Delays in motor insurance claims are common in the Philippines—sometimes because the claim genuinely needs more verification, but often because of slow internal workflows, unclear documentation requirements, or “pending approval” loops that quietly stretch into weeks or months. This article explains (1) what the law and standard policy conditions generally require, (2) what steps prevent delays, and (3) how to follow up, escalate, and enforce rights in a Philippine setting.

1) Know what kind of motor claim you have (because the rules and “usual delays” differ)

A. Own Damage (OD) / Comprehensive Motor Insurance

Covers damage to the insured vehicle from collision, vandalism, etc.
Often includes theft, acts of nature (if purchased), and sometimes personal accident.
Usual delay points: adjuster inspection, repair estimate disputes, parts availability (not always insurer’s fault), “betterment/depreciation” computations, salvage/totalloss valuation.

B. Third Party Liability (TPL) under a comprehensive policy

Covers the insured’s legal liability to third persons for bodily injury and/or property damage (depending on purchased cover).
Usual delay points: proving liability, competing narratives, police report availability, settlement negotiations with the third party.

C. Compulsory Third Party Liability (CTPL)

Mandatory coverage tied to vehicle registration; primarily for third-party bodily injury/death (not property damage).
Many CTPL frameworks include a no-fault medical indemnity concept (commonly used to quickly pay limited medical expenses regardless of fault, subject to conditions and documentary requirements).
Usual delay points: missing medical documents, unclear “which vehicle’s CTPL responds,” duplicate claims, and insurer requests for originals.

D. Acts of Nature / Flood / Typhoon add-ons

Often require stronger proof of cause and timing (photos, weather-related context, location).
Usual delay points: catastrophe volume surges, fraud controls, and cause-of-loss disputes (e.g., flood vs. engine damage due to operation in water).

Why this matters: A follow-up strategy that works for OD repair authorization may be the wrong approach for CTPL injury claims. Escalation also depends on whether you are the insured, the third-party claimant, or acting through a broker.

2) The legal backbone in the Philippines (what insurers must do, and what “delay” means)

A. Prompt payment duty under the Insurance Code (non-life claims)

Philippine insurance law generally requires insurers to pay claims within a prescribed period after:

receipt of proof of loss, and
ascertainment (determination) of the loss.

Commonly referenced timelines in non-life claims include:

payment within 30 days after proof of loss and ascertainment of the loss, and
if ascertainment is not made within a certain period from proof of loss, payment must still be made within a longer “outer limit” (often discussed as within 90 days from proof of loss), unless the claim is denied or disputed on valid grounds.

Practical takeaway: Insurers cannot indefinitely stall by keeping a claim “under review” without communicating a clear basis and what remains needed.

B. Interest/penalty exposure for unjustified delay

When an insurer refuses or fails to pay without just cause, the law may impose interest/penalties from the time payment should have been made. Even when not framed as a penalty, courts can award legal interest and damages depending on circumstances and bad faith.

Practical takeaway: A written demand that anchors the timeline (date of complete documents, date of inspection, date of estimate approval) increases leverage.

C. “Unfair claim settlement practices” (why documentation and written follow-ups matter)

Insurance regulation in the Philippines recognizes that certain patterns can be unfair—like failing to act promptly on communications, failing to adopt reasonable standards for processing, denying claims without a reasonable investigation, or compelling insureds to accept less by dragging the process.

Practical takeaway: A calm, documented record showing repeated unanswered follow-ups and shifting requirements can support regulatory complaints and legal claims.

D. Contract law and bad faith (Civil Code principles)

Insurance is a contract. Delays can become a breach of obligation. If the insurer’s conduct rises to bad faith (dishonest purpose, moral obliquity, conscious wrongdoing), courts may award:

moral damages,
exemplary damages, and
attorney’s fees (when justified by law and circumstances).

Practical takeaway: Not every delay is bad faith, but stonewalling, inconsistent reasons, or refusal to decide despite completeness can move a dispute into that territory.

