The Hindu Business Line : Four steps to easy claims

Claim settlement is one of the most important services that an insurance company can provide to its customers. When you lose a loved one, filing a death claim can be painful and confusing, but insurance goes a long way in alleviating the affected family’s financial burdens. Fortunately, the process of death claims is not so difficult. The following aspects, if kept in mind, will make filing a death claim a lot easier, with any life insurance company.

Step 1. Claim intimation/notification form: The claimant can get a claim intimation/ notification form from the nearest local branch office of the insurance company or their insurance advisor/agent.

Some insurance companies also provide the facility of downloading the form from their Web site. The claimant must submit the written intimation as soon as possible to enable the insurance company to initiate the claim processing. The claim intimation should consist of basic information such as policy number, name of the insured, date of death, cause of death, place of death, name of the claimant.

Step 2. Documents required for claim processing: The claimant will be required to provide claimant’s statement, original policy document, death certificate, police FIR and post-mortem exam report (for accidental death), certificate and records from the treating doctor/hospital (for death due to illness) and advance discharge form for claim processing. Based on the sum at risk, cause of death and policy duration, insurance companies may also request some additional documents.

Step 3. Submission of required documents for claim processing: For faster claim processing, it is essential that the claimant submits complete documentation as early as possible since a life insurance company will not be able to take a decision until all the requirements are complete. Once all relevant documents, records and forms have been submitted, the life insurer can take a decision about the claim.

Step 4. Settlement of claim: As per the insurance regulator IRDA (Insurance Regulatory Development Authority) guidelines, the insurance company is required to settle a claim within 30 days of the receipt of all documents.

However, the insurance company can set a practice of settling the claim even earlier. Further, as per the IRDA, if the claim requires further verification, the insurance company has to complete its procedures within six months from receiving the written intimation of claim.

Usually the claimant is the nominee as appointed by the insured at the time of taking policy or subsequently but before the occurrence of death claim. At times, the proposer of the policy is different than the life assured. In such cases, the proposer receives the claim settlement proceeds.

In case, there is no nomination or in case the nominee is not alive; it becomes “Open Title” situation. The life insurance company would then require the proof of title/succession certificate issued by the competent court.

The claim would be paid to the person specified in the proof. It is very important for the policy holder to provide nomination. This saves the heirs, the inconvenience of time-consuming court procedures at a claim stage.

One should be aware of the claims process that involves intimation, submission of documents, and the settlement to be prepared for an unforeseen event. Last but not the least, it is important that premium payments are made regularly so that the insurance policy does not lapse and the cover remains in force thereby providing security to the family.

(The author is Chief – Underwriting and Claims, ICICI Prudential Life Insurance Co.)

More Stories on : Insurance | Insight | Young Investor

Article E-Mail :: Comment :: Syndication :: Printer Friendly Page