Claims Notification Form
  Life Policy
Non - Life Policy
     

 

NEM Insurance Plc has straight forward claim procedure with clearly spelt out documentations. The company knows that prompt settlement of genuine claims in the best form of advertisement and as such empower the branch offices to speed up claim documentations at their end. All departments concerned with claims are fully aware of prompt need to deliver claim cheques without delay.

Listed below are documents needed when filing claims on some of our classes of insurance.

 
   
  Workmen Compensation Group/Personal Account  
  Money  
  Householders/All Risks/Burglary & Fire  
  Fidelity Guarantee  
  Motor Claim Accident  
  Motor Theft/Fire  
  Marine Cargo  
  Marine Hull  
  Goods-In-Transit  
       
Workmen Compensation Group/Personal Account
  Documents to be submitted in case of injury as a result of accident.  
  Duly Completed Claim Form  
  Original Doctor’s Report  
  Original Excuse Duty/Discharge Certificate  
  Itemised Medical Bill/Payment Receipts  
  Carbon Copies of three months payslips preceding injury  
       
    Note The injured person may be required to undergo a medical re-examine if there is permanent disability  
     
  In addition to the above, following documents are required for Death Claim  
  Certificate of Cause of Death  
  Burial Certificate  
  Coroner’s Report  
  Police Report  
   
   
Money  
  Duly Completed Claim Form  
  Details of Parties Carrying the Cash  
  Statement of Claims  
  Written Statement Relating to the Incident  
  Police Report  
  Bank Balance Statement (a week before and a week after)  
       
   
Householders/All Risks/Burglary & Fire  
  Duly Completed Claim Form  
  Estimate of Loss  
  Witness Statement  
  Purchase Receipts/Invoice of Stolen Items  
  Police Report (Theft Claims)  
  Fire Brigade Report for (Fire Claims)  
  Photograph(s) depicting extent of damage  
  Written Statement by the Insured/Claimant  
       
       
Fidelity Guarantee  
  Duly Completed Claim Form  
  Police Report  
  Estimate of Loss  
  Description of Loss  
  Details of any Query and or Dismissal Letter  
  Full Employment Detail of the Defaulters  
  Details of the Character Reference  
  Insured Investigation Report on the Matter  
       
       
Motor Claim Accident  
  Accident/Vandalisation  
  Duly Completed Claim Form  
  Estimate of Repair  
  Abstract Police Report indicting the negligent party (also required for injury/fatal accident)  
  Photograph(s) depicting the extent of damage  
       
       
Motor Theft/Fire  
  Duly Completed Claim Form  
  Original Certificate of Insurance  
  Original Vehicle Licence  
  Original Purchase Invoice(s)/Receipts  
  Ignition Key/Other Lock Keys  
  Interim and Final Police Report  
       
       
Marine Cargo  
  Detailed Statement of Claim  
  Claim Estimate  
  Original/Copy of the Insurance Certificate  
  N. P. A. T Form 38  
  Container Condition Report  
  Original Bill of Lading/Airway Bill  
  Packing List  
  Original Final Invoice  
  Original Discrepancy Certificate  
  Shortlanding/Non-Delivery Certificate  
  Superintending Report  
  Copy of Custom Bill of Entry  
  Copy Clean Report of Inspection  
  Copy of Form “M”  
  Original Delivery Waybill  
  Copy of Correspondence Exchanged with Carriers and/or others that considered liable for the Loss  
       
       
Marine Hull  
  Assured’s Statement of Claim  
  Claim Estimate  
  The Log Book  
  Protest and/or Extended Protest  
  Particulars of Tenders for Repairs which must be approved by the Insured.  
  Surveyors Report or other Documentary Evidence to confirm Loss or Damage  
  Receipt for Disbursements  
  Particulars of Amount Realised on Sale of “Old” for “New”  
  Statement of Time Occupied in repairs for Owners Account  
  Average Statement showing Extract from Log Book.  
  Correspondence Exchanged with other Parties regarding their Liabilities/Loss or damage  
       
       
Goods-In-Transit  
  Detailed Statement/Estimate of Claim  
  Driver’s Report  
  Original Police Report  
  Photocopy Vehicle Particulars  
  Original Delivery Way Bill/Invoice  
  Photographs taken at the Scene of the Accident  
  Written Statement Surrounding the Loss by the Carrier  
       
   
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