Some Kenyans with house insurance tend to assume that everything is covered under whatever policy they take up. The truth of the matter is, only a comprehensive cover can yield relatively substantial returns in the event of an accident.

In most cases, the insurer only pays for a fraction of the damages. For instance, CIC Insurance gives an initial 10% of the documented property value in cases of theft or fire. The rest is only received after they have surveyed the damage and calculated the estimated expenses. The amount of money given to the home owner depends on the insured value of the property.

A KES 10 million maissonette will give the insured party an initial down-payment of KES 1 million. The insurer will pay the remaining KES 9 million as long as the insured party is not liable and continues to pay his annual premiums.

However, if the owner is found to be at fault, the insurance company will not pay for any of the damages. That’s when the real work begins. In order to claim any policy, the insured party must prove that damages were caused as a result of an accident and not some kind of negligence.

Check Your Policy

Before making any claims, the home-owner must first review his policy. Some claims can go undetected if the insured party is unaware of what their policy entails.

Basic house insurance covers the house in case of fire, burglary, floods and other natural disasters. Comprehensive insurance caters for riots, accidents and third party claims, especially in case someone is injured within the household.

Some policy holders may fail to realize that items like furniture and jewelry are not part of the basic cover. However insurers like Dawit offer a service that caters for Stolen or damaged property for up to 5% of its documented value.

UAP Insurance offers a similar service although the money returned to the home-owner is calculated at a flexible deductible rate. This means that UAP employs a damage assessment expert to review the value of the item before determining how much the company will cover. A 32-inch Plasma TV may have cost KES 70,000 a few years ago but its value will have depreciated since then. If it is stolen or otherwise damaged in a house accident, the insurance company calculates how much it will pay for a similar item in the current economy. In such cases, Dawit could pay about KES 3500 while others like CIC Insurance, which covers up to 80% of the insured value, would pay KES 56,000.

Get Some Evidence

Insurers can always cry foul when it comes to claims based on the fact that fraud is a fast-growing trend in the country. Believe it or not, some people would actually lie to get a fraction of the value of their house in money. According to a report by the Internal Revenue Authority (IRA), insurance fraud has gone undetected for quite some time. This has since prompted the Authority to establish an anti-fraud unit to help solve cases that would otherwise remain a mystery.

That’s why it pays to get visual evidence of a stable structure long before disaster strikes. If you can get irrefutable video footage of your house on a weekly basis, you can avoid all the hassle of trying to convince your insurer that you didn’t set it on fire immediately after a lightning strike. A publication by Herald Services, a UK investigations firm, states that companies can use video footage to dismiss fraudulent claims from their clients.

From a more local perspective, major insurers like APA use property surveyors, auditors and accountants to determine a property’s worth. They collect and store pictures of the property before a policy can be drafted. If a home-owner does the same thing frequently, their claims will seem more substantial as long as they can support them with some evidence.

Hire a Lawyer

Hiring a lawyer should only be a last resort. If you and your insurer have reached a stalemate, take the argument to court. Based on the Kenya Insurance Act, insurers are put under more scrutiny than their clients. So if you luck out and win the case, the company may be forced to pay your claims and cover all your legal fees. If you lose, you will have wasted money on legal representation and your claims will be dismissed. You can also be accused of fraud and face a fine or a jail sentence determined by the judge. There are currently no fixed penalties for insurance fraud in Kenya

Report Damages Immediately

If a car runs through your living-room wall, don’t wait two weeks to tell your insurer. Timely claims seem more legitimate than delayed reports. The sooner you inform your service provider about damages, the faster they can complete their investigation and pay you your claims.

House fires are no different. Instead of paying someone to fix your burnt up staircase, tell the insurer as soon as you can. If you make repairs without consulting your insurance company, you can lose the right to make claims. In other words, he who pays the piper, calls the tune.