Life Insurance Claims – Check Full Process & Documents Required

life-insurance-claims

Before initiating a claim, an individual should make sure that the policy is active and all its premium payments have been cleared.

Henceforth, the procedure of making a claim under life insurance policy is a simple and an uncomplicated process for various companies like edelweiss tokio, hdfc life, icici prudential etc.

In this article, you will understand all you need to know about making a life insurance claim for the term plan bought by you.

Life Insurance Claim Procedure

There are 2 MUST required steps to make a life insurance claim:

  1. STEP 1 – The insurance company needs to be updated immediately about the death of an insured for making a death claim.
    The nominee should then fill the claim intimation form with details such as policy number, date of death, insured’s name, date of death, reason of death, place of death, etc.
    The form is available to download online from the website of the insurance provider or can also be acquired from the nearest branch of the insurance company.
  2. STEP 2 – The insurance company updates the policyholder in advance and sends a claim discharge form during a Maturity or Survival Claim.
    The form is needed to be filled and submitted to the insurance company along with original policy document, copy of pass book, ID proof and Cancelled Cheque so that the maturity or survival claim can be paid.
Also Read: Edelweiss Tokio Life Insurance Review

Documents required for Life Insurance Policy Claim Reimbursement

A nominee of the policy of its deceased insured needs to submit the following documents to make a death claim under the term plan purchased in Life Insurance Policy:

  1. The death certificate of the insured
  2. Original documents of life insurance policy
  3. ID proof of the nominee, beneficiary or the claimant
  4. Age proof of the life insured if it was not provided at the time of buying the policy
  5. Police FIR if death occurred due to an accident
  6. Medical reports and hospital records for accidental death claim cases
  7. Any other relevant required document as needed by the insurance company
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Investigations done by Life Insurance companies before settling a claim

Additional investigations are run by the insurance companies in case of death claims (life insurance claim) initiated within two years of the commencement of its insurance policy to ensure that it is an authentic claim.
Henceforth, in such situations, the Insurance companies might follow the below mentioned steps to confirm the genuineness of the claim:

  1. Cross-check with the concerned hospital if the deceased holder was admitted actually admitted there.
  2. In case of death due to an air crash, the company contacts the concerned airline authorities to confirm if the deceased holder wasa passenger on the crashed plane.
  3. The insurance company gets in touch with the hospital to obtain the doctor’s certificate, records of treatment, etc. in case of death caused by any medical cause. This helps the company to determine if the medical cause was sudden or if the insured suffered from the illness while buying the policy.
    If the medical cause was pre-existent, the insurance company would check whether the details of such cause were disclosed by the policyholder at the period of purchase of the policy.
    In case if the medical condition was concealed from the company, it results in violation of good faith on which the insurance policy is issued.
    The policy is called null and void in such a case and the insurance company rejects the claim.
  4. Required additional documents in case of death, murder or accident area police FIR report, post mortem report, police inquest report, panchnama, etc.
Also Read: SBI Life Insurance – Compare Plan, Premium Payment

Documents required by Life Insurance Companies for settling Claim Amount

For making the maturity claim of the Life Insurance Policy, the following documents are necessary to be deposited to your insurance company:

  1. Original insurance policy document
  2. Copy of identity proof of the candidate
  3. Copy of address proof of the candidate
  4. Bank mandate form with accurate bank details
  5. A cancelled cheque leaf

To get the maturity claim of your Life Insurance Policy settled at the earliest by your insurance provider, the accurately filled form with all the demanded relevant documents should be submitted to the company at least in 5 to 7 working days prior to the plan’s maturity date.

Also Read: 4 Unpopular Reasons Why Life Insurance May Not Beneficial For Everyone

Life Insurance Claim FAQs

Steps to claim for Life Insurance?

You can get in touch with your insurance provider for acquiring expert guidance while making a claim.
However,the procedure of initiating a claim is dependent upon the kind of claim you wish to make.
In case of a maturity claim, the insurance company starts claim proceedings days before maturity. It sends a claim discharge voucher which you should fill up and submit to the company for the payment of claim.
Along with the discharge voucher you are also required to submit your policy document and identity proof. In case of death claims, on the other hand, the nominee should inform the insurance company about the death of the insured.
A death claim form should be filled and submitted to the insurance company with the death certificate of the insured.
Identity proof of the nominee and his/her bank account details would also be required so that the claim can be credited directly to the nominee’s bank account.
Copies of the police FIR, coroner’s report, panchnama, inquest report, etc. are the necessary documents needed to be deposited by the nominee in case of accidental deaths.

