How to Make an Insurance Claim in Nigeria

What Does “Insurance Claim” Mean in Nigeria

An insurance claim is when you (the policyholder) tell your insurance company: “Something bad happened that my insurance policy covers. Please pay for the damage, loss or cost.”

• You pay a premium (money regularly) so the insurer agrees that if damage or loss happens (as defined in policy), they will help pay or replace or cover cost.

• Example: you have motor insurance, someone hits your car. You claim to have repairs paid (minus what you pay as deductible, etc.).

Related Terms You Should Know

• Policyholder: the person who owns the insurance policy.

• Insured event / loss / peril: what must happen for insurer to pay (e.g. fire, accident, theft).

• Premium: what you pay to keep insurance active.

• Deductible / Excess: amount you must pay first before insurance pays the rest.

• Sum insured or coverage limit: maximum amount insurer will pay under the policy.

• Claim form: document you fill to report your claim.

• Adjuster / Surveyor: person insurer sends to check damage or verify your loss.

• Exclusion: things policy doesn’t cover.

Types of Insurance Claims Nigerians Often Make

Different kinds of insurance have their own claim types. Here are common ones.

Motor / Auto Insurance Claims

• Claims after a car accident (your car damaged or third party damaged).

• Theft of vehicle.

• Vandalism damage.

• Natural disaster damage (flood, hail etc.), if covered.

Health / Medical Insurance Claims

• Hospital bills: inpatient or outpatient treatment.

• Surgical procedures.

• Prescription medications.

• Emergency care.

Property Insurance Claims

• House fire, storm damage, flood (if covered), theft.

• Office / business premises damage.

Life Insurance Claims

• Death of insured. Nominees apply.

• Maturity claims (policy ends and pays out).

Travel Insurance Claims

• Loss or delay of baggage.

• Medical emergency abroad.

• Trip cancellation.

Agricultural Insurance Claims

• Loss of crops due to weather, pests etc.

• Loss of livestock.

Why Some Claims Are Delayed or Rejected

Knowing why claims fail or get delayed helps you avoid mistakes.

Not Reading the Policy Carefully (Exclusions / Conditions)

• If the event is excluded (for example, flood not covered unless you have flood rider).

• If policy requires certain conditions (e.g. use particular repair shops, follow safety guidelines) and you didn’t.

Late Notification of Claim

• Many insurance policies require you to report the loss or damage quickly. If you wait long, insurer may reject.

Poor or Incomplete Documentation

• Missing receipts, no proof of loss, no police or medical reports if required.

• Weak or no evidence (photos, videos).

Discrepancies in your statements or dishonesty

• If you misstate facts, exaggerate damage, or omit something, insurer may deny.

Unlicensed / Illegal Activity

• If damage due to illegal act, or if you don’t have valid license (for your car), insurer may deny coverage.

Poor Communication / Non‑cooperation

• If you don’t allow adjuster to inspect, or don’t give required information or documents, claims may stall or be denied.

Step‑by‑Step Guide: How to File an Insurance Claim in Nigeria

Here is a detailed step‑by‑step process. Different claim types may have slight differences, but these general steps apply.

Step 1: Review Your Insurance Policy

• Read your policy document. Look at what perils are covered, what exclusions exist. Understand deductible, coverage limit, what you must do when loss happens.

• If unclear, ask your insurance company or your broker to explain.

Step 2: Immediately After the Incident – Safe the Scene & Notify

• If it’s an accident (car), theft, fire, flood, etc., try to take pictures or video of the damage. Document everything.

• If theft or crime involved, go to the police, get a police report.

• Notify your insurer quickly. Many policies say you must report within certain time (e.g. 24‑72 hours).

Step 3: Gather Required Documents and Evidence

• Receipts, invoices for damaged items or repair, proof of ownership (e.g. purchase invoice).

• Photographs or videos of damage.

• For medical: hospital bills, prescriptions, medical reports.

• For life insurance: death certificate, proof of identity, policy document, sometimes medical records.

• For auto: driver’s license, vehicle registration, police report if required, repair estimates.

Step 4: Fill the Claim Form and Submit

• Obtain the correct claim form from the insurer. It might be physical or online.

• Fill it carefully. Include your policy number, details of incident (what happened, when, where), list of items lost or damage, how much you think the loss is (estimate).

• Attach all required documents. Keep copies for yourself.

• Submit to the insurer or via your broker.

