Life Insurance Claims Process

by SMCIB on Tuesday, 18 October 2022

Life Insurance Claims Process

Filing an insurance claim is quite a complex process, and this task can seem more daunting to your family in your absence. You should ensure that you and your family know about how the policy works and its claim settlement process in detail, to have a seamless and smooth experience without facing any hassles.

We’ve compiled the steps you or your nominee need to follow while making a claim, to make this a bit easier. Let’s have a look.

Claim Settlement Process For Life Insurance Plans

A life insurance plan can be claimed under two situations -

  • In case you pass away

  • In case you survive the policy term - in case of plans with maturity benefits. For example, endowment plans, guaranteed income plans, whole life plans, etc.

Let's take a closer look at how the claims process works in each of these scenarios.

In Case Of The Insured Person’s Death

  1. Notify The Insurer

    The first step is to intimate the insurance company about the death so that they can begin the necessary procedures. Your nominee can contact the insurance company via their toll-free number, email/SMS, website, or by visiting a branch office.

  2. Submit The Necessary Documents

    To file a claim, your nominee will have to submit the claim form and other relevant documents to your insurance company.

    Things To Keep In Mind -
    • When submitting the documents, the insurer should provide your nominee with a system-generated acknowledgement of receipt.

    • Your nominee should keep a scanned copy of the entire document set for future reference.

    • Once your nominee submits the mandated documents, the insurer will verify them and initiate the claim intimation request.

  3. Submit Additional Documents If Needed

    Your insurer may also request additional documents from your nominee. Such requirements may be sent to their email address or other communication address. The relevant documents must be produced within 90 days of the date of request.

    Your nominee may need to submit the following documents:

    Mandatory Documents
    • Claimant statement form

    • Death certificate (self-attested copy)

    • KYC document of the beneficiary (self-attested copy)

    • Bank details of the beneficiary

    Additional Requirements For Claims Within 3 Years:
    • Original policy document

    • Medical attendant's certificate (if any)

    • Self-attested copies of hospital or treatment records (if any)

    • Employer's certificate (if applicable)

    Additional Requirements For Accidental Or Unnatural Death Claims:
    • FIR and final police closure report

    • Driving licence (in case of death while driving)

    • Post mortem report

    • Valid insurance document of the vehicle (in case of death due to a road traffic accident)

    • Police inquest report/inquest panchnama

    • Newspaper cutting (if any)

  4. Claim Approval and Payout

    Once your nominee submits all the requisite documents, the insurance company evaluates them and decides whether to approve or reject the claim. For instance, if the documents have any incorrect information, the claim may get rejected.

    If the insurance company approves the claim request, the claim amount will be paid out to your nominee as per the payout option you’ve chosen.

In Case The Insured Person Survives

  1. Get In Touch With Your Insurance Company

    If you, the insured person, want to file a claim, you need to visit your insurance company's branch office and provide the needed documents.

  2. Submit The Required Documents

    For a claim request to be processed, you need to submit the following documents -

    • Duly filled claim form or policy payout form in the stipulated format.

    • Original policy document.

  3. Verification

    To determine whether the claim is valid, an assessor will verify the submitted documents.

  4. Approval Of Claim:

    Once the claim is verified and approved, the maturity amount will be deposited within 30 days into your registered bank account.

    If the insurer rejects a claim for any reason, they will contact you by phone, SMS, or email to let you know why the claim was rejected.

    Important Note -
    • The claims process and document requirements are subject to change and vary across insurers. Hence, you should discuss the entire process and required documents with your insurer before purchasing a life insurance plan.

    • Once you have received the entire document checklist, you should gather all the policy documents and store them in a safe place to avoid misplacing or losing them. Additionally, you can set up an account with DigiLocker or open an e-insurance account, store the files digitally, and share your account details with your family members.

Wrapping up!

Now that you have an understanding of the entire claim process, make sure you or your nominee follow each step appropriately for a seamless claim experience. If you have any claim-related queries, speak with your insurer and get it clarified right away. Also, keep all relevant documents on the DigiLocker app or your e-insurance account and ensure your family is aware of the details.

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