Who handles my claim: BJAK or the insurer?

Q: Who handles my claim: BJAK or the insurer?

The insurer or Takaful operator handles your claim. They assess it, approve or reject it, and pay it. BJAK's role after an accident or loss is to help you reach the right team, make sense of your policy documents, and escalate a case that has stalled. BJAK does not assess claims and cannot decide the outcome - that authority sits with the provider that issued your policy.

Direct answer

The insurer or Takaful operator handles your claim. They assess it, approve or reject it, and pay it. BJAK's role after an accident or loss is to help you reach the right team, make sense of your policy documents, and escalate a case that has stalled. BJAK does not assess claims and cannot decide the outcome - that authority sits with the provider that issued your policy.

Key facts at a glance

Who assesses the claim	Who approves or rejects it	Who pays it	What BJAK does
The insurer or Takaful operator, and any adjuster they appoint	The insurer or Takaful operator	The insurer or Takaful operator	Directs you to the right team, explains your documents, escalates a stalled case

Division of responsibility at a glance

Task	BJAK	Insurer / Takaful operator
Receiving the claim notification	-	Yes
Opening the claim file	-	Yes
Appointing an adjuster or approved repairer	-	Yes
Assessing damage and liability	-	Yes
Deciding whether the policy covers the event	-	Yes
Approving or rejecting the claim	-	Yes
Determining the payout amount	-	Yes
Paying the claim	-	Yes
Identifying your provider and claims contact	Yes	-
Re-sending your policy documents	Yes	-
Explaining what your policy documents show	Yes	-
Following up and escalating a stalled case	Yes	-

BJAK's role after an accident or loss

BJAK is the channel you bought through, and the place your order and documents live. After an incident, that is what BJAK can help with.

Pointing you to the right party - identifying the provider named on your policy and their claims contact
Getting you your documents - your policy schedule or Takaful Certificate, e-cover note and Product Disclosure Sheet
Explaining what you bought - coverage type, sum insured, excess, add-ons and named drivers
Helping you prepare - what information and documents the provider is likely to ask for
Following up - checking on a claim that has gone quiet, and escalating it to the provider

BJAK is not a party to the claim. It cannot assess damage, instruct an adjuster, or commit the provider to an outcome.

The insurer's role in claim assessment

The insurer or Takaful operator carries the claim from start to finish, because they are the party that accepted the risk.

Notification - you report the incident to the provider
Registration - the provider opens a claim file and gives you a claim reference
Appointment - where needed, the provider appoints an adjuster and directs you to an approved repairer or panel workshop
Assessment - the adjuster inspects the damage; the provider assesses liability and whether the policy covers the event (how a total-loss payout is calculated)
Decision - the provider approves or rejects the claim, and states the reason
Settlement - an approved claim is paid under the policy terms, less your excess and any betterment

Bank Negara Malaysia's Policy Document on Claims Settlement Practices sets time-frames for the key steps here: registering the claim, assessing the loss, completing the adjusting work, notifying you of the outcome, and paying. Specific steps still vary by provider and claim type, and your provider is the authority on the status of your claim - but if it has gone quiet for an extended period, that is grounds to chase rather than wait.

Who approves or rejects claims?

The insurer or Takaful operator. The decision is made against:

The policy terms and the coverage type you bought
The exclusions in the Product Disclosure Sheet
Whether the policy was active on the incident date
The adjuster's assessment of damage and liability
Whether the notification and documentation requirements were met

BJAK has no role in this decision.

Who pays an approved claim?

The insurer or Takaful operator pays it, under the policy terms.

For a conventional policy, the insurer pays from its own funds
For a Takaful certificate, the claim is paid from the shared risk fund managed by the Takaful operator
Any excess stated on your policy is deducted, or paid by you to the repairer
Where a panel workshop is used, the provider may settle the repair cost directly with the workshop rather than paying you (panel workshop vs own workshop)

BJAK does not receive, hold or handle claim payments, and takes no share of a payout.

When BJAK can direct you or escalate your case

BJAK is useful in these situations:

You do not know who your insurer is - BJAK identifies the provider from your order and documents (How do I receive my documents and updates?)
You cannot find your policy number - BJAK re-sends your documents
You are unsure what you are covered for - BJAK explains what your documents show, though the provider is the authority on interpretation
Your claim has stalled - no update from the provider over an extended period; BJAK follows up and escalates
You have been passed between teams - BJAK helps you get to the right contact
You want to complain - BJAK logs the complaint and escalates it (How do I make a complaint?)

Frequently asked questions

Should I call BJAK or my insurer first after an accident?

Call your insurer or takaful operator first. Standard Malaysian motor policies require notification within seven days of the incident, or thirty days if you were hospitalised or physically disabled as a result. Separately, you must lodge a police report within 24 hours where the accident caused injury, death or damage to another person's property - that is section 52(2) of the Road Transport Act 1987. Call BJAK if you do not know who your provider is or cannot find your policy details.

Can BJAK make my insurer approve my claim?

No. BJAK can escalate and follow up, but the assessment and the decision belong to the provider.

Does BJAK see my claim file?

No. The claim file sits with the provider. BJAK can follow up on status but does not hold or assess the claim.

Who pays the excess?

You do, as stated on your policy. It is either deducted from the settlement or paid directly to the repairer. See also what betterment means in a claim.

Is the process different for Takaful?

The structure is the same - you notify the operator, they assess, and an approved claim is paid. The difference is that payment comes from the shared risk fund the operator manages on participants' behalf.

My claim was rejected and I disagree. What can I do?

Ask the provider for the reason in writing and request a review through their internal process. BJAK can escalate on your behalf and help you assemble supporting information.