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How to Claim Life Insurance

TeamAckoJan 25, 2024

Life is unpredictable, so we buy insurance to protect ourselves and our loved ones from the financial consequences of unexpected events. When the policyholder passes away, the beneficiaries of their life insurance policy can claim the death benefit, the sum of money the insurer pays out. However, filing a life insurance claim can be daunting, especially if you're grieving and unsure what to do. In this article, we'll guide you through the Life Insurance claim process and the required documents in India, so you can be prepared when the time comes.

Contents

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Types of claims in Life Insurance

There are three main types of life insurance claims: 

  1. Maturity claims

  2. Death claims

  3. Claim against Riders

Life Insurance Claims Process

There are three main types of life insurance claims — maturity, death, and riders. Beneficiaries will receive life insurance payouts in the case of the policyholder's untimely demise. Here is a list of claims one can make under Life Insurance.

1. Death claim

Here are the steps to file a death claim.

Step 1: Written claim intimation

The beneficiary must immediately inform the insurer of the claim. Insured's name, policy number, death site, date, claimant's name, etc. The beneficiary can obtain a claim notification form by contacting the insurance company directly, submitting an online request, or visiting any of the insurer's local offices. The beneficiary must provide the following details.

  • Their full name

  • Policy number

  • The deceased insured's full name

  • The date and location of death

  • The reason for death in the claim intimation

You can get a claim notification form from your insurance agent or advisor or visit your local insurance agency. You should also check your insurance company's website to see if the claim intimation form is available for download.

Step 2: Submit a claim form by filling it out

In the event of your untimely demise, your insurance provider would most likely ask for the following types of paperwork. Documents required for a policyholder's natural death include the following.

  • The original policy.

  • A copy of the death certificate.

  • A fully completed and signed claim form.

  • Any practical assignments.

In the event of an accident

  • Hospital certificate

  • Post-mortem report

  • Medical records of the deceased, including test results, discharge summaries, etc.

  • Original or copy of the FIR

  • Other documents (as asked by insurance provider)

Death due to a medical condition

  • Completed and signed claim form original policy documents

  • Nominee's bank account details (such as a bank statement or cancelled check)

  • Local authority-issued death certificate

  • Medical records

  • Statements from the treating physician and the attending physician

For a smooth claim settlement, be sure to submit all necessary paperwork. The nominee must submit documents such as a death certificate, proof of the insured's age, the original policy, etc. The insurance provider has 30 days from receiving the necessary documentation to issue a final decision on the policyholder's claim. There could be a situation, however, that necessitates more research on the part of the insurance provider. In this scenario, the time limit for the insurance company to resolve the claim is six months from the date it was notified of the claim in writing.

2. Maturity & survival claims

The insurance company will make a final payment to the policyholder on the policy's maturity date. Bonuses and incentives are added to the sum assured to determine the final payout amount.

The insurance firm notifies the policyholder by issuing a bank discharge form. Include the original policy document, a government-issued photo ID, a cancelled check, and a copy of your bank passbook when sending the form back to the insurer. 

Documents required

  • Policyholder's photo identification

  • Original Policy

  • Policyholder's bank account information (bank statement or cancelled check)

  • Completed Policy Discharge Form

3. Claim against add-ons/riders

Insurance Riders can be added to a standard life insurance policy to increase coverage. A claim process depends on the rider in question. For example, medical history documentation, including a record of the first diagnosis, a report from a doctor, etc., is required for the Critical Illness Rider. A copy of the police report, a certificate of disability signed by the attending physician, medical information, etc., are all necessary for the accidental disability rider.

A rider is an ancillary benefit to a basic insurance policy for which the policyholder pays a higher premium. A life insurance policy can be supplemented with a wide range of riders, including those that cover critical sickness, accidents, hospitalization costs, premium waivers, and more.

Settling a death claim also applies to claims related to riders, such as Accidental Death Benefit RiderPremium Waivers, etc. Submitting the required documentation, such as a copy of the policy and a properly filled-out claim form, will help in a smooth claim settlement.