Step 5: Investigation or Assessment by Insurer (Surveyor)

• Insurer assigns a claims adjuster or surveyor who inspects damage or loss. They verify that it matches your report.

• They may visit property, car etc. Check photos, documents.

• They might ask more questions or request more documents.

Step 6: Offer / Settlement Decision

• After assessment, insurer decides whether claim is valid and what amount they will pay (minus deductible).

• They will send you a settlement offer: amount, payment method, any repairs or replacements allowed.

• If you agree, you accept; insurer will pay. If not, you can negotiate or appeal.

Step 7: Payment of Claim

• Once approved, insurer makes payment. Could be by bank transfer, cheque, or settlement with repairer (in auto or property repair).

• Payment is often less deductible and may take some days after approval.

Step 8: Completion & Record Keeping

• After payment or repair, keep all documents. Receipts, photos, communications. They matter in case of dispute or for your future insurance claims or renewals.

• Check policy to ensure your claim doesn’t affect premium badly or policy renewal.

Required Documents & Proofs for Different Types of Claims

Each type of claim needs special documents. Below is what you often need for each type.

Auto Insurance Claim Documents

• Your insurance policy document and premium payment proof.

• Valid driver’s license and vehicle registration.

• Police report (if accident or theft).

• Photos of damage (multiple angles).

• Repair estimates or invoices.

• Witness statements if others saw the incident.

Health / Medical Insurance Claim Documents

• Policy document and proof of premium payment.

• Hospital bills, doctor’s reports.

• Prescriptions and receipts.

• Admission/discharge papers if inpatient care.

• Laboratory reports, scans, diagnostic test proof.

Property Insurance Claim Documents

• Policy document.

• Proof of ownership or lease.

• Photos or videos of damage.

• Fire, police, or other agency report if needed.

• Repair or replacement estimates.

Life Insurance Claim Documents

• Policy document.

• Death certificate.

• Proof of identity of insured and nominee.

• Medical records (before death) if policy requires.

• Any other forms insurer asks (affidavit, cause of death).

Other Types (Travel, Agricultural etc.)

• Travel: tickets, proof of delay/cancellation, baggage loss report, receipts.

• Agricultural: crop yields, loss assessment by agricultural officer, weather reports, photographs.

Timelines: How Long Each Stage Should Take in Nigeria

Knowing approximate timelines helps you know when to expect action and payment.

Time to Report and File Claim

• Many policies require reporting within 24‑72 hours after incident, or as soon as possible. Delay can cause rejection.

Insurance Acknowledgement

• Once insurer receives claim notification, they often must acknowledge receipt within few business days.

• Example: Nigerian Agricultural Insurance Corporation (NAIC) aims to acknowledge within 48 working hours of receipt of claim notification.

Investigation and Assessment Period

• Depending on complexity: small claims (auto minor damage, small property loss) might be assessed in a few days. More complex claims (major damage, multiple parties, life insurance, injury etc.) may take weeks.

Settlement or Payment

• For valid claims, insurer should pay within policy or regulatory time frame after approval.

• Some insurers or regulators publish service standards: e.g. small claims paid within 2–5 days after valuation for general business at NAIC.

• Larger claims may take longer.

What Happens If Timelines Are Exceeded

• You should follow up with insurer.

• Use regulatory channels, complaint department.

• NAICOM (the National Insurance Commission) oversees insurer behavior and policyholders’ rights.

 What to Do If Your Claim Is Denied or Delayed

Sometimes despite doing everything, claim gets denied or delayed. Here’s what you can do.

 Understand the Reason for Denial or Delay

• Ask the insurer for the specific reason. It could be missing documents, excluded peril, late reporting, or wrong information.

• Check your policy terms and exclusions.

Appeal or Negotiation

• If you believe claim should be valid, negotiate. Provide extra documents.

• Some insurers have appeal or review process internally.

• Use broker if you have one—they often help in negotiation.

Involve Regulatory Body: NAICOM

• If insurer is unreasonably delaying or unfairly denying, you can escalate to NAICOM.

• NAICOM regulates insurance companies and protects policyholders.

• Keep copies of all correspondences as proof.

 Use Dispute Resolution Options

• Insurance Ombudsman (if available) or other consumer protection agencies.

• Court as last resort (if necessary).

Tips for Speeding Up & Improving Success of Your Claim

Here are practical tips to avoid delays and increase chances of successful claim.

