Know the life insurance claim process and required documents. Get your claim processed efficiently and effectively with this guide.
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.
There are three main types of life insurance claims:
Claim against Riders
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.
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
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
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
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.
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.
Policyholder's photo identification
Policyholder's bank account information (bank statement or cancelled check)
Completed Policy Discharge Form
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, hospitalisation costs, premium waivers, and more.
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.
The following are some of the most typical explanations for claim rejection.
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.
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.
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.
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.
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.
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.
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.
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.
There is no deadline for filing a life insurance death benefit claim in India.
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.