Know Your Insurance Rights

Know Your Rights: Ensuring Insurance Companies Honour Their Covers

Insurance is supposed to protect you when unexpected events happen—whether it’s illness, an accident, property loss, or business interruption. But too often, policyholders find themselves struggling to get insurers to pay out, even after faithfully paying premiums.

Here’s what you need to know as a consumer to make sure insurance companies honour their covers.

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1. Your Legal Rights as a Policyholder

Kenyan law protects you against unfair treatment by insurance providers:

• Constitution of Kenya (Article 46): Guarantees consumer rights, including fair treatment and access to accurate information.
• Insurance Act (Cap 487): Requires insurers to act in good faith and settle valid claims promptly.
• Consumer Protection Act, 2012: Outlaws unfair business practices and protects you from exploitation.

👉 In short: If you have a valid cover, your insurer is legally required to honour it.

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2. Common Tactics Insurers Use to Avoid Paying

Be aware of red flags such as:

• Hidden clauses being used as excuses to reject claims.
• Long, unexplained delays in processing payouts.
• Pressure or intimidation to discourage you from pursuing your claim.
• Lack of transparency on why your claim is being denied.

Knowing these tactics helps you push back with confidence.

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3. Steps to Take if Your Claim is Denied or Delayed

1. Review Your Policy Document
   Carefully check the terms and conditions of your cover. Many disputes come down to poor communication or unclear language.
2. Request Written Explanations
   If your claim is denied, demand a written explanation citing the exact policy clause.
3. Escalate the Matter
   • Write formally to the insurance company’s complaints department.
   • If unresolved, escalate to the Insurance Regulatory Authority (IRA), which supervises insurance companies.
4. Seek Legal Help
   • Under the Consumer Protection Act, you can file a complaint in court or with consumer protection agencies.
   • Organizations like the Kenya Association of Intellects (KAI) can support you in demanding justice.
5. Document Everything
   Keep copies of all communication, receipts, medical reports, and evidence related to your claim.

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4. How KAI Can Help

The Kenya Association of Intellects stands with policyholders to:

• Expose unfair insurance practices.
• Support individuals and families in pursuing claims.
• Advocate for stronger regulation to protect consumers.
• Raise awareness so Kenyans know their rights before and after signing policies.

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5. Final Word

Insurance is meant to give you peace of mind, not extra stress. If you pay your premiums, you are entitled to coverage when you need it. Don’t be intimidated by delays or excuses—you have the law on your side.

Remember: Protection paid for must be protection delivered.