THE IMPACT OF CLAIMS MANAGEMENT PROCEDURES IN LIFE ASSURANCE COMPANIES IN NIGERIA

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ABSTRACT

This research work is carried out to appraise the claim management procedure in Life Assurance companies. To achieve the above, the researcher obtained the necessary data from both primary and secondary sources which consisted of oral interview and questionnaires distributed. In course of carrying out this study successfully, 45 questionnaires were administered to the management and staff of Industrial and General Insurance (IGI) and NICON Insurance Company, out of which only 40 were retrieved. The researcher used simple percentage table to analyze the data obtained. Chi-square (x2) statistical tool was used to test the research hypothesis of which the alternative hypothesis was accepted based on the decision rule. Base on the relevant data obtained, the researcher recommended that insurance companies should endeavour to acknowledge all genuine claims reported at their offices and communicate to the insured if the claim is repudiated on the basis of fraud or breach of contract conditions.

 

CHAPTER ONE

INTRODUCTION

1.1   BACKGROUND OF THE STUDY

Insurance is a safe-guard against risk. Any device aimed at reducing the chances of a risk occurring when it happens, reducing the extent of its damage and providing the affected persons with compensation is a form of insurance, Enwerezoir, C.D.R (2000).

Insurance as a modern concept for solving risk related problems depends on cooperation of a large basic fundamental of insurance (Udeze J.O (2005).

According to Aneke (2004) claims in life assurance is a demand by a person or persons to recover under a policy of insurance for the loss which may arise within the policy.

Also a renowned scholar of insurance Epectinchin (1998) in his study defined insurance claims as the right of the insured to ask for compensation from the insurer should any loss occur.

An efficient and prompt claims settlement services is the most effective form of advertisement for an insurance company. But this does not mean that the insurance company must settle all claims whether they are genuine claims or not. According to Irukwub (1997) only genuine claims covered by the terms in the policy should be settled and then must be done promptly and equitable.

Claims management therefore involves settling losses under that assurance contracts and adjusting any difference that arises between the company’s policy holder and possibly a third-party. Claims settlement on its own means not just money or compensation extended to the policy holder who suffered a loss but refers to the whole process involved in receiving the processing and documentation of claims form to decide if payment is to be made or not and how it should be made.

The reason is because the process takes time and involved some monetary cost, and this add to the overall cost of settlement which in the early state much attention was given to claims administration as a dominant of purchasing claims by the members of the public, this was because it was assumed that the public is aware of the claims that would afflation and those that would not. It should be remembered that any company that must be able to carry out its function must have a good reputation and trust among the populace, but this has continued to decline over the years and given insurance practitioners and firms great concerns but for the current reforms in the sector by the government with complexities in policy from in the likes of confused wordings there could be incidence where eligible claims could be denied by company based on the condition or warranting. These have led to more attention being on claims management since a dissatisfied insured can decide not to insured again with that company or refuse insurance entirely. He can resort to litigation action or even take other actions which will darken the image of insurance before other prospective insured who may decide not to insure the risk again.

However, all life assurance policies contain a condition which lay down the procedure to be followed in the interest of the company with procedures. The general procedure involved in the management of claims include the notification of claims, proof of loss and settlement of claims. (Oluoma 2000).

1.2   STATEMENT OF THE PROBLEM

In realization of the importance of claims, life assurance business would like to know the impact that the various claims settlement decision of a company would have on the growths. The study is concern with an appraisal of claim management procedures in life assurance companies. As state earlier, the claims amount is rising faster than premium income it can be seen that the image of life assurance company has been glooming over the years due to inability to settle claim as at and when due.

There have been some impending factors that have led the poor public image of life assurance business which claims settlement is said to be one of them, there has been some advance default on the insured inability to comply with the policy condition with the policy condition and also ono-notification of the agent and broker to forward the premium paid by the policy holder to the life assurance company can contribute to the reason why losses caused by insured perils are not paid by life assurance.

Lack of professionalism on the part of the current crusade4 for better insurance cultures in the country. High incident and difficulty in processing complicated nature by insures who due to their fraudulent nature intentionally defy payment of claims to the insured thereby contributes to dwindling mature of the image of the company.

1.3   PURPOSE OF THE STUDY

The purpose of the study is to point out the procedure associated with claim management in life assurance companies in Nigeria.

To identify the procedures in claims management and its implication on the performance of the life assurance companies in Nigeria

To map out guideline on how to review the procedures associated with claim

The technique used in settling life assurance claim in Nigeria.

To also look at the ways of management and personnel in the companies that handle claims.

To evaluate the extent the Nigeria insures have gone in effective claims settlement to life assurance company.

To seek means in which government can adopt measures of procedures of claims settlement in life assurance in contrast in Nigeria.

1.4   SIGNIFICANCE OF THE STUDY

This research work will be meaningful to the insurance company because certain guidelines, rules and regulations, recommendation given here to enable them act accordingly.

Also the government will benefit because if the rules are followed as outlined, it will go a long way to awaken our economy.

When the appraisal of claim management procedures in life assurance companies in Nigeria is adopted our economy will not be at a standstill. The government, insurer and the insured will be satisfied.

This study gives the insuring public, the necessary awareness of the insurance services as they will reduce the loss of confidence in them. Insurance scholars will also benefit from the work, because the procedures adopted will improve the sector.

1.5   RESEARCH QUESTION

The research question below will guide the researcher n the discovering of dependable knowledge on the subject matter under investigation.

Has claims management procedures impacted positively on life assurance companies in Nigeria

In what ways can appraisal of claims management procedures in life assurance companies in Nigeria be improved

To what extent have claims management procedures create awareness to insured for effective life assurance policy in Nigeria?

In what ways can claims management procedures improve the lives insured in life assurance companies in Nigeria?

1.6   STATEMENT OF HYPOTHESIS

Ho:  The claims management procedures adopted by the life assurance companies has no positive effect on the life assurance companies in Nigeria?

Hi:   the claims management procedures adopted by the life assurance companies has positive effect on the life assurance companies in Nigeria

1.7 SCOPE OF THE STUDY

The work cover the port Harcourt metropolis therefore the study is aim at analyzing the appraisal of claims management procedures of life assurance companies in Nigeria, this area of coverage of this study is thus limited to the claims department of life assurance companies in Nigeria. It attempts to provide the framework of working condition for the management in an ordinary manner.

1.8 LIMITATION OF THE STUDY

One of the limitations of this study is the problem of time constraints; this is because the duration given for the completion of this research is too short compare to the nature of work needed to be done. Also financial adequacy is another crucial limitation of the study, which hampered few necessities of the study to be decently successful.

1.9   DEFINITION OF TERMS

Adjuster: A person who adjusts losses investigates its causes pressures the salvage.

Agent: A person who acts on behalf of another,

Appraisal: This is the action of judging the value, quality or nature of something.

Arbitration: This is an alternatives to litigation for settlement of disputes as regards the amount to be paid under the policy after the occurrence of loss

Claims: A demand by the insured upon the insurer to fulfill his guarantee of indemnity by reason of an accident in respect of the insured property.

Claims Form: Form filled to notify the insurer by the insured that the event insured against has occurred.

Claim Appointment: The method of rationing claims in proportion of degree cost suffered.

Claimants: Is a person who is legalized to collect payment insuring public. These are the client of the life assurance companies that participate in insurance business.

Clams procedure:   This is condition which the insured should fellow to ensure settlement of claims.

Impact: This mean to have a strong effect on someone or something.

Policy: Document evidencing the existence of the contract between the individuals and the life assurance company.

 

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