Kaddunabbi Ibrahim Lubega, the IRA Chief Executive OfficerMore than 40 percent of what insurance companies pay out in claims are actually fraudulent claims, but many genuine claimants leave frustrated, according to the Insurance Appeals Tribunal (IAT).The claims payouts have continuously grown over the year as the industry leaders encourage it, so as to boost public confidence in the industry.Total insurance claims payouts for 2024 were reported at UGX 887.4 billion, representing 50.3 percent of the total gross written premiums for the year, according to the Insurance Regulatory Authority of Uganda (IRA).However, IAT Chairperson, Rita Namakiika Nangono says that they have noted a persistence of cases when the insurance companies intentionally make it hard for claims to be paid. According to her, insurance is there to protect policyholders against losses, and not to take people’s money.The Insurance Appeals Tribunal was set up to handle complaints regarding disagreements, mainly between the insurer and the policyholder/client.It is an appellate step in the dispute resolution mechanism, handling disagreements that could not be resolved by the Insurance Regulatory Authority (IRA) Uganda Complaints Bureau.Before the Complaints Bureau are the complaints handling desks at the insurance companies, which are the first instance levels.Speaking at the CEO’s 65th interaction with Ms Nangono said that one of the main issues that features in the complaints was the lack of clarity in the policies and other documents.She urged the insurance companies to do an audit of their policies and some documents, which she said were archaic and hard to understand even by the insurers themselves.Insurers, including their brokers, have also been accused of mis-selling, a practice where a product is sold to a client, but without revealing all the associated risks. Sometimes, the client is enticed into buying an insurance policy, only to realise that it was not what they actually required.This sometimes leaves one of the parties unsatisfied, and they end up at the tribunal. But the chairperson also says some loss assessors and adjusters are just not up to the task, with some unable to even make basic investigations and write clear reports. This, according to her, makes it hard for the Tribunal to decide because every detail in the report matters.Beri Sharma, a loss assessor, urged insurance companies to work more closely in streamlining the policies, and to utilise the IRA policy resources.According to the Tribunal’s report on its four years of existence, more than 51 cases have been handled, 41 of them successfully, while the other 10 are still in the pipeline.Kaddunabbi Ibrahim Lubega, the IRA Chief Executive Officer, says that the IRA Complaints Bureau received 198 complaints, and that for only 51 to be taken to the Appeal Tribunal, shows good performance of the Desk.On the issue of mis-selling, the CEO says this is unprofessional and is one of those issues that affect public confidence in the industry, as it does not help in the efforts to present insurance as an honest business.He urges the insurance companies and brokers to always be sure of what they are selling, disclosing all factors and conditions so that the client makes an informed decision.Haji Lubega decries the reports that some assessors and insurers actually intentionally make reports that are aimed at frustrating the clients by failing the claim bid.He says the industry has been focusing on paying claims over the last few years so that the public understands that insurance is there to protect them. Therefore, he says, insurers must focus on finding a reason to pay a claim, not a reason not to pay a claim.He adds that the insurance loss assessors must always share their reports with the insurers and with the client/policy holder, so that each party is in the know of all details in the case.-URNThe post Insurers Frustrating Clients Intentionally As Fraudulent Claims Remains High- Tribunal appeared first on Business Focus.