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Life Insurance Claims Life Secured, Health Assured.

Term insurance claim settlement is a process in which the nominee files a claim with the insurance company to receive the death benefit in case of the untimely death of the life assured or the maturity benefit in case of the survival of the life assured till the end of the policy term.At Bimasure, Our dedicated team provides complete assistance  and unconditional support at the time of claim.Generally, the entire process of term insurance claim settlement will be completed within 30 days of filing the claim.

Types of Life Insurance Claims

Understanding the different types of life insurance claims is crucial for policyholders and beneficiaries. Life Insurance claim process is classified into below categories i.e. death claim maturity claim and rider claims. Let's discuss the process in detail;

Death Claim

Filed by beneficiaries in case of the policyholder's demise.

Survival or Maturity Claim (TROP)

Made when the policy reaches its maturity date, and the insured is alive.

Rider Claim

Pertains to additional benefits or riders attached to the policy, such as critical illness or disability claims etc

Life Insurance Claim Process

Below mentioned are the steps involved in the term insurance claim process:

  • CASHLESS CLAIM

  • Claim Intimation Below mentioned are the steps involved in the life insurance claim process:

    number10

    Life Insurance Claim Process

    Intimation of claim is the first step that needs to be followed in case of death claims. The nominee/ beneficiary must immediately inform the insurance company about the claim. This can be done by contacting the insurance company on call or visiting the nearest branch. They can also  submit an online request. The beneficiary must provide the following details.

    • Claim Form (The nominee or beneficiary can seek the form from the nearest branch or download it from the official website of the insurance provider)
    • Inured complete details
    • Policy number
    • The date and location of death.
    • The reason for death in the claim intimation.
    • Beneficiary details
    number11

    Document Submission

    For a smooth claim settlement, it is very crucial that the nominee/beneficiary has all the documents ready which are required to be submitted to the insurance company. The nominee/beneficiary must submit all the required documents as per the type of claim within the timelines.

    Claim Settlement

    The insurance provider has 30 days from receiving the necessary documentation to give a final decision on the policyholder's claim. Sometimes there could be a situation, where it would require more time to come to a decision, however 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.

  • DOCUMENTATION

  • Claim Documentation Smooth processing of life insurance claims necessitates proper documentation. Typically, required documents are as follow;

    Natural Death

    • Claim Form
    • Policy certificate (original)
    • Copy of death certificate issued by local authorities
    • NEFT mandate form attested by bank authorities along with a cancelled cheque or bank account passbook
    • Nominee's photo identity and address proof such as copy of Passport, PAN card, Voter identity card, Aadhar (UID) card, etc.
    • Medico-legal cause of death copy
    • Medical records (admission notes, death/ discharge summary, test report, etc.)
    • Any additional documents required by the insurance company

    Unnatural Death

    • Claim Form
    • Policy certificate (original)
    • Copy of death certificate issued by local authorities
    • NEFT mandate form attested by bank authorities along with a cancelled cheque or bank account passbook
    • Nominee's photo identity and address proof such as copy of Passport, PAN card, Voter identity card, Aadhar (UID) card, etc.
    • Medico-legal cause of death copy
    • Health records (like test reports, admission notes, discharge/death summary, etc.
    • Driving license
    • FIR copy
    • Panchanama
    • Inquest report
    • Postmortem report
    • Any additional documents required by the insurance company

    Survival or Maturity Claim (TROP)

    • Claim Form
    • Policy certificate (original)
    • Policyholder’s photo identity and address proof such as copy of Passport, PAN card, Voter identity card, Aadhar (UID) card, etc.
    • Policyholder’s bank account information (bank statement or cancelled check).

    Claim against add-ons/riders

    Rider claims are settled through different processes. In case of accidental deaths, waiver of premium etc. are rider claims and are resolved after the death claim settlement, other rider claims are settled after submitting relevant documents along with the policy copy and duly filled forms.

Claim Intimation Below mentioned are the steps involved in the life insurance claim process:

number10

Life Insurance Claim Process

Intimation of claim is the first step that needs to be followed in case of death claims. The nominee/ beneficiary must immediately inform the insurance company about the claim. This can be done by contacting the insurance company on call or visiting the nearest branch. They can also  submit an online request. The beneficiary must provide the following details.

  • Claim Form (The nominee or beneficiary can seek the form from the nearest branch or download it from the official website of the insurance provider)
  • Inured complete details
  • Policy number
  • The date and location of death.
  • The reason for death in the claim intimation.
  • Beneficiary details
number11

Document Submission

For a smooth claim settlement, it is very crucial that the nominee/beneficiary has all the documents ready which are required to be submitted to the insurance company. The nominee/beneficiary must submit all the required documents as per the type of claim within the timelines.

