Non-motor claims process

CLASSES OF INSURANCE

On the happening of any event or incident that may lead to a loss occurrence the same is to be notified to Sesa immediately. The procedure for the same is detailed below:

OVERVIEW OF CLAIMS WORKFLOW

1.Events giving rise to the claim

This may be an insured loss event, often provokes a discussion between the insured and insurer as to whether the event is a circumstance worthy of notificatio

2. Claim Notification
Is when insured or insureds representatives (agents or brokers) reports the claim to Sesa Insurance Ltd in the prescribed format (by phone, email, claim forms etc.) The purpose is to enable us to take steps to investigate the claim (or occurrences of which might give rise to the claim) in order to minimize its exposure under the policy. Notification ought to be done immediately through Sesa Insurance Ltd email address: generalclaims@sesainsurance.co.ke
2. Claim Notification
4.Response to Claimant

The insurer’s first response to the insured may be an acknowledgement, request for more information/documentation and claim estimate.

5. Claim Investigation

Armed with the full facts of the case along with supportive documentation, a settlement offer is made. Settlement proposal will be shared in the form of a discharge voucher for Insured’s execution and return for settlement.

7. Claim Recoveries

Following payment of the claim, often the insurer under subrogation rights will be able to recover all or part of the outlay from other sources e.g. negligent third parties, reinsurers etc.

8. Review of Performance

Reviews are normally carried out in respect of a sample of outstanding/closed files, or any particular problematic claims.

This is important in order to ensure that service standards are maintained, internal decisions were correctly made, adequacy in reserving and lessons learnt can be incorporated in our Claims Management philosophy.