3) The normal motor-claim workflow—and where delays usually happen

Step 1: Notice of loss / claim reporting

What’s usually required:

prompt reporting to insurer/broker
basic facts: date/time/place, circumstances, parties involved
initial photos/videos

Delay triggers:

late reporting (insurers may ask why)
repairs done before inspection (insurers may question causation/extent)

Step 2: Document collection (“proof of loss”)

Typical OD/comprehensive set:

policy copy / certificate of cover
driver’s license (driver at time of accident)
OR/CR (vehicle registration), sometimes deed of sale/authority if ownership issues
police report / blotter report (often required for collision, theft, major incidents)
photos of damage, scene
repair estimate from shop (sometimes insurer-accredited)
sworn statement / claim form
for theft/carnapping: additional PNP/LTO/clearance-type requirements are common

Typical CTPL / bodily injury:

police report / incident report
medical records, receipts, doctor’s certificate
IDs and proof of relationship (for death claims)
sometimes affidavits on circumstances

Delay triggers:

insurer claims “incomplete documents” without giving a definitive checklist
repeated requests for “originals” without explaining why certified true copies won’t do
unclear authority where vehicle is mortgaged (bank endorsement needed)

Step 3: Inspection / adjustment

insurer’s adjuster inspects vehicle, reviews estimates, verifies cause and extent
may negotiate parts/labor rates and scope of repair

Delay triggers:

adjuster backlog
shop–insurer ping-pong on supplemental estimates
“subject to head office approval” without SLA dates

Step 4: Repair authority and payment mode

Common arrangements:

cashless with insurer-accredited shop (insurer pays shop, insured pays deductible and uncovered items)
reimbursement (insured pays first, insurer reimburses)

Delay triggers:

insurer approval delays before repairs start
insurer pays late after repair completion
disputes on depreciation/betterment, deductible, excluded items

Step 5: Settlement or denial (must be clear)

A proper denial should be in writing and cite policy grounds and facts.

Delay triggers:

“neither approve nor deny” posture
partial approvals without clear computation

4) Preventing delays: the “complete file + timeline” method

A. Get a written checklist and lock it

Early in the claim, request in writing:

the claim number,
the assigned claims handler/adjuster contact,
the complete list of required documents, and
confirmation of where to submit and in what form (original vs copy).

Key move: Once you believe everything is submitted, send a “Notice of Completion of Requirements” email listing every document with dates submitted and ask them to confirm in writing that the claim file is complete. This matters because legal payment timelines often hinge on completion of proof of loss.

B. Keep a claim log

Maintain a simple log:

date/time of call/email
who you spoke to
what was promised
next action date

C. Submit documents in a way that proves receipt

email with attached PDFs and a single consolidated index
courier with tracking and receiving copy
if physical submission: insist on receiving stamp on your transmittal

D. Avoid common self-inflicted issues

don’t authorize full repairs before inspection unless you have written permission (emergency towing/temporary measures are different)
don’t admit liability in writing to third parties without insurer guidance (liability policies often require insurer consent)
preserve damaged parts when practicable (insurer/adjuster may need to inspect)

5) How to follow up effectively (without burning time)

A. Use structured follow-ups (every 3–5 business days when stalled)

A strong follow-up has:

claim number in subject
current status requested (approve/deny/need more)
a short list of what’s pending and since when
a requested action date

Example follow-up email (status + decision request):

Subject: “Motor Claim [Claim No.] – Request for Status and Settlement Timeline (Complete Docs Submitted [date])”
Body (essentials):
- list documents submitted
- ask confirmation claim file is complete
- ask target date for approval/settlement
- ask if any additional documents are needed, to be listed exhaustively

B. Don’t accept vague “pending approval” replies

Reply with:

who is the approving officer/unit,
what specific item is under review (coverage? amount? liability? fraud check?),
what date it was forwarded for approval,
expected decision date.

