Handpicked Guide: Life Insurance Claim Process

Selecting a life insurance policy from a good insurance provider with a high claim settlement ratio is one of the major factors to be considered while planning to purchase life insurance. It is the primary responsibility of your insurance provider to ensure that the timely settlement of your valid claim should be done for the premium paid. Moreover, your dependents must know in detail the process involved in the settlement of claims otherwise there is no point in having the life insurance policy.

So, let us know about the process associated with the life insurance claim.

Mainly, life insurance claims are categorized into three categories- Death claim, Maturity claim, Survival claim and Rider claim.

How to Make a Death Claim?

In case of your death during the policy term, your nominee can claim the death benefit. This claim is usually known as the life insurance claim or the death claim.

Step 1: Intimating Insurance Provider about the Claim

• Your nominee must intimate the insurance provider about the claim as soon as possible
• The basic details which are needed for intimation are the policy number, name of the insured person, death date, place of death, cause of death, nominee’s name, etc.
• You can easily obtain the claim intimation form from the nearest branch of your insurance provider or download it from the company website.

Step 2: Documents Needed

• The major documents which would be needed for claim settlement are

1. Death Certificate
2. Original policy document
3. Age proof of the insured person
4. ID proof of your nominee
5. Discharge form
6. FIR in case of unnatural death
7. Medical Certificate as a proof of death
8. Postmortem report in case of an unnatural death
9. Records of the hospital if death has occurred due to an illness
10. Cremation certificate and employer certificate in case of an early death

• For some death claims which have taken place quite early i.e. within three years of the policy incepted, the insurance company will perform some additional investigation to make sure that the claim made is a genuine one.

1. The life insurance company would check with the hospital authorities if you were admitted into the hospital or not.
2. If there is an air crash, then the insurance company would check with the authorities of the concerned airlines to confirm if you were present on the flight or not.
3. If your death has occurred due to any medical cause, then the hospital authorities would be asked for a doctor's certificate, records of treatment, etc.
4. Furthermore, if it has been a murder case, suicide, or an accident then a police FIR report, post mortem report, etc. shall be needed.

Step 3: Submission of the Documents

For the processing of the claim, your nominee should complete the entire documentation procedure quickly and must share all necessary documents too.

Step 4: Claim Settlement

According to the IRDA regulations, the insurance provider must settle a life insurance claim within 30 days of the receipt of the necessary documents. In case of a claim requiring further investigation, the insurance provider must complete its procedures within 6 months from the receipt of the written claim for intimation.

How to Make a Maturity Claim?

You can make a maturity claim to your insurance provider once your life insurance policy reaches maturity. The payment which is made by the insurance provider on policy maturity is known as Maturity payment.

Step 1: Obtain the Policy Discharge Form

Your insurance provider would be sending you the Policy Discharge Form before a month of your life insurance policy expiration. You would also be informed about the documents which need to be submitted along with the form. Moreover, you can also obtain the form from the company website.

Step 2: Form Filling and Document Submission

The necessary details which must be entered in the discharge form are your name, your designation, your address, the sum assured, and the details of your bank account. Your form must be signed by two witnesses.

The documents which must be submitted along with the policy discharge form are

1. Original policy document
2. Your ID proof
3. Your Address proof
4. Bank mandate form along with details of the bank
5. A cancelled cheque

Step 3: Sending of the Documents

You must send the policy discharge form to the insurance providers within at least 5-7 days before your policy expires. By this, you would ensure a hassle-free settlement process of your maturity claim.

Step 4: Claim Settlement

After your life insurance policy matures, your maturity benefits will be sent to your bank account. Moreover, you can also opt to obtain a post-dated cheque at your address.

In case, there is a situation like your demise occurs after your policy matures but before the policy discharge procedures have been done then your nominees would be eligible to receive the maturity benefits.

How to Make Survival Claim?

• The Survival benefits in life insurance plans are calculated as a percentage of the sum assured. They are paid at regular intervals during the policy tenure.
• The payout structure i.e. interval and the percentage of Sum assured which is paid are not fixed and can vary from one insurance plan to another.
• The survival benefit is paid to you if you are alive when the policy reaches the fixed intervals at which the benefit has to be paid. It is paid automatically and does not require any particular claim procedure to be followed.
• Your nominee would be obtaining the entire death benefit after your demise irrespective of the amount that has been paid off to you as Survival benefit.

How to Make Riders Claim?

Various riders such as Accidental riders, Critical illness rider, Waiver of premium rider, etc. can be included in your base life insurance policy to enhance the coverage provided by the policy.

• Different riders have different procedures for making the claims. Riders such as Accidental riders are valid with death claims whereas some riders like Waiver of premium needs to be processed stand alone.
• In the case of a Critical illness rider, certain medical documents are necessary such as a Doctor's report, First diagnosis report, etc. for making a claim.
• In Accidental disability rider, claims can be made by submitting documents such as a copy of FIR, Certificate of disability by the doctor, doctor's report, etc.

Conclusion

So, with all the above-mentioned procedures life insurance claims would be smooth processes. All you need to do is to remain careful about regular premium payment, take extra effort in following the procedures, and arranging the necessary documents for the claim process.