Claims and complaints

First reflexes

These seven steps apply to every kind of claim.

1. Make things safe and limit the damage. Emergency measures are your duty and their cost is normally covered.
2. Collect evidence. Photos, names and phone numbers of witnesses, the police report number, a complaint receipt after a theft.
3. Read the section of your contract on claims. It lists the documents and any shorter time limit.
4. Declare within 5 days, in writing. Use a registered letter, a declaration handed in against a receipt, or the channel named in your contract, and note the claim number.
5. Do not admit liability and do not sign anything you have not understood.
6. Do not repair or throw anything away before the adjuster has come, apart from emergency measures.
7. Keep a file. Copies of everything you send, with the dates and the names of the people you spoke to.

A declaration states the contract number, the date, time and place, what happened, the damage, the other people involved and the witnesses.

Car accident with material damage

At the scene

Fill in the accident report form, the constat amiable, with the other driver. One form is enough for two vehicles.

• Write the facts only: date, place, vehicles, insurers, certificate numbers.
• Tick the boxes that describe what each vehicle was doing. Insurers decide liability from these boxes and from the sketch.
• If you disagree with the other driver, say so in the box for observations. Do not leave it blank.
• Both drivers sign and each keeps a copy. Nothing may be changed after signing.
• If the other driver refuses to sign, note the plate, photograph everything and take the witnesses' details.

An electronic version of the form is being introduced. Ask your insurer whether its app already offers it.

Afterwards

1. Hand in the form to your own insurer within 5 days.
2. The insurer appoints an adjuster who assesses the repairs. Wait for the visit before any work.
3. Under the direct compensation convention between insurers, known as CID, your own insurer pays for your damage according to your share of liability and recovers the money from the other insurer. You deal with one company only.
4. If the repairs cost more than the car is worth, the car is declared a total loss and you are paid its market value, less the value of the wreck if you keep it.

If you were at fault, your insurer pays the other driver. Your own car is paid only under all-risks or collision cover, and your next premium carries a surcharge: see the CRM.

Step by stepFill in the constat amiable, box by box

Road accident with injuries

1. Call the police or the Gendarmerie. Their report is the central document of the file: note its number and the unit that wrote it.
2. See a doctor the same day and obtain a first medical certificate, even for injuries that seem minor.
3. Declare the accident to your own insurer within 5 days, whoever is at fault.
4. Keep every medical document, bill and proof of lost income.
5. The insurer of the person at fault must make a compensation offer within 60 days of receiving the complete file. You have 30 days to answer.
6. If you refuse the offer, the court decides.

Compensation follows a legal scale based on age, income and the rate of permanent disability set by a medical expert. It covers medical costs, lost income, permanent disability, pain and disfigurement and, after a death, the losses of the family.

• You were a passenger. You are a third party, including in a relative's car, and the insurer of the vehicle at fault compensates you.
• You were the driver at fault. Only driver protection pays for your own injuries.
• The driver at fault is unknown or uninsured. The Fonds de Garantie des Accidents de la Circulation compensates bodily injury.

Home claim

1. Stop the cause: cut the water or the power, call the fire service on 15.
2. After a theft, file a complaint within 24 to 48 hours and keep the receipt.
3. Declare to your insurer within 5 days, or within the shorter time your contract sets for theft.
4. Draw up a list of what was damaged or stolen, with values and proof.
5. Let the adjuster see the damage before permanent repairs.
6. If a neighbour is involved, tell the managing agent and the neighbour, and let the insurers settle between themselves.

More on home claims

Health claim

• AMO refund missing or too low. Check that the care sheet was complete and sent in time. Write to your fund, quoting the file number. If the answer does not satisfy you, refer the matter to ANAM.
• Prior agreement refused. Ask your doctor for a detailed report and send a written appeal to the fund's medical service.
• Complementary insurer. It pays after AMO, so send the AMO statement with your claim. A refusal must state the clause on which it relies.

Disputes with a private health insurer follow the steps below. The Mediator accepts health disputes above 5,000 MAD.

Step by stepYour AMO refund, step by step

If you disagree with the insurer

Go up one step at a time and keep written proof of each.

The Mediator's opinion binds the insurer when the amount at stake does not exceed 50,000 MAD. You remain free to go to court whatever the opinion. ACAPS checks that the insurer has respected the rules. It does not award damages.

Letters that work

Write to an insurer in French or in Arabic, the languages of your contract. The models below show what to say. The French and Arabic versions of this page give the same letters in those languages.

Declaring a claim

[Your name, address and phone number]

Contract no. [number]

[Place and date]

Subject: declaration of a claim

I declare the following event, which is covered by the contract above.

Date, time and place: [details]

What happened: [short account of the facts]

Damage observed: [list]

Other people involved and witnesses: [names and contact details]

Police report or complaint no.: [number]

Please confirm receipt of this declaration, and tell me which documents you need and the name of the adjuster.

[Signature]

Enclosed: [accident report form, photos, invoices]

Asking for payment or contesting a refusal

Registered letter with acknowledgement of receipt

Subject: claim no. [number], request for payment

I declared this claim on [date]. [You refused cover by your letter of (date)] or [I have received no offer since then].

I contest this position for the following reasons: [reasons, with the clause of the contract].

I therefore ask you to pay the compensation due, [amount] MAD, within 15 days.

This letter interrupts the limitation period in accordance with article 38 of the Insurance Code.

Failing a satisfactory answer, I will refer the matter to the Insurance Mediator and to ACAPS.

[Signature]

Ending a contract at its yearly date

Registered letter with acknowledgement of receipt

Subject: cancellation of contract no. [number]

I inform you that I am ending the contract above at its next yearly date, [date], in accordance with article 6 of the Insurance Code and with the notice period set in the contract.

Please confirm this in writing and send me my claims statement.

[Signature]

Time limits

All time limits and how they restart