• Tajudeen Olalekan Yusuf Department of Actuarial Science and Insurance, Faculty of Business Administration, University of Lagos
  • Sunday Stephen Ajemunigbohun Department of Insurance, Faculty of Management Sciences, Lagos State University
Keywords: Claims handling process, effectiveness, efficiency, promptness, insurance industry, Nigeria


This study was designed with the aim of investigating the effectiveness, efficiency and promptness of claims handling process within the Nigerian insurance industry. To this end, the researchers have been able to assess the effectiveness and efficiency of claims handling process and thus, examine its promptness in relation to the organizational productivity of insurance companies in Nigeria. The study employed a cross-sectional type of survey design. A judgmental sampling technique was employed and relevant data were gathered through the use of structured questionnaire. The sample population consisted of 107 respondents made up of some members of staff within claims department drawn from 33 insurance companies which were selected from the directory of member companies. The major statistical technique employed for this study was a One Sample T-test. Two hypotheses were tested in this study. The hypotheses tested in the study found that managing claims effectively and efficiently will significantly affect operational process in claims management and thus, promptness in claims handling processes does essentially assist in fraud detection and prevention. The study recommends that claims manager should put forward strategic plans to ensuring that insurance claims complaint files are properly kept, monitored and handled for needs that may warrant its usefulness in the future. Claims handling procedures should be promptly managed to avoid deficiency in organization’s operational objectives, and lastly, Government should ammonize their resources and technical knowhow with the Nigerian insurance industry in ensuring that insurance claims are well designed to curtail fraudulent claims experienced in the past.


Ashturkar, P. B. (2014). Comparative study of effectiveness of claims settlement operations in Indian life insurance companies. International Journal of Advance Research in Computer Science and Management Studies, 2(11), 148-155.

Asokere, A. S & Nwankwo, S. I. (2010). Essential of insurance: A modern approach (1st ed.). Lagos: Fevas Publishing.

Association of Insurance and Risk Managers in Industry and Commerce (2009). Delivery excellence in insurance claims handling: Guide to best practice. London: AIRMIC.

Brooks, P. J., Popow, D. J., & Hoopes, D. L. (2005). Introduction to claims. Pennsylvania: American Institute for Chartered Property Casualty Underwriters.

Capgemini (2011a). Claims transformation: Enhancing brand value by delivery on customer commitments, capturing efficiency gains, and optimizing indemnity expenditures.

Capgemini (2011b). Capturing operational efficiency and sustainable value through claims. Guidewire. Retrieved from http://www.capgemini.com/claims

Crawford (2007). Trends in claims handling: Insurance industry update. Canada: Crawford & Company Inc.

Derrig, R. A. (2002). Insurance fraud. Journal of Risk and Insurance, 69(3), 271-287.

Derrig, R. A., & Krauss, L. (1994). First steps to fight workers’ compensation fraud. Journal of Insurance Regulation, 12, 390-415.

Dhanushkoti, S., & Coates, P. (2006, April). Insurance claims management – improving efficiency and effectiveness to reduce cost of claims. AIR Cover Story. Retrieved from: http://www.asiainsurancereview.com

DiNapoli, T. P. (2013). Improving the effectiveness of your claims auditing process. Office of the New York State comptroller. Retrieved from http://.www.osc.state.ny.us.

Esri (2012, April). GIS for the insurance claims process: five steps for an effective workflow. California: Esri White Paper.

Francis, P., & Butler, S. (2010). Cutting the cost of insurance claims: taking control of the process. Booz & Company. Retrieved from http://www.booz.com.

IBM (2011). Three ways to improve claims management with business analytics. USA: IBM Corporation.

Ilona, B., and Evelina, S. (2013). Organizational assessment: effectiveness vs. efficiency. Social Transformations in Contemporary Society, 1, 45-53.

Khan, M. T., Khan, N. A., Ahmed, S., & Ali, M. (2012). Connotation of organizational effectiveness and factors affecting it. International Journal of Business and Behavioural Sciences, 2(9), 21-29.

Krishnan, B. (2010). Claims management and claims settlements in life insurance. The Journal of Insurance Institute of India, 36 (Jul-Dec), 49-57.

Kuria, J. T., & Moronge, M. (2014). Effect of fraud control mechanisms of the growth of insurance companies in Kenya. International Journal of Innovative Social & Science Education Research, 2(1), 26-39.

Low, J. (2000). The value of creation index. Journal of Intellectual Capital, 1(3), 252-262.

Michael, K. (2008). The increasing importance of claim management to insurers. Claims Vendor Showcase, FINEOS Corporation.

Nicola, J. M, Linden, J. B., & Thomas, C. O. (2006). How the detection of insurance fraud succeeds and fails. Psychology, Crime & Law, 12(2), 163-180.

Organization for Economic Co-operation and Development (2004). Guidelines for good practice for insurance claims management. Retrieved from http://www.oecd.org/corporate/ca/corporategovernace principles

Pinprayong, B., & Siengtai, S. (2012). Restructuring for organizational efficiency in the banking sector in Thailand: a case study of Siam Commercial Bank. Far East Journal of Psychology and Business, 8(2), 29-42.

Productivity Commission (2002). Public liability claims management. Canberra: Research Report.

Productivity Commission (2013). On efficiency and effectiveness: some definitions. Canberra: Staff Research Note.

Rose, S. (2013). Predictive claims processing: transforming the insurance claims life cycle using analytics. SAS White Paper, 1-8.

Scott, A., Simon, B., Nick, H., & Karina, W. (2008). Assessing multilateral organization effectiveness: Evaluation Study 2008/3, from Danida’s Evaluation Department-Development Cooperation, Ministry of Foreign Affairs.

Singh, V. (2012). Global trends in non-life insurance: claims. Capgemini.

TIBCO (2011). Dynamic claims processing. USA: TIBCO Software Inc.

Vaughan, E. J., & Vaughan, T. M. (2008). Fundamental of risk and insurance. USA: John Wiley Sons, Inc.

Viaene, S., & Dedene, G. (2004). Insurance fraud issues and challenges. The Geneva Papers on Risk and Insurance, 29(2), 313-333.

Yusuf, T. O. (2010). Brokers and the control of postcontractual opportunism in the Nigerian Insurance market. Journal of Financial Crime, 17(2), 223-239.

Yusuf, T. O., & Babalola, A. R. (2009). Control of insurance fraud in Nigeria: an exploratory study (case study). Journal of Financial Crime, 16(4), 418-435.

Yusuf, T. O., & Dansu, F. S. (2014). Effect of claims cost on insurers’ profitability in Nigeria. International Journal of Business and Commerce, 3(10), 1-20.

Zheng, W., Yang, B., & McLean, G. (2010). Linking organizational culture, structure, strategy, and organizational effectiveness: mediating role of knowledge management. Journal of Business Rsearch, 63(7), 763-771.