Importance of submitting the right claim documents 

Giving your insurance company as much detail as possible can help them issue your policy and handle claims quickly. Submitting correct documents in time is extremely important.. Some of the paperwork is necessary to finalise a claim, while other pieces of paper are situation-specific necessities. The following are some of the most important aspects of the required paperwork for a life insurance application or claim.

  • The life insurance claim settlement process will go more smoothly if all the necessary paperwork is on hand.

  • If you present all the required documentation when applying for a life insurance policy, the life insurance coverage amount can aid your loved ones through a tough time.

Reasons why an insurance company may reject your claim

The following are some of the most typical explanations for claim rejection.

Incomplete application

Details like age, income, occupation, credentials, lifestyle (smoking/drinking), and information on previous policies and statements, if any, must be filled out accurately and completely. Policy benefits can be cancelled if false or missing info is submitted to the insurer.

Medical records confidentiality

Insurance premiums are affected by the patient's disclosure of current and past medical conditions, treatments, operations, etc. When estimating insurance costs online, many sites require you to submit personal information, including whether or not you smoke. Family members need to communicate their medical histories to avoid having life insurance claims denied due to a preexisting condition.

Keeping coverage a secret

All your current insurance plans must be disclosed when applying for a new policy. People often omit these specifics since digging through ancient records to discover the information is a hassle. Insurance claims could be dismissed if evidence supporting the claim is hidden.

Failure to update nominee data

In the event of the insured's or policyholder's death, benefits will be paid to the designated beneficiary or nominee. Therefore, keeping the insurance company updated on the nominee's information is crucial. A life insurance claim could only be allowed if the policyholder accomplished this very important thing.

Claims against exclusions

Insurance policies typically include a list of exclusions detailing the circumstances in which benefits will not be paid. Therefore, a claim will be denied if submitted for a condition listed in the 'exclusion' section of the policy.

Submitting false information

It will be denied if a claim is found to be false or inflated. In addition, there may be legal repercussions and a higher cost associated with the fraud investigation. The insurance company must be notified immediately if an accident has occurred. However, the insurance company may deny coverage if the claimant delays filing their claim and fails to provide all required paperwork by the deadline.

Frequently Asked Questions

Here are some common questions about life insurance claim process and documents.

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Which documents are required to file a death claim?

For the claim to be processed, the claimant will need to give a claimant's statement, the original policy document, a death certificate, a police FIR and a post-mortem exam report (if the death was caused by accident), a certificate and records from the treating doctor or hospital (if the death was caused by illness), and an advance discharge form.

How long does it take for life insurance claim settlement?

Most people expect to get money from their life insurance in 14 to 60 days. The cause of death, the status of the beneficiary, and mistakes in the documentation are all things that can delay the payout. Life insurance companies sometimes need more information before they can pay out.

How long do we have to file a life insurance claim?

There is no deadline for filing a life insurance death benefit claim in India.

How do I file a life insurance claim?

You can file a life insurance claim by getting in touch with the insurer. Understand their claim process (as it may vary among insurers). You may need to fill a claim form and submit documents like the life insurance policy and a death certificate.

What happens after I submit the claim documents?

After you submit the claim documents, the insurer will review them and keep you updated about the next steps. They may request more documents to process the claim faster.

Can the insurance company deny my claim?

Yes, the insurance company can deny your claim. 

How long does it take to receive the life insurance payout?

The duration it takes to receive a life insurance payout can be between a few weeks to a couple of months.

Can I appeal a denied life insurance claim?

Yes, you can appeal against a claim rejection. However, you need to check if there were some gaps in the process or documentation that you sent. Sometimes, improper documents or late claims can lead to rejections. Try to fix these issues if possible.

Are life insurance proceeds taxable?

No, life insurance proceeds are nontaxable. 

Should I consult a lawyer for assistance with a life insurance claim?

Consulting with a lawyer is not necessary. However, you can go ahead if you feel comfortable with a lawyer by your side. The claim process is often straightforward and doesn't require legal expertise.

Disclaimer: The content on this page is generic and shared only for informational and explanatory purposes. It is based on industry experience and several secondary sources on the internet, and is subject to changes.

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