What is process to claim if the person is missing?

The settlement for the benefit amount of claim would be provided only after the completion of 7 years in case if the insured goes missing.
Hence, after the completion of 7 years from the date the missing person report was filed with the police, the court would declare the missing person ‘presumed to be dead’.
On such announcement, you can get in touch with your insurance provider to make the claim with their assistance.
In that case, the court decree should be submitted to the insurance company along with the claim form and identity of the nominee or the claimant making the claim.
Once the documents are submitted, the insurance company would settle the claim and terminate the policy.
The claim settlement is made by the insurance company only after receiving the court’s decree, otherwise inconsiderate even if the policy gets matured during those period of seven years.

Is there a time limit to file a life insurance claim?

To easily and rapidly acquire the settlement of the claim benefit without any hindrance, a life insurance claim should be initiated in the shortest possible time.
Although, there is no specific time limit to file a life insurance claim.
However, in case of delay in filing the claim, the insurance company might get suspicious about the reason for delay and there might be investigations into the claim, which would result into a longer waiting period.
Hence, the life insurance claims should be filed at the earliest to avoid and hindrance or deferral in receiving the payment.

Documents required to claim in case of Life Insurance Policy?

Documents like the claim discharge voucher, policy bond and a valid identity proof of the policyholder are necessary to be deposited to the insurance provider while applying for a maturity claim.
Moreover, if the age proof was not submitted at the time of buying the policy, it would be required at the time of claim.
In case of a death claim, the death claim form, death certificate, policy document, identity proof of the nominee and bank details of the nominee would be required.
In addition to these documents, a copy of the police FIR, police inquest report, post mortem report, coroner’s report, etc. would be demanded by the insurance company contingent upon the death of the insured by an accident.

Can I claim from 2 life insurance policies?

Yes, it is possible to make a claim without any difficulty from more than two life insurance policies.
Inconsiderate of the benefit already acquired under one policy, you will still achieve the full claim amount from the other policies.

How long does an insurance company have to investigate a claim?

A life insurance company can acquire a period of up to 6 months for running investigations into a case, and then make the settlement of the claim as per the rules specified under the IRDA regulations.
However, a supplementary claim amount equivalent to bank rate + 2% would needed to be paid by the insurance company in case if they delay the investigation or claim payment.

Why would life insurance deny a claim?

Rejection of a life insurance claim is dependent upon various factors which involve situations like – if the claim is fraudulent, if the insurance company catches out an essential information which was concealed at the time of buying the policy, the life insurance claim would immediately get cancelled and the policy would be stated as null and void.
Additionally, if the claim is made for an exclusion under the policy, if the required documents for the claim has not been submitted, if the life insurance claim is made under a lapsed term insurance policy or a surrendered policy are the grounds based on which a claim might get denied.

How do I appeal a denied life insurance claim?

To make an appeal for a denied claim, you can get in touch with your life insurance company.
You should communicate with the company’s internal grievance redressal department and appeal for the denial of the claim.
You can also contact IRDA and make an appeal for your life insurance claim denial.
There is an insurance ombudsman who handles insurance related disputes where you can take your request for resolution.
Otherwise, to make an appeal against your life insurance claim rejection, you can also connect with the consumer court or judicial court for attaining possible resolvement of your case.

What are the different modes of claim payment?

A cheque, demand draft or direct credit into the account of the claimant are different modes through which the claim settlement of a life insurance policy is made.

Can I cancel the life insurance policy?

There are two circumstance under which the cancellation of a life insurance policy can be initiated – the first one is to make a cancellation during the free-look period and the second would be to cancel post the conclusion of the free-look period.
If you terminate the policy within the free-look period of 15 days after commencement of the its tenure, you can avail the refund of the premium paid after the deduction of the administrative costs of issuing the policy and the insurance cost for the period for which the policy was in force.
Although, if you opt to turn down the policy after the expiration of the free-look period, it would be called as surrender.
In such a case, you will get a specific surrender value based on the date after which you cancel your plan.
The policy would successfully get terminated post the payment of the surrender value to its policyholder.

How do claim settlement ratio calculated?

With consideration to one financial year, the evaluation of a ratio depicting the number of claims settled by the insurance provider against the total claims made is called as its Claim Settlement Ratio. The ratio is expressed as a percentage and is calculated as follows –

Calculation of Claim Settlement ratio?

Claim Settlement Ratio = (number of claims settled / total number of claims made) * 100

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