Personal Accident Claim Form (Ghana)

A Personal Accident Claim Form in Ghana records the particulars required for the matter it documents.

Section 40 of the Insurance Act 2006 (Act 724) requires every insurer in Ghana to handle claims promptly and to pay valid claims within a reasonable time. The NIC, established under Section 1 of Act 724, has the power to issue guidelines on minimum claims handling standards, investigate complaints by policyholders, and impose sanctions on insurers who fail to honour valid claims. An insured person who is dissatisfied with the insurer's decision on a claim may refer the matter to the NIC Customer Services Unit or to the Insurance Brokers Association of Ghana (IBAG) before commencing proceedings in the High Court (Commercial Division) in Accra.

Personal accident insurance in Ghana is typically provided as a standalone policy or as a rider attached to life insurance policies issued under the Insurance Act 2006 (Act 724). Key benefits under a standard personal accident policy in Ghana include: accidental death benefit; permanent total disablement (PTD) benefit; permanent partial disablement (PPD) benefit; temporary total disablement (TTD) weekly benefit; and medical expenses reimbursement. The policy schedule sets out the benefit limits, expressed in Ghana Cedis (GHS), for each category of loss. NIC-licensed insurers operating in Ghana include SIC Life Company Limited, Enterprise Life Assurance Company Limited, Star Life Assurance Company Limited, and other companies regulated by the NIC under Act 724.

The Motor Vehicles (Third Party Insurance) Act 1958 (Act 42) provides a separate regime for claims arising from motor vehicle accidents in Ghana. Where an accident is caused by a motor vehicle, the injured party may have a claim under both a personal accident policy and under Act 42 against the vehicle owner's compulsory third-party insurer. The Motor Transport and Traffic Directorate (MTTD) of the Ghana Police Service handles traffic accident reports, which are typically required as supporting documents for motor-related personal accident claims in Ghana.

A Personal Accident Claim Form in Ghana differs from a Workplace Accident Report Form (gh-accident-report-form) in that the former is directed to the private insurer for compensation under a contractual policy, while the latter is a statutory report submitted to the employer and the Department of Factories Inspectorate under the Factories Offices and Shops Act 1970 (Act 328) and the Workmen's Compensation Law 1987 (PNDC Law 187). Both documents may be required in cases of workplace accidents involving personal injury. The Limitation Act 1972 (NRCD 54) sets a six-year limitation period for insurance claims in Ghana, from the date the cause of action arose.

A Personal Accident Claim Form in Ghana is required in the following circumstances.

The Form is required immediately after an accident causing bodily injury to the insured, as most personal accident policies issued by NIC-licensed insurers in Ghana specify a notification period (typically 30 days) within which the insurer must be notified of the accident. Failure to submit the claim form within the policy's notification period may give the insurer grounds to deny the claim.

The Form is needed when an insured person suffers an accident resulting in accidental death, permanent total disablement, permanent partial disablement, temporary total disablement, or incurs medical expenses that are covered by their personal accident policy. The Form initiates the claims process that triggers the insurer's obligation under Section 40 of the Insurance Act 2006 (Act 724) to investigate and pay valid claims.

The Form is required when an insured person is admitted to hospital following an accident and requires reimbursement for medical expenses from their insurer. The Form should be submitted together with original hospital bills, receipts from pharmacies, doctors' reports, and discharge summaries from a licensed healthcare facility in Ghana.

The Form is needed when an accident has resulted in permanent disability and the insured wishes to claim the permanent disablement benefit specified in their policy schedule. A medical certificate from a doctor registered with the Ghana Medical and Dental Council confirming the nature and degree of permanent disability will be required as a supporting document.

The Form is required when a nominee or legal personal representative of a deceased insured person wishes to claim the accidental death benefit under the policy following the death of the policyholder in an accident. In such cases, the death certificate issued by the Births and Deaths Registry, a copy of the probate or letters of administration issued by the High Court (Probate Division), and a police accident report from the MTTD are typically required alongside the claim form.

Parties in Ghana should submit the Personal Accident Claim Form as soon as possible after the accident, retaining copies of all documents for potential reference if the claim is disputed before the NIC or the High Court (Commercial Division) in Accra.

A valid Personal Accident Claim Form in Ghana under the Insurance Act 2006 (Act 724) must contain the following essential elements.

Policyholder and Insured Details: Full name of the policyholder and the insured person (if different), residential address, Ghana Card number or passport number, contact telephone number, and email address. Where the claimant is a nominee or legal personal representative, their relationship to the deceased insured must be stated. The Ghana Card is issued by the National Identification Authority (NIA) and is the primary identification document for insurance claims in Ghana. Legal personal representatives must provide a copy of probate or letters of administration issued by the High Court (Probate Division) in Accra or the relevant regional capital.

Policy Details: The policy number, the name of the NIC-licensed insurance company, the type of policy (personal accident, group personal accident, or personal accident rider), the period of insurance, and the benefit limits (in GHS) applicable to the claim. The policy schedule sets out the sums insured for each benefit category under the Insurance Act 2006 (Act 724).

Accident Details: The date (DD/MM/YYYY), time, and place of the accident; a factual description of how the accident occurred; the names and contact details of any witnesses; the police case number (if the accident was reported to the Ghana Police Service or the Motor Transport and Traffic Directorate); and the reference number of any MTTD accident report where a motor vehicle was involved.

Nature of Injuries: A clear description of the injuries sustained, the body parts affected, and the initial diagnosis provided by the attending physician. The insured must indicate whether the injuries have resulted in permanent disablement (total or partial) and, if so, attach a medical certificate from a doctor registered with the Ghana Medical and Dental Council (GMDC).

Medical Treatment: Name and address of the hospital or clinic (licensed by the Ghana Health Service or a teaching hospital of a Ghanaian university such as Korle Bu Teaching Hospital in Accra or Komfo Anokye Teaching Hospital in Kumasi) where treatment was received; dates of admission and discharge; names of attending doctors; and a complete schedule of medical expenses incurred in GHS.

Financial Loss: Details of earnings lost during the period of incapacity, including the claimant's occupation, monthly income, employer's name and address (with TIN issued by the Ghana Revenue Authority), and the period of temporary total disablement certified by a medical professional.

Supporting Documents: Original hospital bills and receipts; medical certificates; police report or MTTD accident report; employer's confirmation of loss of earnings; death certificate and probate documents (for death claims); and any photographs or other evidence of the accident scene.

Declaration: A signed declaration by the claimant confirming the truth of the information provided and authorising the insurer to obtain medical and other records relevant to the claim. False declarations may constitute fraud under the Criminal Offences Act 1960 (Act 29) and the Insurance Act 2006 (Act 724).

Forms-legal.com provides this template as a starting point for Ghana-compliant personal accident claim documentation. The insurer's own claim form should be used where available, as some NIC-licensed insurers in Accra and Kumasi require their proprietary forms. This template captures all information required under the Insurance Act 2006 (Act 724) and NIC claims handling guidelines. Where a claim is disputed, the claimant may refer the matter to the NIC Customer Services Unit before initiating court proceedings.