Service delivery standards

Service Delivery Standards

Goldstar has a commitment process all claims falling under insurance contracts underwritten as expeditiously as possible. Below are our service bench-marks based of type of class of claims as follows;

Applicable To Group Personal Accident And Workers Compensation Insurance

Step NO. Activity GSI Service Time lines Limitations we may have
1 Claim acknowledgement and requisition of documents/ contact with the claimant. Within 24 working hours acknowledgement with advice on procedure and claim supporting documents required. Unless it is a Public Holiday.
2 Appointment of an industrial medical doctor for the second medical consideration on the injured personnel( where applicable). Within 48 working Hours upon submission of all claims supporting documents. Considerations should be made upon full and complete recovery of the injured personnel.
3 Submission of final adjusted and investigating reports and documentation by insurer. Within 2-3 working days upon accomplishment of assignment number 2 above by insurer. Subject to Doctor’s submission of the final assessment report.
4 Making settlement offer from receipt of final supporting documents or final adjustment report where applicable by insurer. Within 1-2 working days upon accomplishment of assignment number 3 above by insurer. Unless it is a Public Holiday
5 Claim Settlement from receipt of signed discharge voucher/ claim acceptance.
    • Within 7 working days upon receipt of the signed Discharge Voucher for all claims below Ushs10m.
    • Above Shs10 M to Shs50 M: Within 15 working days after receipt of discharge voucher.
    • Above Shs50M: within 20 working days after receipt of discharge voucher or upon receipt of cash call payment from reinsurers whichever occurs first.
Step NO. Activity GSI Service Time lines Limitations we may have
1 Claim acknowledgement and requisition of documents/ contact with the claimant. Within 24 working hours acknowledgement with advice on procedure and claim supporting documents required. Unless it is a Public Holiday.
2 Appointment of a loss assessor / Adjuster depending on the nature, value and complexity. Within 48 working Hours upon submission of all claims supporting documents. The period might be slightly longer if we are to appoint an external specialist since this requires regulatory approval first.
3 Submission of final adjusted and investigating reports and documentation by insurer. Within 2-3 working days upon accomplishment of assignment number 2 above by insurer. This will depend on the availability of information and complexity of the matter. Simple cases like motor, burglary, marine cargo would fall in this category. However, major fire, machinery breakdown claims might take slightly longer.
4 Making settlement offer from receipt of final supporting documents or final adjustment report where applicable by insurer Within 1-2 working days upon accomplishment of assignment number 3 above by insurer. Unless it is a Public Holiday
5 Claim Settlement from receipt of signed discharge voucher/ claim acceptance.
    • Within 7 working days upon receipt of the signed Discharge Voucher for all claims below Ushs10m.
    • Above Shs10 M to Shs50 M: Within 15 working days after receipt of discharge voucher.
    • Above Shs50M: within 20 working days after receipt of discharge voucher or upon receipt of cash call payment from reinsurers whichever occurs first.
Large claims would take slightly longer time up to 21 working days. In this case IRA guide lines would be followed.