Personal Finance

How to make a claim from a life insurance policy?

Bavadharini KS | Updated on March 31, 2020

Life insurance policies are among the most important assets of an individual and play a significant role in his/her family in the event an unfortunate event. While the loss of an individual will be difficult for the family to cope with, life insurance helps soften the financial blow.

An insurance claim request should either be placed by the nominee (in case of death of policyholder) or by the insured himself/herself in case of maturity claim (or in case of accident). But the nominee or the insured is required to carry out certain procedures to receive the claim amount.

Here is how to go about the claim process.

In some cases, claim investigation may be conducted and claim settled after conclusion of the investigation.

Claim procedure

Depending on the situation, you (nominee or policyholder) can invoke various types of claims including accidental claim, death claim and maturity claim. Life insurance companies have an obligation to settle claims promptly. Thus, the first step is claim intimation and next is to submit the requisite documents. Most insurers including ICICI Pru Life, HDFC Life, Bajaj Allianz Life and Aditya Birla Sun Life have made the entire claim process online.

To start with, maturity claim settlements are simpler and quicker. The maturity amount (sum assured plus bonuses, if any), is credited to the policyholders’ account if he/she has taken endowment, ULIP, term policy with return of premium or any other savings policy.

Amit Garg, Term Insurance, Business Unit Head, Policybazaar.com, says, “Most of the insurers intimate the policyholder three months prior to the maturity of the policy and send a policy discharge form for the policyholder to fill out along with the original policy document.”

Life insurers, these days, make payment of the maturity amount through direct credit to the policyholder’s or nominee’s account. “The bank details are usually filled in by the policyholder at the time of purchase of policy. Otherwise, before maturity, the bank details will have to be sent to the insurer along with policy discharge form,” adds Amit.

In case of death claims, the first step for the nominee of the policyholder is to intimate the claim to the insurer. Life insurance companies have simplified this process to the maximum extent. Your nominee can intimate the claim request to the insurance company online through email, WhatsApp or Chatbot. You can also call the customer service or your agent for claim initiation request. Your insurer will then send the claim request form or provide the link from where the same can be downloaded. The claimant would be asked to fill the claim intimation form, along with the required details (which varies from insurer to insurer). Common in the form is requirement for basic details such as policy number, name of the insured, date of death, cause of death, place of death, and name of the claimant (person initiating the claim).

The next step, post claim intimation, is the submission of documents.

Documentation

Depending on the type of claims, the documentation requirement would vary. For instance, in the case of accidental death, the insurer would ask the nominee to submit documents such as FIR copy and final police investigation report. Similarly, in the case of permanent disability, medical certificate, FIR copy and all medical-related reports including lab tests, X-rays and scans should be submitted.

There are a few basic documents to be submitted in case of any claim ― maturity or death. These include original policy document, original attested copy of death certificate issued by local authority, NEFT mandate form along with cancelled cheque leaf or bank account statement, nominee’s identification proof such as passport copy, and PAN card, among others. Further, death claim application form, doctor’s certificate and employer certificate should be duly filled, signed and submitted along with the documents. In case of unnatural death (accident or homicide), forms such as post-mortem report and related death claim form should be filled.

Do note that if a person meets with early death (death within three years of taking the policy), then cremation certificate is also required to be submitted to the insurer.

As per the Insurance Regulatory and Development Authority of India (IRDAI), life insurers must settle claims within 30 days of claim intimation. But if a claim warrants an investigation, then the insurer should conduct such investigation within 90 days from the date of receipt of the claim intimation and the claim should be settled within 30 days thereafter. That said, many insurers settle claims within seven working days or less. For instance, ICICI Pru Life claims to settle death claims within a day after the receipt of the mandatory documents. This is provided the policy has been active for three continuous years, the claim amount is less than or equal to ₹1.5 crore and the claim does not require any investigation. Similarly, HDFC Life claims to settle claims within a day for policies of sum assured up to ₹2 crore, and it is available exclusively for policies purchased online.

Points to note

To ensure that your claim is not rejected by the insurer, make sure you provide nominee details. If you don’t have a nominee in your policy, though the sum assured will be paid to the legal heir (spouse, children and mother), it may take longer than usual for claim settlement.

Similarly, ensure that your premiums are paid regularly. However, if an individual defaults on premium payment, a grace period is allowed without any penalty or additional charges. The grace period would be 15 days if your premium payment schedule is on monthly basis, while in other cases (quarterly, half-yearly and annual) the grace period is 30 days. This is common to all insurance companies. If premiums are left unpaid beyond the grace period, your policies may lose the benefits.

Published on March 31, 2020

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