Claim

After suffering a peril that causes damage to the insured property, an insured submits a claim. A claim is an official request for repairs to or replacement of the insured item. Only those perils listed in the insurance policy can be claimed for. For example, should an insured have third-party insurance only, he or she cannot make a claim for theft as this peril is not included in his or her policy.

As a client of the insurance company, the insured has a legal right to make claims, but it is the insurance company’s right to challenge the legitimacy of the claim. Claims are lodged either in writing or telephonically with the insurance company who then decides whether the risk is covered in the policy and whether or not the insured lived up to his or her obligations in the policy.

Should a claim be rejected, and the insured unhappy with the decision, he or she can challenge the insurance company’s decision by appealing it and then taking the matter to the insurance ombudsman.

Claims should be made as soon after a peril occurs as possible. If the insured waits longer than 30 days after the incident to make a claim, the insurance company can reject it.