CLAIMS PROCESS THE DISCOVERY INSURE 4 AUTHORISATION 1 WHEN BAD LUCK STRIKES 2 LOGGING A CLAIM 5 SETTLEMENT ASSESSMENT AND VALIDATION

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1 Discovery Insure strives to give you all the information you need to manage your clients Discovery Insure Plans. The process for claiming from Discovery Insure is an important part of every Discovery Insure Plan. This document is a summary of the steps that are followed when your clients claim, and gives you information on Discovery Insure s claims service delivery. Remember each claim is unique and there may be instances where these processes are not followed strictly. 1 WHEN BAD LUCK STRIKES 4 AUTHORISATION 2 LOGGING A CLAIM 5 SETTLEMENT 3 ASSESSMENT AND VALIDATION

2 1 WHEN BAD LUCK STRIKES CAR BUILDING HOUSEHOLD CONTENTS PORTABLE POSSESSIONS Driveable Non-drivable Theft Damage to building Damage Theft Damage Theft 2 LOGGING A CLAIM A claim can be logged with Discovery Insure in the following ways: Call from the financial adviser or client. For emergencies call or if it is not an emergency. Client submits through the Discovery Insure Smartphone app. This applies to motor accident claims only. Immediate assistance is provided if required, for example: Towing Car hire Security guards Despatch of emergency car recovery team Despatch of emergency assistance, including medical assistance if needed Claim is logged on the Discovery website by the financial adviser or client. A Discovery Insure claims consultant is allocated to the claim and will be the contact person for the financial adviser and client until the claim has been fully processed. Discovery Insure Ltd is an authorised financial services provider. Registration number 2009/011882/06. Limits, maximum fuel limits, terms and conditions apply. Go to for more details or call

3 3 ASSESSMENT AND VALIDATION Discovery Insure needs to assess the damage of the claim to understand how the claim happened and the cost of the claim. CAR BUILDING HOUSEHOLD CONTENTS PORTABLE POSSESSIONS Drivable Non-drivable Theft Damage to building Damage Theft Damage Theft Clients will need to take their car to one of Discovery Insure s preferred assessment centres to be assessed. Client s car will be moved to a Discovery Insure preferred assessment centre for assessment. n/a An assessor may be sent to the client s physical address. An assessor may be sent to the client s physical address. An arrangement could be made for the items to be sent away for assessment at one of Discovery Insure s preferred assessors. n/a The client may need to get an assessment report from one of Discovery Insure s preferred assessors. The items may need to be sent away for an assessment at one of Discovery Insure s preferred assessors. n/a Specialist reports may be required. For example, in the case of subsidence and landslip a geotechnical report or an electrical report following a power surge claim Discovery Insure will validate each claim to make sure, amongst other things, that the client has cover and that their premiums are up to date. The table below lists typical things that Discovery Insure could check in the event of a claim. Driver s licence Primary driver Use of car Previous claims history Contacting third parties and witnesses Confirm car is registered as stolen with the police if applicable. Previous claims history Adequate cover (including sum insured) Lack of maintenance Wear and tear Pre-existing conditions Defective workmanship This list is not comprehensive and depending on the claim, additional items could also be considered for validation. Previous claims history Adequate cover (including sum insured) Limits per section of cover, for example jewellery and valuable articles have a one-third limit Proof of ownership and valuation certificates Contacting third parties and witnesses Confirm items are registered as stolen with the police if applicable. Previous claims history Cover (Specified items and General clothing and personal effects) Sum insured and limits, including estimated maximum loss Proof of ownership and valuation certificates Confirm items are registered as stolen with the police and/or blacklisted where relevant or applicable Contacting third parties and witnesses. Discovery Insure Ltd is an authorised financial services provider. Registration number 2009/011882/06. Limits, maximum fuel limits, terms and conditions apply. Go to for more details or call

4 4 AUTHORISATION Once all the information above is obtained by Discovery Insure, a final authorisation decision can be made. If a claim falls within the client s cover and all the plan details are correct, then the claim is authorised for approval. If not, the claim is rejected. When a claim is rejected, the client and financial adviser will be sent a rejection letter which contains: The reasons for rejection, as well as Details of the Short-term insurance Ombudsman, so that the client can appeal the decision if they would like to. Discovery Insure has a weekly claims forum to discuss claims that do not fall within the scope and parameters of cover to ensure fairness and consistency of all Discovery Insure claims decisions. 5 SETTLEMENT The settlement process includes steps to make sure that an item is either repaired or replaced or a client is reimbursed for their loss. This includes: CAR BUILDING HOUSEHOLD CONTENTS PORTABLE POSSESSIONS Drivable Non-drivable Theft Damage to building Damage Theft Damage Theft Authorise repair Arrange repair Settle payment with repairer once repairs are completed Arrange car hire If car is written-off, an original car registration certificate and signed change of ownership form is needed. If the car is financed, the finance house will supply these documents. If the car is recovered, it may need repair, which will be arranged. De-registration certificate and signed change of ownership form will be needed. If the car is financed, the finance house will supply these documents. Appoint service provider Settle payment with service provider after repair or replacement of the damaged or lost item Clients with household contents and buildings claims may benefit from Xpress assessing where assessments (if necessary) will be made within one day of their claim being logged, else we will waive their excess. Xpress assessing is available in the major metropolitan areas. FastTrack claims replaces clients specified electronic devices within 48 hours. For approved claims where we don t meet this promise, we will waive the client s excess. Discovery Insure Ltd is an authorised financial services provider. Registration number 2009/011882/06. Limits, maximum fuel limits, terms and conditions apply. Go to for more details or call

5 DISCOVERY INSURE CLAIMS SERVICE DELIVERY Settling claims in a fast, professional, fair and efficient manner is important to Discovery Insure. With FastTrack-approved claims, applicable to certain portable possessions claims for specified electronic devices, clients get a replacement device delivered, or a cash settlement authorised within 24 to 48 hours, or we waive their excess. Clients in the main metropolitan areas also benefit from Xpress assessing, where should we appoint an assessor, we promise to have a claims assessor at their premises within 24 hours of a household contents or building claim being logged, or we waive their excess. Unfortunately there are circumstances beyond our control that may lead to delays in claim settlement. These include: CAR BUILDING HOUSEHOLD CONTENTS PORTABLE POSSESSIONS Drivable Non-drivable Theft Damage to building Damage Theft Damage Theft Delays in getting: Car parts (panel beaters are reliant on agents and parts suppliers) Information as part of the investigation process. For example, awaiting information from third parties. Car registration and de-registration certificates Blood results in cases of suspected driving under the influence Delays due to: Availability of repairers after a catastrophic event, for example a large hail storm damaging several thousands of cars, which all then need repairs at the same time. Complications that arise during a repair process that were impossible to detect before starting the repairs Delays in obtaining: Specialist damage assessment and cause of loss reports Information as part of the investigation process. For example, awaiting information from third parties. For more information on claiming, plan details, benefit limits and excesses please refer to the Discovery Insure Plan Guide, Excess Annexure and Benefit Limit Annexure on the Discovery website Discovery Insure Ltd is an authorised financial services provider. Registration number 2009/011882/06. Limits, maximum fuel limits, terms and conditions apply. Go to for more details or call

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8 Discovery Insure 155 West Street Sandton GM_23774IN_24/10/13_V8 Discovery Insure Ltd is an authorised financial services provider. Registration number 2009/011882/06. Limits, maximum fuel limits, terms and conditions apply. Go to for more details or call