C. Ask for the computation

If there’s a delay because “amount is being computed,” request:

the adjuster’s report date
the basis of depreciation/betterment
deductible application
parts and labor breakdown

6) Escalation ladder (practical and Philippine-realistic)

Level 1: Claims handler and adjuster

Ask for a clear written status and timeline.
Ask for “complete documents confirmed” in writing.

Level 2: Claims supervisor / branch manager

Send an escalation email attaching your timeline log and the “complete file” index.
Ask for a written decision date.

Level 3: Company’s formal grievance / compliance channel

Many insurers have a customer care/complaints process. Use it and request a case/reference number.

Level 4: Broker/agent escalation (if you purchased through one)

Brokers can sometimes accelerate internal routing because they know the insurer’s escalation paths and can validate whether requirements are reasonable.

Level 5: Insurance Commission (regulatory complaint)

For insurer delay, the primary regulator is the Insurance Commission (IC). A complaint typically works best when it includes:

policy details (insurer, policy number, coverage)
claim number
incident date
documents submitted (indexed)
timeline log of follow-ups
the exact relief sought (approve repair authority; release payment; issue written denial with reasons; provide computation)

What the IC process often aims to do first: facilitate settlement/mediation and require the insurer to respond formally. Even when the dispute proceeds further, a regulator-facing file pushes the insurer to justify delays with specificity.

Level 6: Arbitration (if applicable) and courts

Options depend on what is being disputed:

A. Arbitration (common in motor policies for amount-of-loss disputes)

Many policies require arbitration if the only issue is the amount of loss (not coverage).
Arbitration clauses are often invoked when both sides agree there is coverage but dispute valuation/repair scope.

B. Small Claims

If the dispute is essentially a money claim and within the current small-claims threshold, small claims can be faster and more procedure-driven.
Thresholds and rules can change, so check the latest Small Claims rules for the current cap and coverage of insurance-related money claims.

C. Regular civil action

Used when amounts exceed small claims, or when issues involve coverage interpretation, bad faith, or damages beyond straightforward reimbursement.

D. Direct action in liability insurance (third-party claimant angle)

For liability insurance, Philippine rules generally allow an injured third party to pursue the insurer under certain conditions, often alongside or after establishing liability. This is more complex than OD claims.

Prescription / suit limitation caution:

Contract-based actions often have long prescriptive periods under general civil law for written contracts, but many policies include shorter contractual limitation periods for filing suit after denial. These clauses can be enforceable if reasonable and not contrary to law, so treat denials and “final positions” as time-sensitive.

7) The “demand letter” that actually works (and what to attach)

When ordinary follow-ups fail, a demand letter should be factual, indexed, and deadline-driven.

A. What to include

Policy number, claim number, incident details
A chronology (one page) with dates
A statement that all required documents were submitted as of [date], with an index
A request for:
- immediate issuance of repair authority or
- immediate payment/reimbursement or
- a written denial stating policy grounds and facts
A firm deadline (e.g., 5–10 business days)
A statement reserving rights to file an IC complaint and pursue legal remedies for unjustified delay, including interest/damages as allowed by law

B. Attachments checklist

claim document index (with submission dates)
email thread screenshots/PDF print-to-file
receiving copies / courier proofs
adjuster report (if you have it) / estimate / invoices
photos, police report, medical records (as relevant)

Tone matters: Firm and professional, not insulting. Regulators and courts respond well to clean records.

8) Common insurer delay reasons—and how to respond

“Incomplete documents.”

Response:

Request a single consolidated list of missing documents.
Ask the insurer to confirm that no other documents will be required after submission.
Send a completion notice once submitted.

“Still for adjuster’s report.”

Response:

Ask when inspection occurred, when the report is due, and whether any issues were noted.
If inspection already happened, ask what specific data the adjuster still needs.

“For head office approval.”

Response:

Ask the date it was submitted for approval, approving unit, and target decision date.
Request escalation to a supervisor if target dates lapse.

“We are validating possible fraud / inconsistent statements.”

