintaining this trust is essential for both insurers and policyholders. The regulator’s current focus on claims settlement and the commitment of industry players to improve claims processing are positive steps towards rebuilding trust. However, policyholders also have a crucial role to play. By understanding their policies thoroughly, diligently gathering and submitting necessary documentation, and maintaining honest communication with their insurers, policyholders can significantly improve their chances of receiving timely and fair claim settlements.
In conclusion, the current regulatory environment in Nigeria’s insurance industry, with its strong emphasis on claims settlement, offers renewed hope for policyholders. However, a proactive approach from policyholders remains essential. By being informed, prepared, and transparent, policyholders can effectively navigate the claims process, protect their rights, and ensure that insurance provides the financial security and peace of mind it promises. The combined efforts of a proactive regulator, responsive insurers, and informed policyholders can pave the way for a more trustworthy and efficient insurance sector in Nigeria.
