How to claim your life insurance policy? – Forbes Advisor INDIA

Ease of claims is paramount for a consumer before investing in an insurance policy. Especially for a life insurance policy, a thorough understanding of the claims process makes it easier for you when making use of your insurance policy.

Here’s everything you need to know about claiming your life insurance policy.

Life insurance claim resolution process

Life insurance claims can be divided into three categories: death claims, maturity claims and rider claims. The settlement procedure for each of these insurance benefits is different:

  1. Death requests: The agent or the beneficiary can avail himself of the insurance benefits in the event of the premature death of the insured. Death claims can only be processed if the policy has ended three years and all premiums are paid.
  • Intimation of the complaint: The intimation of the claim is the first step that must be taken in the event of death claims. The agent must inform the insurance company of the insurance claim as soon as possible. He or she must complete the death request form and provide the necessary information such as the policy number, the name of the policyholder, the date of death, the place of death, the time of death and the name of the applicant, etc.

The agent or beneficiary can search for the form from the nearest agency or download it from the insurer’s official website.

  • Delivery of documents: Applicant must submit death request form along with other required documents such as original police document, copy of bank book / voided check, applicant contact details, photo ID and death certificate of the policyholder.
  • Claims settlement: Once the applicant submits the documents, the insurer registers the claim and is expected to pay it off within 30 days. However, in cases where the insurer needs to carry out further investigations, it may be authorized to settle the claim within six months from the date of receipt of the death claim form.
  1. Complaints at maturity: Maturity claims are paid at the end of the insurance period. The insurance service provider makes payment to the policyholder on the due date. The amount payable on the due date consists of the sum insured and any incentives, if any. The policyholder must complete a bank discharge form, attach the required documents and deposit them at the bank.
  1. Riders’ complaints: The additional benefits that are associated with the original policy on the payment of an additional premium are called rider claims. Different riders can be attached to a life insurance plan, such as an accidental rider, a hospital cash rider, a waiver of premium rider and a critical illness rider.

The complaints of the amendments are settled by different processes. In the event of accidental death, waiver of premiums, etc. are rider claims and are resolved after the death claim is settled, other rider claims are resolved after submitting the relevant documents with the copy of the policy and completed forms.

Documents required for the settlement of claims

The insurer sends a claim file to the agent or beneficiary once the claim has been registered. This pack consists of forms that must be submitted to initiate the claims process. The candidate can collect these forms at the respective office or at the nearest branch.

The candidate can also access these forms and download them from the insurer’s website to speed up the process. Given the current extreme pandemic scenario, this process appears to be more appropriate.

  1. Death declaration form: The main document in which the nominee must fill in the details of the policy and the circumstances of the death of the insured person.
  2. Doctor’s statement: This form should be completed by doctors such as the doctor who treated the deceased or the regular / family doctor of the deceased. It involves clinical observation of the circumstances in which the death occurred.
  3. Attending hospital certificate: The authorities of all hospitals that treated the deceased for the illness that caused his death must complete this form.
  4. Employer certificate / school / college certificate: The employer of the deceased must complete this form. If the deceased was a minor, the authorities of his school or college must complete the form.
  5. KYC documents: The beneficiary’s KYC documents are required to process the request. All KYC documents (identity photo and proof of address) must be certified by one of the following: a company agent, a company relations manager, a branch manager of the distributing bank, a bank manager of a nationalized bank with stamp, an official civil servant, a principle of a public school, a magistrate or an employee of the company.
  6. Copy of canceled check and bank statement
  7. Legal representative: The legal representative of the candidate must submit documents proving his identity and authority.
  8. In the event of unnatural deaths, certain additional documents must be submitted:
  • FIR copy
  • Autopsy reports
  • Death certificate issued by the municipality

Different methods of settling complaints

As part of our streamlined claims settlement process, applicants must submit the above mentioned documents to expedite settlement. Companies have now started to extend the flexibility to submit these documents digitally or physically.

The applicant / beneficiary can directly contact the Nodal agents assigned by the companies, usually lists of these agents are also available on the respective company website or the requester can call the customer service managers for instant assistance.

The claim once submitted is then thoroughly verified by the company under the supervision of their underwriters and legal advisers, once this step is completed, the approved claim amount is then transferred to the registered account of the nominee indicated in the supporting documents.

Importance of the claims settlement ratio

The claims settlement ratio for any life insurance company is of the utmost importance. The “claims settlement ratio” is a calculation process used to determine the number of claims settled relative to the number of claims received by the insurer. This helps to assess the insurer’s commitment to resolving insurance claims in a timely manner.

A higher ratio means that the insurer’s claims settlement efficiency is high. It gives the candidate a better chance of settling claims after the unfortunate death of the insured.

The importance of life and other insurance has increased in the wake of the pandemic and it is in the best interest of clients to choose an insurance plan that is best for them and that can support their family in the event of an eventuality. In addition, a thorough understanding of the claims process is required so that the candidate / beneficiary can obtain the appropriate benefits within the prescribed time frame.

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