Pillar 4 : Fair, Timely & Transparent Claims Settlement Process

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PILLAR 4

FAIR, TIMELY & TRANSPARENT CLAIMS SETTLEMENT PROCESS

 

Description

Deliver a seamless claims processing and settlement experience wherein customers are aware of:

 
  • Procedures, documentation and steps including various options (if any) for first notification of loss in an event of a claim.
  • Expected service standard for claims processing and specific time taken for each step within the claims processing stages.
  • Various redress mechanisms for unsatisfactory claims payment.
 

Expected Outcome

Provide Peace Of Mind To Customers

 

NO.

COMMITMENT

SERVICE LEVEL

 

4.1

We will set clear timeline for claims settlement process and strive to settle claims within these prescribed timeline and in a transparent manner.

We have set clear timeline for claims settlement process and strive to settle claims within these prescribed timelines and in a transparent manner by adopting the following procedures:

 
  1. Customers will be informed of the estimated time taken for claims settlement process and expected service standard. This information shall be made available upon inquiry at our branches, call centre 03-27239696 or email ikhlascare@takaful-ikhlas.com.my.

  2. Customers shall be informed on the acknowledgment of their claim within 7 working days from receipt of claims notification.

  3. All claims notifications through agents must reach us 3 working days, except for crime related claims which should be notified within 24 hours from time of loss.

  4. If documentation/information is incomplete, customers shall be informed within 14 working days from acknowledgement of the claim by the Claims Department.

  5. Claims procedures and assign timelines to it, i.e. appointment of adjuster, claims assessment, etc. is available in our website https://www.takaful-ikhlas.com.my/

  6. Customers will be updated on the progress / decision every 14 working days. For General Claims motor/non motor; customer may check status via website https://www.takaful-ikhlas.com.my/

  7. In the event of a catastrophe / disaster, e.g. large number of claims may be received, as such meeting timelines stipulated may not be possible, we will strive to update every 20 working days on the progress.
 

Note: Claims settlement and timeline for general insurance business is governed by Bank Negara Malaysia’s Guideline on Claims Settlement Practices and general insurers / takaful operators shall operate accordingly.

 
 
 

 

4.2

 

We will inform customer of the next level of escalation if the claims settlement/ rejection is not to his/her satisfaction.

 

We will keep the customer informed of the next level of escalation if the claims settlement /repudiation is not to his/her satisfaction.

 
  1. Customers shall be provided with available channels to appeal on a decision / raise disputes upon inquiry at our branches, call centre 03-27239696 or email ikhlascare@takaful-ikhlas.com.my.

  2. Any letter of rejection/repudiation of any element of a claim and dispute on quantum which is within the purview of the Financial Ombudsman Scheme, will include following statement prominently:

    “Any person who is not satisfied with the decision of the Insurer / Takaful Operator, should refer to the procedure for appeal as stated in the leaflet issued by the Financial Ombudsman Scheme, entitled: ………


     (Note: for the certificate owners who made a claim / report).

 
 
 

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