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Step by Step understanding of Life Insurance Claim Process

Life insurance is a contract between the policyholder and the insurance company in which the insurance company agrees to pay a definite amount of money to the nominee of the policyholder in exchange for a premium paid by the policyholder. Life insurance penetration in India is still on the lower end as compared to the other countries. The life insurance penetration in India is 3.7 % of the GDP as against the World average thf 6.31%. Once upon a time in India, life insurance was considered as a waste of investment due to the frauds and lack of awareness among the public.

But due the advancement in the technology and the entry of private sector insurance companies, life insurance has become accessible to many people. The level of awareness regarding the life insurance has increased in the recent days and the sector is growing at 11 % to 12% YOY. Insurance is a service since the product is intangible and is useful only at the time of demise of the policyholder or during maturity. The main purpose of taking a life insurance is to help the family of the policyholder in the event of sudden demise of the policyholder.

Let us understand the step by step procedure of life insurance claim process:-

Step 1: Claim Intimation

  • In case of Maturity claims, policyholder should inform the insurance company regarding the maturity of the policy or survival of the policyholder.
  • In case of Death claims, the nominee of the policyholder or the immediate family members can lodge a claim with the insurance company.

The claim intimation can be done online or offline which should contain basic information such as the Name of the Policyholder, Policy number, Date of Maturity etc. In case of offline intimation the claim form can be availed from the nearest life insurance branch and duly filled before submission.

A claim intimation number is provided by the insurance company which is to be retained and used for any further communication with the insurance company.

Step 2: Submission of Documents

Once the claim intimation is done and the claim intimation number is obtained, the next step is to provide all the relevant documents to the insurance company. It is advisable to submit all the documents in one go to avoid to and fro communication with the insurance company.

The following documents are to be provided by the nominee or the policyholder:

  • Certificate of Death (Death Claim)
  • Panchanama report (Death claim)
  • Statement from hospital if the insured is admitted
  • Certificate from medical attendant stating that the illness of the insured
  • F.I.R Report (Accident death claim)
  • Cremation or burial report
  • Certificate from employer if the deceased is an employee.
  • Age proof
  • Residence proof
  • Relation proof with the policyholder(Death claim)
  • Deeds of assignment (if any)
  • Policy document
  • Duly filled claim form/ claim intimation number
  • Bank account details
  • Any other documents as required by the insurance company.

Step 3: Claim Settlement

As per the regulation 8 of the IRDA (Policyholder’s Interest) Regulations, 2002, the insurer is required is required to settle a claim within 30 days of receipt of all the required documents. If the claim is an early claim (claim which is occurred within 3 years from the date of policy start date) then there would be further investigation by the insurer. This procedure has to be completed within six months from the date of receiving written intimation of claim.

After receiving all the documents the claim is processed and the insurance company releases the funds into the account mentioned in the claim intimation form.

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