Response:

Cooperate but require specificity: what inconsistency, what additional proof is needed.
Provide sworn statements and objective evidence (photos, CCTV if available, repair history, GPS, etc.).
Ask for a written list of questions.

“Parts are unavailable / shop delays.”

Response:

Distinguish insurer obligation vs shop logistics:
- insurer must still decide coverage and release payment approvals timely
- parts availability is often outside insurer control, but insurer-caused payment delays that stall ordering can be addressed
Ask whether insurer will allow non-accredited shops or alternative sourcing consistent with policy terms.

“Vehicle is mortgaged; bank endorsement needed.”

Response:

Coordinate early with the bank/mortgagee.
Ask insurer exactly what bank documents/endorsements are needed and in what form.

9) Computation issues that often become “hidden delays”

A. Deductible / participation

Confirm the deductible amount in your policy schedule.
Ask if any additional participation is being imposed and why.

B. Depreciation/betterment

Insurers may apply betterment where new parts replace old (especially tires, batteries, wear-and-tear items).
Ask for the exact formula and item-by-item application.

C. Salvage and total loss

If the insurer declares constructive total loss, settlement may involve salvage value, transfer of ownership documents, and release forms.
Ask for the valuation basis (market value references, depreciation model, comparable sales) and the salvage handling plan.

D. Storage fees and towing

Clarify whether towing and storage are covered and up to what limits.
If storage fees are growing due to insurer delay, document it and raise it in writing as consequential cost attributable to inaction (subject to policy terms and proof).

10) Special Philippine scenarios to watch

A. CTPL and “no-fault” medical payments

In practice, limited medical reimbursements are often processed with specific documentary requirements and “which vehicle pays” rules.
If delayed, insist on a written checklist and confirmation of completeness; medical reimbursements are often document-driven.

B. Hit-and-run / uninsured other party

Own damage coverage becomes the primary path if you have comprehensive insurance.
For third-party recovery, subrogation may be impractical unless the offender is identified and collectible.

C. Flood/typhoon claims

Provide strong evidence linking damage to covered peril and timeframe.
Avoid running the engine after suspected flood ingress; insurers may scrutinize “engine damage due to operation” issues depending on policy wording.

D. Multiple vehicles/policies and subrogation

If your insurer pays you, they may pursue the at-fault party (subrogation).
You may be asked to sign subrogation documents; read releases carefully to avoid waiving rights beyond what’s necessary.

11) A practical escalation kit (copy-and-use structure)

A. One-page chronology (sample format)

[Date] Accident occurred (location, brief facts)
[Date] Claim reported; claim no. issued
[Date] Inspection conducted by [name/adjuster]
[Date] Estimate submitted by [shop]
[Date] Insurer requested [documents]
[Date] Documents completed and submitted (see index)
[Date] Follow-up emails sent (no substantive response / “pending approval”)
[Date] Escalation to supervisor/customer care
[Date] Current status: [no repair authority / no payment / no written denial]

B. Document index (must be clean)

Number every attachment and name files consistently:

A-01 Policy schedule
A-02 Claim form
A-03 Police report
A-04 Driver’s license
A-05 OR/CR
A-06 Photos
A-07 Repair estimate
A-08 Email thread PDF
A-09 Proofs of receipt/transmittal
A-10 Invoices/official receipts (if reimbursement)

C. The three outcomes to demand (always)

Ask the insurer to do one of these by a date certain:

Approve and issue repair authority / pay; or
Partially approve with a written computation and basis; or
Deny with written policy grounds and factual basis.

This prevents indefinite limbo.

12) Bottom line

A delayed motor claim becomes easier to fix once it is treated like a formal case file: lock the documentary checklist, create a dated record that the file is complete, require the insurer to choose an outcome (approve/compute/deny), escalate internally with a clean chronology, and move to the Insurance Commission when delay persists without clear justification. The combination of (1) a complete proof-of-loss file and (2) disciplined written follow-ups is what turns “pending approval” into a decision.