Claim Settlement

The insurance provider has 30 days from receiving the necessary documentation to give a final decision on the policyholder's claim. Sometimes there could be a situation, where it would require more time to come to a decision, however 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.

Claim Documentation Smooth processing of life insurance claims necessitates proper documentation. Typically, required documents are as follow;

Natural Death

  • Claim Form
  • Policy certificate (original)
  • Copy of death certificate issued by local authorities
  • NEFT mandate form attested by bank authorities along with a cancelled cheque or bank account passbook
  • Nominee's photo identity and address proof such as copy of Passport, PAN card, Voter identity card, Aadhar (UID) card, etc.
  • Medico-legal cause of death copy
  • Medical records (admission notes, death/ discharge summary, test report, etc.)
  • Any additional documents required by the insurance company

Unnatural Death

  • Claim Form
  • Policy certificate (original)
  • Copy of death certificate issued by local authorities
  • NEFT mandate form attested by bank authorities along with a cancelled cheque or bank account passbook
  • Nominee's photo identity and address proof such as copy of Passport, PAN card, Voter identity card, Aadhar (UID) card, etc.
  • Medico-legal cause of death copy
  • Health records (like test reports, admission notes, discharge/death summary, etc.
  • Driving license
  • FIR copy
  • Panchanama
  • Inquest report
  • Postmortem report
  • Any additional documents required by the insurance company

Survival or Maturity Claim (TROP)

  • Claim Form
  • Policy certificate (original)
  • Policyholder’s photo identity and address proof such as copy of Passport, PAN card, Voter identity card, Aadhar (UID) card, etc.
  • Policyholder’s bank account information (bank statement or cancelled check).

Claim against add-ons/riders

Rider claims are settled through different processes. In case of accidental deaths, waiver of premium etc. are rider claims and are resolved after the death claim settlement, other rider claims are settled after submitting relevant documents along with the policy copy and duly filled forms.

Reason for Claim Rejection

Having life insurance is crucial for ensuring financial protection. However, there are certain instances where the life insurance company rejects the claim. As a policyholder, you would never like to face this situation of a claim getting rejected. The event of getting a claim after an accident is very stressful, and the claim getting rejected only adds further to the stress. Let's take a closer look at the reasons behind these rejections:

Policy Lapses

If premiums are unpaid

Material Misrepresentation

Providing false information during policy issuance.

Exclusions

Claims falling under policy exclusions.

Non-Disclosure

Failure to disclose critical information during application.

Fraudulent details

If the nominee of the policy makes a fraudulent claim to get the amount of the claim.

cross-round

Failure to update nominee data

Benefits will be paid to the designated beneficiary or nominee. Therefore, keeping the insurance company updated on the nominee's information is crucial.

Tips to Avoid Claim Rejection

Life Insurance offers a vital protection to the policyholders, yet navigating the claim process and preventing claim rejection requires understanding and precautions to minimise the stress and ensure coverage, Here are some preventive measures to avoid claim rejection;

Fill Form Correctly

Double-check all application details, Seek professional assistance if uncertain about any information

Honest Disclosure

Provide accurate and complete information required during policy application, Communicate openly about health conditions

Timely Premium Payment

Maintain a consistent premium payment schedule, Explore options for missed payments to prevent policy lapses

Keep the Nominee Information Updated

You should update the insurance company about the details of the beneficiary, such as address, phone number, email ids, etc. Also, if the already nominated person dies, then change the nominee.

Don't Delay in Filing Insurance Claims

The sooner you intimate the company about whatever has happened that requires medical attention, the easier your claim processing will be. Timely intimation can also keep you clear of this accusation.

Review Policy Terms

Read and comprehend policy documents thoroughly, Seek clarification from insurers about any ambiguous terms

FAQ's

As the need for insurance increases, doubts and queries also increase. Navigating insurance complexities can be overwhelming. To help you with this, We have tried to address common doubts for a seamless journey with Bimasure;

The duration varies but generally takes a few weeks to a few months. It depends on factors like documentation completeness and the nature of the claim.

 

Contact the insurance company immediately. Submit the required documents, including the death certificate. The insurer will guide you through the process.



  •  

Yes, if the policy has multiple benefits or riders, separate claims can be filed for each, provided the criteria for each claim are met.

  •  

During the contestability period (usually two years), the insurer may investigate the policy details closely. If the death is due to reasons not disclosed during application, the claim might be contested.



  •  

Generally, there’s a suicide clause. If the policyholder dies by suicide within a specified period (often two years from policy inception), the claim may be denied. After this period, suicide is typically covered.



  •  

Beneficiaries can inquire about the claim status directly with the insurance company. Many insurers provide online portals or customer service hotlines for such inquiries.

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