Insurance: What Policyholders Should Know About Claims

When tragedy strikes, insurance should offer relief—not additional pain. Yet many Nigerian policyholders still struggle to receive timely payouts when they file claims. This article explains how to ensure claims are paid faster, especially in the current regulatory environment aimed at rebuilding trust in the industry.

In August 2024, Commissioner for Insurance, Olusegun Omosehin, declared that genuine claims must be paid to restore public trust. He announced the establishment of a dedicated claims department and emphasized a shift in market attitude towards prioritising claims settlement.

The National Insurance Commission (NAICOM) has since doubled down on this commitment by publicly highlighting consumer complaints over unpaid claims. At the 18th meeting of the Insurers Committee, key stakeholders aligned with the Commission’s priorities.

Despite the positive rhetoric, many policyholders remain frustrated. NAICOM data shows that 1,582 complaints involving over N24.59bn and $22.56m in unpaid claims remain unresolved. Most disputes are related to life, group life, and motor insurance.

Take Bose Abidemi, for instance. She has waited five years for a life assurance claim after her uncle’s death. Though he named her a beneficiary, her attempts to collect have been met with excuses. “We haven’t received the money. Instead, we’re left with heartaches,” she lamented.

Similarly, a Lagos-based entrepreneur’s comprehensive auto insurance claim was denied because he didn’t use a partner repair centre, even though the location was far from the crash site. These genuine claims remain unpaid due to technicalities or documentation issues, feeding a perception that insurers frustrate claimants until they give up.

Understanding how insurance claims work and what policyholders can do is critical. Coronation Life Assurance defines a claim as a formal request by a policyholder or beneficiary for compensation after a covered loss. Claims may follow events like car accidents, fire outbreaks, or death.

To ensure prompt payment:

Understand your policy. Policyholders and beneficiaries must be clear on what is covered, any exemptions, and deadlines. Being informed helps manage expectations and allows better planning.

Review your policy for misrepresentations or gaps before emergencies arise. Ask questions and seek legal advice if needed.

Ensure documentation is complete. Lack of proper paperwork is a major reason claims are denied. Obtain medical reports, death certificates, identity cards, and any other documents required by the insurer.

Be transparent. Avoid omitting facts or exaggerating the situation. Insurers often request further information, and any dishonesty can delay or derail legitimate claims.

With regulators increasing pressure on insurers to pay valid claims—and threatening licence withdrawal for defaulters—insurance companies now have a stronger incentive to comply. However, policyholders must play their part with clear understanding, proper documentation, and honesty.