An Overview
Life is unpredictable; that’s why insurance exists. Insurance offers financial assistance during uncertain times to us and our loved ones. The insurance company tends to pay an amount after the insurer’s death, but claiming the amount can become a complex task as it requires a procedure. Filing the life insurance claim can be challenging, especially when you’ve recently lost someone and are still determining the entire process. But don’t worry, as today in this blog, we will cover the basics of filing a life insurance policy claim.
Types of Claims in Life Insurance
There are three types of claims in life insurance.
- Maturity claims
- Death claims
- Claim against Riders
Life Insurance Claim Processes
There are majorly three types of claim processes under Life Insurance. If the insurer dies untimely, then beneficiaries are entitled to receive an insurance payout. But it requires a procedure. So, let’s take a look at the procedure to be followed under certain causes.
1. Death Claims
If the claim is due to natural death, the death certificate is the primary document required to be issued by the authorized authority. The insurance company may also require additional documentation for verification purposes.
Written Claim Request
The first step is to inform the insurance company about the policyholder’s demise and define the cause of death. This notification can be sent through a written claim request, which can be submitted online, via mail, or through the insurance company’s designated channels.
Submission of Documents
Once the claim request is initiated, the next step is to collect and submit all the required documents to support the claim. These documents typically include:
- Original policy documents
- Death certificate (for natural death)
- Completed Claim Form
- Medical records (if applicable)
- Any other relevant documents requested by the insurance company
In Case of an Accident
If the cause of death is an accident, then apart from the death certificate, a copy of the FIR and a detailed report by the police are required. The insurance company may ask for the post-mortem report. This report helps the insurance company verify the cause of death and process the claim accordingly.
Due to Medical Procedure
If the claim arises due to complications from a medical procedure, the insurance company may request medical records and reports related to the treatment that the policyholder might have undergone. Documents serve as the most crucial form of evidence in the claim process, hence keep a copy of all necessary documents to be present at any time during the claim process. It is essential for the beneficiary to carefully read and review the documents required by the insurance company. Forms and other details should be mentioned correctly and with all honesty. Additionally, maintain open communication with the insurance company to address queries or concerns that may arise during the claim settlement process.
2. Maturity and Survival Claims
When the policy reaches its maturity date, the insurance provider will make the final payment to the policyholder. This sum is calculated by including bonuses and rewards into the initially determined cash amount.
In this process, the insurance company will furnish the insured with a bank discharge form for processing. Alongside this form, ensure to include important documents such as a copy of your bank passbook, a cancelled check, a government-issued photo ID, and the original insurance paperwork when sending back the required paperwork to the insurer. This ensures a smooth and efficient completion of the process.
Documents Required
- Identity Proof
- Policyholder Bank Details
- Policy Discharge Form
- Policy Document
3. Claims Against Add-ons / riders
Claims related to add-ons or riders attached to the insurance policy are subject to the terms and conditions outlined in the policy agreement. When filing a claim against any additional benefits or riders, policyholders should carefully review the specific provisions applicable to those features.
It’s essential to thoroughly understand the coverage provided by each add-on or rider, including any limitations, exclusions, or requirements for filing a claim. Additionally, ensuring that all necessary documentation and evidence are provided according to the insurer’s guidelines can expedite the claims process.
Reasons why your Insurance Claim can be rejected
Incomplete Documents/Application
There are vast chances that your claim can get rejected if you fail to provide any crucial documents such as age, income, documentation, or etc. Also, one must apply correctly and make sure that all the details are correct and genuine.
Medical Record Confidentiality
Sometimes, due to hospital policy, the beneficiaries are unable to fetch the particular report/medical record of the deceased patient, hence that could hinder the process. Family members need to share their medical histories to prevent life insurance claims from being rejected because of a prior medical condition.
Failure to Update Beneficiary Data
If the policyholder fails to update the nominee/beneficiary before their death, then there are very strong chances that your claim can be denied. A claim can only be approved if the name of the nominee or beneficiary has been updated.
Limitations
Your claim can also be denied if you fall under the designated list of causes. A list of incidents has been provided by the insurance company where the claim cannot be approved. If you fall under the following list, then your claim can be rejected.
Conclusion
In conclusion, while filing a life insurance policy claim can be a complex task, one must understand the basics as it is crucial for a successful claim process. With Insurance Samadhan providing guidance and support, we aim to empower individuals to confidently handle this aspect of their financial planning, ensuring they receive the assistance they deserve during uncertain times.
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