A claim has to be settled in 30 days of receipt and claims made after three years of policy commencement have to be paid
A life insurance policy is a contract between the insurance company and the insured in which the insurer agrees to pay a pre-defined amount-sum assured or the insurance money-upon the death of the insured during the policy term. This insurance money is given to the nominee of the policy. If you are working and have people who depend on your income, a life insurance policy is a must.
The most cost efficient way to get life insurance is to buy a term plan, as others have an element of investment, making them a tad expensive. Term plans only include the cost of insurance so they are the cheapest kind of life insurance product. If you die during the term, your nominee gets the sum assured, but if you survive the term, you get nothing back.
You must know the process of making an insurance claim, so that you educate your near and dear ones on how to make a claim if they need to. Here is how to make a claim.
Documents needed
To start with, the nominee needs to fill up a claim form. This can be downloaded from the insurer's website or will be available from the agent or the insurer's office. This claim form will capture details such as the policy number, date and time of death of the policyholder, reason of death, name of the nominee, bank account details of the nominee and details of any other policies held by the policyholder.
One also needs to submit documents such as original policy papers, death certificate of the insured and medical death summary in case of death due to an illness. If death was accidental, a first information report (FIR) and a post mortem report have to be attached. In addition, the nominee needs to provide her know-her-customer (KYC) details.
In case of catastrophes, insurers may decide to waive off these documents and may just rely on any proof of death from the government, hospital or municipal record.
How long does it take?
As per regulations, a claim has to be settled within 30 days of receipt of all the relevant documents. The insurer can ask for clarifications or supporting evidence. If this happens, a deadline of six months from the date of intimation of the claim is laid down for its settlement.
Where can it get rejected?
You need to make sure that you fill up the proposal form accurately. Even as the new rules laid down by the Insurance Laws (Amendment) Act, 2015, are in favor of the customer, correct information has to be provided.
The new rules state that insurers must compulsorily pay all claims made three years after the date of commencement of a policy. But claims that are less than three years old can face high levels of scrutiny and also rejection by insurance companies. The insurer would typically reject a claim in case of fraud or non-disclosure of material information. So make sure you make all the important disclosures to your insurer.
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