Ease of claims is paramount for a consumer before they invest in an insurance policy. Especially for a life insurance policy, a thorough understanding of the claims process makes it easier for you at the time of making use of your insurance policy.
Here’s all that you should know about claiming your life insurance policy.
Process for Settlement of Life Insurance Claims
Life insurance claims can be divided into three categories: death claims, maturity claims and rider claims. The settlement procedure of each of these insurance services is different:
- Death Claims: The nominee or beneficiary can avail insurance benefits in case of untimely demise of the insured person. Death claims can be processed only if the policy has completed three years and all the premiums are paid.
- Intimation of claim: Intimation of claim is the first step that needs to be followed in case of death claims. The nominee must inform the insurance company about the insurance claim at the earliest possible instance. He or she needs to fill in the death application form and provide necessary information as required including policy number, name of the policyholder, date of death, place of death, time of death and name of the claimant etc.
The nominee or beneficiary can seek the form from the nearest branch or download it from the official website of the insurance provider.
- Submission of documents: The nominee needs to submit the death application form along with other requisite documents such as the original policy document, copy of bank passbook/cancelled cheque, claimant’s address details, photo ID proof, and death certificate of the policyholder.
- Claim settlement: After the nominee has submitted the documents, the insurer registers the request and is expected to settle it within 30 days. However, in circumstances where the insurance provider needs to carry out further investigations, they may be allowed to settle the claim within six months from the date of receipt of the death application form.
- Maturity Claims: Maturity claims are paid on the completion of insurance tenure. The insurance service provider makes the payment to the policyholder on the maturity date. The amount payable on the maturity date consists of the assured sum and incentives if any. The policyholder needs to fill in a bank discharge form, attach the required documents and deposit them to the bank.
- Rider Claims: Additional benefits that get clubbed with the original policy on payment of extra premium are referred to as rider claims. Different riders can be attached to a life insurance plan, like an accidental rider, hospital cash rider, waiver of premium rider and critical illness rider.
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.
Documents Needed For Claim Settlement
The insurer sends a claims pack to the nominee or the beneficiary after the registration of the claim is completed. This pack consists of forms that need to be submitted to initiate the claim process. The nominee may collect these forms from the respective office or the nearest branch.
The nominee can also access and download these forms through the website of the insurer to expedite the process. Considering the current extreme pandemic scenario, this process appears to be more appropriate.
- Death claim form: The primary document wherein the nominee needs to fill in the details of the policy and death circumstances of the insured person.
- Physician’s statement: This form needs to be filled in by medical practitioners like the doctor who attended the deceased or the usual/family doctor of the deceased person. It entails the clinical observation of the circumstances in which the death happened.
- Treating hospital certificate: The authorities of all the hospitals which treated the deceased for the illness that caused his death need to fill this form.
- Employer certificate/school/college certificate: The employer of the deceased needs to fill in this form. If the deceased was a minor, the authorities of his school or college need to fill the form.
- KYC documents: KYC documents of the beneficiary are required to process the claim. All the KYC documents (photo ID and address proof) should be certified by any of the following: an agent of the company, a relationship manager of the company, a branch manager of the distributing bank, a bank manager of a nationalized bank with appropriate stamp, a gazetted officer, a principle of a government school, a magistrate or an employee of the company.
- Copy of Cancelled Cheque and bank statement
- Legal representative: The legal representative of the nominee needs to submit documents proving his identity and authority.
- In case of unnatural deaths, some additional documents need to be submitted:
- FIR copy
- Post-mortem reports
- Death certificate issued by the local authority
Different Ways of Claim Settlement
As part of our simplified claim settlement process, nominees have to submit above mentioned documents to expedite settlement. Companies have now begun to extend flexibility to submit these documents digitally or physically.
The nominee/beneficiary can directly contact nodal officers assigned by the companies, usually lists of such officers are also available on respective company’s website or the claimant can call customer care executives for instant assistance.
Claim once submitted is then thoroughly verified by the company under supervision of their underwriters and legal advisors, once it passes this stage, the approved claim amount is then transferred to nominee’s registered account given in supporting documents.
Importance of Claim Settlement Ratio
The claim settlement ratio for any life insurance company is of utmost importance. The “claims settlement ratio” is a calculation process used to ascertain the number of claims settled against the number of claims received by the insurer. This helps in assessing the insurer’s commitment towards timely settling the insurance claims.
A higher ratio signifies that the claims settlement efficiency of the insurer is high. It assures the nominee of greater chances of claim settlement after the insured person’s unfortunate demise.
The significance of life insurance and other insurance has grown in the wake of the pandemic and it is in the best interest of customers to opt for an insurance plan that is best suited for them and that can support their family in case of any eventuality. Further, having a thorough understanding of the claim process is necessary for the nominee/beneficiary to get the appropriate benefits within the prescribed time limits.
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July 15, 2021 at 07:36PM
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How to Claim Your Life Insurance Policy? - Forbes
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