 Tip 1: Read Your Policy Before Something Happens

• Know the perils covered, exclusions, how to report, what documents are needed.

• Plan in advance: make sure you keep receipts, photos, proof of ownership etc.

Tip 2: Report Immediately After Loss

• Don’t delay. Even one day can matter for evidence.

• Call insurer, your broker, get instructions, get police in case of crime.

 Tip 3: Collect Strong Evidence

• Photos, videos, receipts, proof of purchase, police or medical reports, witness statements.

• Use multiple angles for photos. Preserve physical evidence.

 Tip 4: Use Qualified Professionals for Repair Estimates

• Use certified repairers or proper contractors.

• Get multiple estimates if possible.

Tip 5: Keep Copies of Everything and Maintain Organized Records

• Make copies of documents you send. Keep originals safe.

• Have a folder (physical or digital) of your policy document, receipts, pictures etc.

 Tip 6: Communicate Clearly and Politely with Insurer

• Be honest, clear, accurate.

• Use emails or written communication where possible so you have records.

• Follow up regularly; ask for status updates.

 Tip 7: Use a Broker or Agent You Trust

• Agents/brokers often know faster ways, know what insurer requires.

• They can help prepare documents, follow up, negotiate.

Tip 8: Know Your Rights Under Nigerian Insurance Law

• Policyholders have rights: to fair treatment, to information, to see copies of policy, to negotiation, to lease of events etc.

• NAICOM supports policyholders.

Comparison: Auto, Life, Health, Property Claim Processes

Here is a comparison of how claim process and requirements differ among 4 big types. This helps you see what steps are unique to each.

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Real‑Life Examples: Successful Claims in Nigeria

To help you understand better, here are some examples (fictional but based on common real‑cases) showing how people did good, successful claims, and lessons learned.

Example 1: Auto Accident Claim – Adewale’s Car

• Situation: Adewale drives a saloon car with comprehensive motor insurance. His car collides with another at night, front bumper, headlight damage, some body scratches.

• What He Did Right: Immediately took photos of the damage, called police to get a report, notified insurer within same day, got repair estimates, contacted his broker who helped with preferred repair shop.

• Claim Steps: Filled claim form, submitted documents (license, vehicle registration, police report, repair estimate). Adjuster came next day to inspect. Settlement approved with deductible. Repair shop paid directly under agreement.

• Result: Adewale paid his deductible and minor parts not included, insurer paid remainder. Claim done in about 2 weeks.

Example 2: Hospitalization Claim – Blessing’s Health Insurance

• Situation: Blessing has health insurance with a private insurer. She is admitted for appendix appendicitis.

• What She Did Right: She kept all hospital bills, doctor’s reports, discharge summary; had proof of policy premiums paid; submitted claim form from insurer; followed up.

• What Went Wrong (initially): Some receipts were missing; some lab results not clearly labelled; insurer asked for clarification. Blessing quickly provided missing docs.

• Result: After corrections, insurer approved and paid. Delay of some days due to missing docs, but result positive.

Example 3: Property Fire Claim – Chinedu’s Shop

• Situation: Chinedu owns small shop in Lagos. Fire broke out, destroying inventory, damaging shop structure.

• What He Did Right: Took photos, video, got fire brigade report, police report (if required), collected proof of inventory ownership (receipts, stock lists), notified insurer quickly.

• Challenges: Some inventory had no receipts; some stock had lost invoice. He used business records, sales data, supplier invoices to estimate.

• Result: Insurer assessed damage, structural damage estimate via contractor, inventory estimate via stock records. Paid amount after deductible. Chinedu replaced stock and repaired structure. Took about 1 month.

Summary Table Before Conclusion

Below is a summary table to help you quickly see what needed, steps, tips, timelines, and what to watch out for.

Conclusion

Making an insurance claim in Nigeria can seem hard, but if you know the steps, prepare well, and act quickly, it becomes much easier. The key things: understand your insurance policy before something bad happens, document everything, report loss fast, fill forms carefully, provide required documents, cooperate, and follow up.

Every claim is different—auto, health, life, property—but the basics are the same. If you do the right things, you increase the chance your claim will be approved, paid fairly, and quickly. And if something goes wrong, know your rights, including regulatory body help from NAICOM, and appeal if needed.

Insurance exists to protect you. Be a responsible policyholder. Stay organized. Don’t leave things to luck.