Claim Settlement Process for a Child Insurance Policy

This article will discuss the complete insurance claim process for a child plan in detail.

What is an Insurance Claim?

An insurance claim is a lawful application submitted by the policyholder or nominee to the insurance company. The formal application is to demand payment of maturity, rider, or death benefits from the company after the occurrence of an incident.

The incidents covered are as per terms decided by both the parties (company and policyholder) while buying the plan. A few examples of such incidents are: 

• Accident of policyholder

• Death of assured

• Diagnosis of critical illness of the assured person

• Child attains maturity age

The claim settlement amount helps the policyholder finance different life goals such as child’s education needs, hospital bills, and marriage expenses.

Eligibility Criteria of a Child Policy

The insurance company fixes the eligibility criteria, sum assured, policy term, and other conditions of the child insurance plans. 

The general criteria to buy a child insurance policy are as follows:

• Entry age of Parent: 18—60 years

• Entry age of Child: 30 days—18 years

• Maturity age: 18-65 years

• Policy Term: 5—25 years

• Sum Assured: Rs. 1 Lakh—10 times of premium paid annually

• Premium Payment Frequency: Annually, semi-annually, quarterly, monthly, and One-time

• Premium Payment Mode: Lump sum, Regular, and Limited

Child Insurance Policy Claim Process

The policyholder can claim settlement for rider benefits, death benefits, or maturity amount in case an event covered under the policy terms takes place.

A few details of child insurance claims:

• The death benefits are given to the nominee in case of the demise of the policyholder.

• The maturity benefits are provided to the policyholder on attaining maturity age by the child.

• The best child plans offer a range of rider benefits to the policyholder on payment of extra premiums. These riders help provide an extra financial net to your child and family in an unforeseen event.

• Some of them are:

• Accidental Death Benefit Rider

• Accidental Total or Partial Disability Rider

• Critical Illness Rider

• Hospital Cash Benefit Rider

• Waiver of Premium Rider

Death Claims Settlement Process

Let us learn the child insurance death claim process from the steps mentioned below:

Step 1: On the occurrence of the demise of the policyholder, inform the incident as soon as possible to your insurance company. You (nominee/ beneficiary) can do this in the following ways:

• Going to their nearest office

• Calling on their toll-free number

• Sending an email

Step 2: Fill out the claim form and submit it formally with the following details:

• Particulars of the child plan

• Date of incident/ maturity age

• Cause of incident

• Name of nominee/ beneficiary, etc.

Step 3: Present the supporting documents and relevant reports (mentioned in the next section).

Step 4: The insurance company appoints a claim settlement assessor. They verify the case and the documents provided by you.

Step 5: The assessor passes the case after thorough checking.

Step 6: If further investigation of the case is not required, the company approves your claim.

Step 7: It transfers the maturity or death benefit within 30 days of submission of documents.

Maturity Claims Settlement Process

Follow the following steps for claim settlement of the maturity benefits of your policy:

Step 1: The insurance company reaches out to the policyholder on attaining the maturity age by the child.

Step 2: You need to fill out a bank discharge form provided by the company.

Step 3: Submit the required documents to your bank, with the accurately filled bank discharge form.

Step 4: The insurance company deposits the maturity benefit amount in your bank account.

Rider Claims Settlement Process

Settlement of rider claims is provided in the following ways:

1. For Accidental Death and Waiver of Premium Rider: 

   The process of death claims settlement is followed.

2. For Critical Illness, Hospital Cash, and Accidental Total or Partial Disability Rider:

   Step 1: Inform the insurance company

   Step 2: Give the duly filled claim form to the company

   Step 3: Submit relevant documents

   Step 4: Provide the policy copy to the company

   Step 5: Insurance company investigates the case, as needed

   Step 6: On approval of the case, the company will proceed with the payment of rider benefits to your bank account.

Documents Required

For claiming settlement, the submission of relevant documents is the most important step to prove your case. 

The policyholder/ nominee must prepare the following documents before applying, on a case-to-case basis:

• Duly filled application form for claim

• Original policy document

• Death certificate

• Birth date proof

• Medical certificates/ prescriptions/ health diagnosis reports

• FIR copy (in case of unnatural death)

• Post-mortem report (in case of unnatural death)

• KYC of the nominee/ beneficiary

• Account details (for transfer of payment)

Exclusions for Claim Settlement

The best child insurance plans offer death benefits. However, insurance companies reserve the right to reject a policy claim under certain situations. 

The situations excluded from child insurance claims are as follows:

1. Suicide Cases:

   The insurance company rejects the death benefit claim of the nominee if the policyholder commits suicide before the completion of 1 policy year.

2. Participating in Adventurous Activities:

   The insurer also rejects the claim if the policyholder willingly participates and dies while performing dangerous sports like skydiving, bungee jumping, and mountaineering.

3. Overdose from Alcohol or Narcotics:

   The insurer denies claim benefits if the policyholder dies from overconsumption of alcohol or an overdose of narcotic drugs.

4. Death due to Drunken Driving:

   The nominee does not get any benefit if the insured dies while driving a vehicle under influence of alcohol or drugs.

5. Involvement in Criminal Activities:

   There is the least scope of claim settlement in case of the death of the insured due to involvement in any illegal business, gang wars, or criminal activities.

Types of Child Policies

The type of child insurance policies can be categorised in the following ways:

• Child ULIP Plans

• Traditional Endowment Plans

Here are some details on both:

In Conclusion

Claiming settlement for the best child insurance plans is fast and easy if you immediately communicate with your insurance company on the occurrence of any unfortunate event. The claim settlement process goes smoothly if the policyholder makes timely premium payments during the policy tenure. Submit all the required documents and fully cooperate on your case with the company officers to get the child policy claims in your account.

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