Your insurance should protect you

by Rosemary ONUOHA

As an insurance consumer, your insurance company should protect you once your offer is accepted and until the expiry date of your policy or its written cancellation by you or them.

 

Hence, the fact that you have only the Certificate of Insurance where the policy document is yet to be issued does not invalidate your protection. In addition to your insurance protecting you, there are other rights which you must enjoy as an insurance consumer.

One of such rights is the right to be informed which entails that all the terms of the contract must be expressly stated to you in the policy. The insurer must inform you of the changes in its address, terms of the contract, cancellation of your policy, and change in premium rate all in advance. It is your right under the law to receive in advance a specimen copy of the policy document to be issued to you. Your insurer cannot be telling you of a condition you were not aware of, after you have suffered a loss.

Another benefit is the right to choose which means that you can shop among many insurance providers to compare price, terms, scope of cover, service delivery, ownership structure, regulatory status etc. There is no law that forces you to buy insurance through a broker or agent though insurance is a highly technical contract and dealing direct with the insurer will not reduce your premium. Using a broker may infact reduce your premium, enhance your benefits and help you at the time of claim.

Another benefit is the right to be heard; hence it is your right to be attended to when you have a complaint. In addition to the insurance provider itself, you can also pass your complaint to the National Insurance Commission, (NAICOM); the Insurance Consumers Association of Nigeria (INSCAN); the Nigerian Insurers ASSOCIATION, NIA, or the Consumer Protection Council of Nigeria, (CPC). Most insurance policies contain the condition that both parries must first explore the Arbitration option before embarking on court action.

Also you have a right to redress which means that it is your right to get redress when your right under the insurance contract is trampled upon. You may be entitled to redress in the following cases: denial of claim; delayed claim; professional negligence; inadequate compensation; non-remittance of premium; poor service delivery; denial of premium refund, etc.

Another benefit is the right to good service which entails that you are entitled to prompt and efficient service from your insurance provider in the areas of receipt of your documents, your claims, your refund, and sending to you other support service providers like motor assessors, cargo superintendent, engineers, doctors and loss adjusters. Your insurance company should not be requesting for your claim substantiating document piece-meal. Your claim must be accepted or rejected within 90 days of filing same.

Your responsibility as a consumer

As an insurance consumer, you also have the following duties under the insurance contract and they are the duty to disclose which entails that insurance contract is guided by the utmost good faith requiring fullest disclosure of all the facts that are material to the contract. Failure to obey this rule may invalidate the contract. However, the law requires the insurance companies to expressly ask the questions considered material to them in their proposal forms. Tell them the truth.

Also you have the duty to pay premium which entails that it is both contractual and statutory duty to pay your insurance premium in advance and the condition is that “No Premium, No Cover”. You may request for cover up to the period where your payment can carry you in case you cannot afford the full annual premium at once.

You also have a duty to control losses which entails that in case of loss, you are under the duty to minimize the loss. You are expected to tow your vehicle to the nearest garage/safe place in case of accident. In case of fire, call fire brigade and protect whatever is left of your property from further damage or loss.

Another duty you have is to keep accurate records. There must be documentary evidence of your claims from your insurer. It is your duty to keep an inventory and receipts of all your purchases. In case of value-addition, renovation, increase in market price, you should be prepared to show evidence.

You also have a duty to comply with policy conditions because the policy document is the evidence of the contract between you and the insurance provider and it is its contents that will be interpreted whenever there is a dispute. You will need to take proper notice of provisions like claim notification period, days of grace to pay premium, claims filing procedure, dispute resolution mechanism and the perils that are excluded or exempted from your policy.