Assessing the Factors Causing Delay by Insurance Companies to Pay Claims to Customers: A case of selected Insurance Companies, and Pensions and Insurance Authority (PIA)

Mimi Hankede; Attridge  Mwelwa

doi:10.59413/eafj/v3.i2.8

Authors

Mimi Hankede Author
Attridge Mwelwa Department of Business Administration, University of Zambia Author https://orcid.org/0009-0003-0858-7846

DOI:

https://doi.org/10.59413/eafj/v3.i2.8

Keywords:

Claims Processing Efficiency, Cash flow constraints, Legal related issues, Regulatory Compliance

Abstract

This study examined the efficiency of insurance claims processing in Zambia, emphasizing the time insurers take to settle claims and concerns over delayed payments. Employing quantitative and qualitative descriptive research methods, primary data was collected from employees of the Pensions and Insurance Authority (PIA) and three (3) insurance companies. Open-ended questionnaire was distributed to PIA, a census was conducted on fifteen (15) employees for the qualitative analysis, but only seven (7) responses were recorded. A closed-ended questionnaire was distributed amongst three (3) insurance companies after the census, which determined the thirty-six (36) participants that were selected for the quantitative part. Taking a descriptive approach for the analysis of both qualitative and quantitative data, the findings suggest favorable perceptions of insurers' claim processing efficiency, especially regarding effective handling systems and adherence to payment timelines. Business management gaps leading to delays in payments align with existing literature. Recommendations include investing in advanced technologies, implementing automated communication systems, adhering strictly to legal requirements, fostering transparency, and modernizing documentation processes. These measures aim to enhance claim processing efficiency and customer satisfaction. Overall, the study underscores the need for improvement in the insurance industry's claims processing practices, offering actionable insights for insurers to address delays and enhance their service quality.

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