More claims headaches

Published: Sunday | July 5, 2009



Insurance Helpline with Cedric Stephens

Question: I am 18 years old. In January of this year, I was involved in a very serious motor-vehicle accident. I suffered a broken neck and other spinal injuries. As a result, I have had to spend many months in hospital.

I have missed school and the possibility of getting a scholarship to an overseas college. Now I will have to wait for another year to try. I have just found out the name of the insurance company. Is it now too late to file a complaint?

- Confused

Answer: I am very glad to hear that you are on the road to recovery and are now thinking about taking steps to get on with your life. Seeking information is only one of a number of things that you will have to do.

It is not too late to file a claim for your injury. Claims involving personal injury generally expire six years after the date of the event which gave right to the claim. Other questions based on insurance, medical, legal and other issues will also have to be answered before you reach the stage of filing a claim.

Your best bet at this stage is to obtain the services of an attorney who specialises in handling claims for personal injuries. His/her job would be to find out: 1) How the accident occurred; 2) Who was at fault; 3) What insurance was in place; 4) The nature of your injuries and the prospect for your recovery; 5) What costs were involved for the medical treatment you received.

The items I have listed represent a small part of the information a good lawyer would want to have before making a decision about whether you have a good claim against another party, and how best to handle it.

Matters like these are best handled by a legal professional - not a layman like you or me. If an insurance company is involved, you can rest assured that a good lawyer is hovering somewhere in the background to help it protect its interests.

Question: How should I go about claiming compensation from an insurance company after an accident?

Answer: My short response is: It depends on whether you are seeking compensation for property damage or personal injuries.

In the case of claims involving personal injuries, I almost always recommend getting legal assistance. Claimants who ignore this advice do so at their peril. (See response to Confused.)

Claims for property damage are easier to resolve. Claimants will be required to provide evidence to show that the other party was at fault. This could take the form of statements from witnesses, and/or police reports. The person making the claim will also be required to prove his loss.

Proof takes the form of a written estimate of repair, along with an assessor's report, or a repair bill.

Question: I bought an investment policy from American Life Insurance Company (ALICO) in 1993. Can this policy be brought back to life?

- AS

Answer: ALICO discontinued operations in Jamaica many years ago. Its policies were transferred to Life of Jamaica (now Sagicor Life of Jamaica).

Question: My car was in a collision with another car in June of last year. Both vehicles were insured with the same company. The third party was at fault. Much to my surprise, the company increased my premium from $97,000 to $113,000. When I asked, I was told that I had a claim pending.

Answer: Employees in one department in an insurance company often speak a different language from other employees in a separate department in the same company.

This statement may sound strange, but it is true. Persons handling claims often do not see themselves as members of the same team as those who deal with the renewal of policies. This is the only explanation that I can think of for the 16.5 per cent increase in your premium.

In order to secure a roll-back, I suggest that you go to the top of the food chain. Speak with the 'big boss'. If he (or she) does not grasp the opportunity to correct the company's mistake, find yourself a new insurer.

Cedric E. Stephens provides independent information and free advice about the management of risks and insurance. Email: aegis@cwjamaica.com.