• By Raymond Momanyi

Navigating Accident Claims: Is Your Family Covered by Comprehensive Insurance?

A common question for many Kenyan drivers is whether a standard comprehensive car insurance policy adequately protects them and their families in the unfortunate event of an accident. The answer is nuanced and highlights the importance of understanding your policy's full scope. While comprehensive insurance is the highest level of motor cover, it may not be the all-encompassing safety net you assume for personal injuries.

Comprehensive Cover: What It Does and Doesn't Include

Standard comprehensive car insurance in Kenya primarily covers three main areas:

1. Damage to Your Vehicle: It pays for repairs to your car following an accident, collision, or overturning. It also covers damages from fire and malicious acts.
2. Theft: It compensates you if your car or its parts are stolen.
3. Third-Party Liability: This is a crucial component that covers death, bodily injury, and property damage to third parties (e.g., pedestrians, passengers in the other vehicle) caused by your vehicle.

However, a standard comprehensive policy often provides only a minimal, fixed amount for medical expenses for the occupants of your car, which is typically insufficient to cover serious injuries. It does not automatically provide substantial compensation for death or permanent disability for the driver or their family members.

The Essential Add-On: Personal Accident Cover

To ensure the driver and their family are adequately protected, it is highly recommended to add a Personal Accident (PA) Cover to your comprehensive policy. This supplemental cover is specifically designed to provide a lump-sum payment in the event of:

• Accidental Death: A specified benefit is paid to the insured's beneficiaries.
• Permanent Disability: A lump sum is paid out, often a percentage of the total benefit, depending on the severity of the disability.
• Temporary Disability: Provides a weekly income benefit if you are temporarily unable to work.
• Medical Expenses: It covers medical, surgical, and hospital costs incurred due to the accident, up to a specified limit.
• Funeral Expenses: A benefit is included to cover last expenses.

A robust Personal Accident cover provides peace of mind, ensuring that an accident doesn't lead to a devastating financial crisis for your family.

Anatomy of an Accident Claim: Private Car vs. PSV Taxi

Let's dissect the claims process for the specific scenario: a private car carrying family members collides with a PSV taxi carrying two passengers. Both vehicles are insured comprehensively and have an Excess Protector.

The Scenario:

• Vehicle 1: Private Car, comprehensively insured with Excess Protector, carrying the driver and family.
• Vehicle 2: PSV Taxi, comprehensively insured with Excess Protector, carrying a driver and two passengers.

Here is how the claim would typically progress:

Step 1: Immediate Actions at the Scene

• Ensure Safety: Check for injuries and call for medical help if needed.
• Do Not Admit Liability: Avoid arguments about who is at fault.
• Document Everything: Take clear photos and videos of the accident scene, vehicle damage, positions of the cars, and any visible injuries.
• Exchange Information: Get the other driver's name, phone number, vehicle registration, and insurance details.
• Report to the Police: This is mandatory. Report the accident to the nearest police station within 24 hours to obtain a police abstract. This document is non-negotiable for filing an insurance claim.

Step 2: Notifying the Insurers Both the private car owner and the PSV taxi owner must notify their respective insurance companies of the accident as soon as possible, typically within 48 hours. They will be required to fill out a claim notification form.

Step 3: Vehicle Assessment and Liability

• Assessment: Both insurers will appoint an assessor to inspect the damage to their respective insured vehicles and determine the cost of repairs.
• Determining Fault: The police abstract and the assessors' reports will be key in establishing which driver was at fault.

Step 4: Claim Settlement and Payouts

The resolution of the claim depends on who is deemed liable for the accident.

• If the PSV Taxi Driver is At Fault:
  • Private Car Damage: The taxi's insurance company will cover the repair costs for the private car (as the third party). Because the private car owner has comprehensive cover, their own insurer may handle the repairs first and then recover the costs from the taxi's insurer (a process called subrogation).
  • Injuries to Private Car Driver & Family: This is where their Personal Accident Cover becomes vital. They will claim directly from their own insurer for injuries, disability, or death benefits under this add-on, providing a quicker payout regardless of the fault-finding process. They can also pursue a legal claim against the taxi's third-party liability insurance for injury, but this is often a longer process.
  • Taxi Damage: The taxi owner will claim for their vehicle's repairs from their own comprehensive policy.
  • Injuries to Taxi Passengers: The taxi's PSV insurance, which includes mandatory passenger liability, will cover the medical expenses and compensation for the two passengers.
• If the Private Car Driver is At Fault:
  • Taxi Damage: The private car's insurance will pay for the repairs to the taxi.
  • Injuries to Taxi Passengers: The private car's third-party liability cover will compensate the injured passengers in the taxi.
  • Private Car Damage: The owner will claim from their own comprehensive policy to cover their vehicle's repair costs.
  • Injuries to Private Car Driver & Family: Again, they will rely on their Personal Accident Cover for compensation, as you cannot claim against your own third-party liability.

The Role of the Excess Protector: In both scenarios, because both drivers have an Excess Protector, they will not have to pay the "excess"—the initial amount of a claim that the insured is typically required to pay out-of-pocket. This means their insurance will cover the full cost of the repairs from the first shilling, saving them significant immediate expense.

For expert advice and to ensure your car insurance policy includes these crucial benefits, it's wise to consult with a trusted intermediary. Imana Insurance Agency Kenya Ltd offers comprehensive solutions and can help you compare policies to find one that includes a robust Personal Accident cover and an Excess Protector, ensuring you and your loved ones are fully protected on the road. You can reach them via their website at www.imana.co.ke or call/WhatsApp them at +254796209402.

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