General Claims Procedure

Some important points, which would help you in the claim procedure  are:

The insured should intimate regarding the claim to the relevant Branch of Shaheen Insurance (SICL) about the incident.

• By Telephone
• By Letter
• By Fax
• By Email
• On receipt of claim intimation, the insurer will forward a claim form.

• Submit the completed claim form along with an estimate of the loss to the insurer. It is preferable to submit an itemized estimate with separate values.

• The insurer will arrange for inspection of the damaged items to assess the loss. In case of major losses, a specialist-licensed surveyor is deputed.

• The insured has to provide the required documents to substantiate the extent of loss.

• In case the cause of loss is not established, it is for the insured to prove that the loss or damage has occurred due to an insured peril.

• On agreement of claim amount between the insured and the insurer, the claim is settled.

• Collision/Partial Loss
• Constructive Total Loss
• Theft / Snatched Loss
• Third Party Liability

Following information are obtained from the claimant at the time of claim registration.

• Policy/Certificate No.
• Registration No.
• Name of Insured
• Date of Loss.
• Nature of Loss.
• Contact numbers of insured and workshop.

In case an unfortunate loss covered in the policy occurs we request you to take the following steps to get prompt service

• Notice of accident should be filed with the insurers.

• If damage is a major one, the accident may be reported before the vehicle is removed from the spot so that the insurers can arrange for spot inspection of damage.

• The vehicle may then be moved to a workshop, preferably to authorized workshop, for estimation of repair charges.

• On receipt of completed claim form and estimate of repairs the insurers will arrange detailed inspection of damage and cost of repairs will be ascertained.

• The insurers will ensure that a person duly licensed drove the vehicle at the time of accident and that the vehicle is the one insured in their books. To that end, they will verify the Registration Certificate and the Driving license of the driver who drove at the time of the accident.

• Upon completion of the above procedure, the repairers will be authorized to carry out repairs. The insurer may undertake to settle the repair bills directly with the garage or reimburse the insured.

• Insurers would like to collect the damaged parts for which replacements have been allowed, as salvage. To ensure that replacements with new parts, have in fact, been effected.

• In case of theft of the car or its accessories, it has to be reported to the police and final report should be submitted.

Following information are obtained from the claimant at the time of claim registration.Following information are obtained from the claimant at the time of claim registration.

• Policy/Certificate No.
• Date of Loss.
• Nature of Loss.
• Contact numbers of insured / Person.
• Initial Information of loss & cause of loss.
• Details of items lost / damaged.

In case an unfortunate loss covered in the policy occurs we request you to take the following steps to get prompt service

• Immediately inform the office concerned over phone and in writing the occurrence of the claim along with the correct policy number.
• Obtain the claim form from the office concerned, fill up the same in all respects and submit the same in our office.
• Lodge a police complaint in case of a fire arising out of – rioting mob, striking workers, malicious damage by third parties or terrorist damage.
• In case the loss is very large, prompt intimation is required to send a suitable surveyor to assist you in minimizing the loss and quick settlement of claim which helps to restart the business activity. Our officer may also visit the site of loss to have firsthand information of the loss.
• In order to help to prove your claim the surveyor or office may seek documentary evidence. You may handover photocopies of necessary documents and obtain acknowledgement.
• Necessary information, as if you are an uninsured, should be given to the local fire station, police authorities and other civil authorities as per law and local practice. Copies of their reports should be obtained and handed over to the surveyor or office.
• As soon as the survey report and copies of the document desired by the surveyor / insurer are complied with by you, you may keep in touch with our office for early disposal of the claim

Immediately report to the police and obtain a non-traceable certificate that the items are not found.

• Notify insurer as early as possible.

• The insurers will insist upon a letter of undertaking on a stamp paper of appropriate value – letter of Subrogation, for refunding the claim amount when the stolen property is recovered.

• Obtain a final report from Police

• Insured has to provide the surveyor complete book of accounts and bills substantiating the loss on the day of incidence.

• Immediate notification to the insurer

• Notice of claim and estimated cost of repairs should be filed with the insurers to arrange for inspection.

• In case of partial losses, no depreciation is charged but when the items are not insured for its present day replacement value, the items are treated as underinsured and the claim amount is proportionately reduced. Depreciation is only applied for Total Loss claims.

• If an appliance is partially damaged, it should be repaired (on approval from insurance company) before it is put to use, as otherwise further loss is not covered.

Electronic Equipments

• Immediate notification to the insurer. • Notice of claim and estimated cost of repairs should be filed with the insurers to arrange for inspection.

• In case of partial losses, no depreciation is charged but when the items are not insured for its present day replacement value, the items are treated as underinsured and the claim amount is proportionately reduced. Depreciation is only applied for Total Loss claims.

• If an appliance is partially damaged, it should be repaired (on approval from insurance company) before it is put to use, as otherwise further loss is not covered.

In case an unfortunate loss as covered in the policy occurs, so as to get prompt service we request you to take the following actions:

• Immediately inform the office concerned over phone and in writing the occurrence of the claim along with the policy number.

• Obtain the claim form from the office concerned or the office nearest to you and fill up the same and give an estimate of the loss.

• In case the loss is very large, prompt intimation is required to send a suitable surveyor to assist you in minimizing the loss, for quick settlement of claim and to advise you as to how best to make the claim properly and how to start up activity after the loss.

• In order to help to prove the claim the surveyor or office may seek documentary evidence. You may hand over photocopies of necessary documents and obtain acknowledgement.

• Kindly cooperate with the surveyors and insurance officials visiting the site of loss to examine the cause of loss, to correctly estimate the extent of loss and to work towards a quick settlement of the loss.

• Necessary information as if you are an uninsured should be given to the local fire station, police authorities and other civil authorities as per law and local practice. Copies of their reports should be obtained and handed over to the surveyor or office.

• As soon as the survey report and copies of the document desired by the surveyor/Insurer is complied with by you, you may keep in touch with our office for early disposal of the claim.

As soon as there is a need for hospitalization, please intimate the office (SICL) number as mentioned in your Health Card/Policy Schedule.

You are required to furnish the following information while intimating a claim:

• Contact Numbers

• Policy Number (as on the Health Card//Policy Schedule)

• Name of Insured person who is hospitalized

• Nature of sickness/accident

• Date & Time in case of accident.

• Nature of accident

• symptom of disease in case of sickness

• Location of accident

Procedures for Non-Panel Hospitals

• Settle your medical bills with the medical facility provider (Hospital/Clinic).

• Collect Payment Receipts, Investigation Reports, Discharge Certificate/Card/Summary showing Chief Complaints, Present History, Past History, Operation/Procedure Notes (if any), Diagnosis, Investigations advised and Course of Treatment.

• Fill in the `IPD Claim Form` completely duly signed by attending doctor with his contact no and attach all documents with this claim form

• Dispatch it to the respective branch Shaheen Insurance Company Ltd (Address on brochure) within 1 month.

• The papers will be evaluated and your claim will be processed.

• Claim will be settled within 15-30 working days of receiving the claim form.

Procedure for Planned hospitalization

• The individual should visit the panel hospital and intimate his case via hospital to Health Department, SICL, for approval before getting admitted in the panel hospital.

• In case of medical emergencies, case will be intimated during first aid treatment and charges will be settled as per approval of intimation before discharge.