Pulse logo
Pulse Region

7 reasons insurance companies may fail to pay claims after road accidents

Most insurance companies require accidents to be reported within a specific timeframe, often 24 to 48 hours.
Road accident in the Migaa area near Salgaa area Nakuru
Road accident in the Migaa area near Salgaa area Nakuru
  • Insurance companies may decline to pay claims for various reasons, including policy exclusions and failure to renew coverage
  • Insurance fraud, traffic violations, and delayed reporting can lead to claim denial
  • Lack of proper documentation can result in claim rejection

Road accidents can be traumatic, and the assurance of insurance coverage often provides a sense of security.

However, there are instances where insurance companies may decline to pay claims, leaving affected parties frustrated and financially burdened.

Understanding the common reasons for claim denial can help policyholders avoid pitfalls and ensure smooth claim processing.

Recommended For You
Lifestyle
2025-03-18T12:40:12+00:00
Rachel Ruto is no stranger to making bold yet elegant fashion statements, but during the state visit of the Dutch royals on March 18, 2025, it wasn’t just her outfit that stood out—it was her shoes. The Kenyan First Lady stepped out in a pair of brown suede block heels adorned with a gold emblem.
The Sh83K shoes that completed Rachel Ruto’s State Visit look

1. Policy exclusions and terms

Insurance policies often contain exclusions that outline circumstances under which claims will not be honoured. For instance:

  • If the accident occurred while the driver was under the influence of alcohol or drugs.
  • If the vehicle was being used for purposes not covered by the policy, such as commercial use when insured for personal use.

READ: NTSA answers 5 vital questions about purchase, insurance of motor vehicles

2. Lapsed insurance policy

Failure to renew an insurance policy on time can render it inactive. If an accident occurs during a period of lapsed coverage, the insurer is not obligated to pay the claim.

Policyholders should ensure their premiums are paid promptly to avoid such scenarios.

3. Fraudulent claims

Insurance fraud is a serious issue that prompts companies to scrutinise claims thoroughly.

Providing false information, exaggerating damages, or staging accidents can lead to claim denial and even legal consequences.

4. Violation of traffic laws

If the driver is found to have violated traffic laws, such as reckless driving, driving without a valid licence, or speeding, insurers may reject the claim.

Such violations suggest negligence, which is often not covered by insurance policies.

READ: NTSA lists 3 common errors vehicle owners make during transfer of ownership

5. Delayed reporting of the accident

Most insurance companies require accidents to be reported within a specific timeframe, often 24 to 48 hours.

Delayed reporting can complicate investigations and may result in claim denial.

6. Inadequate documentation

A lack of proper documentation, such as a police report, photographs of the accident scene, or medical reports for injuries sustained, can lead to claim rejection. Insurers rely on detailed evidence to process claims effectively.

7. Uninsured drivers

If the at-fault driver in a road accident is uninsured, and the policyholder’s coverage does not include uninsured motorist protection, the insurer may not pay for damages or injuries resulting from the accident.

READ: How much you’ll pay in taxes when importing a vehicle worth Sh2.3M into Kenya

How to avoid claim denials

To increase the likelihood of a successful claim:

  • Read and understand your insurance policy thoroughly.
  • Ensure your premiums are up to date.
  • Report accidents promptly and provide accurate information.
  • Avoid engaging in behaviours or activities excluded from your policy.
  • Maintain proper documentation of the accident and the claims process.

Conclusion

While insurance is designed to offer financial protection in the event of road accidents, understanding the terms of your policy and adhering to legal and procedural requirements is crucial.

By taking proactive measures and being informed, policyholders can navigate the claims process more effectively and reduce the risk of claim denials.

Subscribe to receive daily news updates.