Claim Process under Professional Indemnity Insurance for Doctors

The indemnity insurance policy for doctor helps the insured or policyholder in providing appropriate support to eliminate or alleviate the loss. The claim process under professional indemnity insurance for doctors helps the medical professionals to perceive their rights and responsibility. Therefore, the claim process must be understood by every policyholder under the indemnity policy.

Let us discuss the claim process under professional indemnity insurance for doctors.

Step 1: Inform the designated claim handler at Policybazaar about the incident that occurred.

Step 2: The claim handler will provide you with a claim intimation format, which must be completed and submitted directly to them. The following details are required:

• Policy Number
• Name of the Insurance Company
• Name of the Policyholder
• Policyholder's Address
• Date of the Incident
• Brief Description of the Incident
• Estimated Loss Amount
• Address of the Incident Site
• Name and Contact Information of the Person at the Incident Site

Step 3: Once you have submitted these details to the claim handler, they will forward them to the insurance company.

Step 4: Upon reviewing the submitted claim intimation format, the insurance company will register the claim and issue a claim reference number.

Step 5: Post creating the claim reference number, the insurance company may assign a surveyor to assess the incident's validity or provide a LOR for further processing of the claim.

Step 6: The insurance company will send you a claim form that needs to be filled out, signed, and stamped with your seal. The following documents are typically required:

KYC Documents Required

• PAN Card
• Aadhar Card
• GST Registration Certificate
• Address proof of the incident location:
• Electricity Bill

Disclaimer: These are the basic documents required. However, if any additional requirements or an LOR are necessary, the insurer will inform the claim handler of policybazaar. Then the claim handler will assist you in collecting and submitting the additional documents to the insurance company.

Step 7: Whether a team of surveyors will be sent to the incident site for verification depends on the insurance company's discretion.

Step 8: If there is an ongoing court case related to the incident, all relevant details pertaining to the case must be shared with the insurance company.

Step 9: Upon conclusion of the court case and the judge's final verdict determining the compensation amount, the insurance company will pay the insured individual according to the terms and conditions of the policy.

Disclaimer: The coverage for lawyer's fees is subject to a predetermined percentage of the insured sum, as specified in the policy. For example, if the sum insured amount is Rs. 1,00,000 and the coverage for lawyer's fees is up to 25% of the sum insured, the insured individual will receive coverage for lawyer's fees up to Rs. 25,000 in accordance with the policy's terms and conditions.

Additionally, in certain cases, the insurance company may provide their own lawyer for the insured's service. However, if the insured individual has already engaged their own lawyer, the coverage will be provided according to the aforementioned condition.

Conclusion

Professional indemnity insurance for doctors is a crucial policy for medical professional. Therefore, they must subscribe to such policy. However, it is also critical to understand the claim process of such policies. The medical professional under the indemnity insurance must inform the insurance company about the claim. He must elucidate the cause of the claim, and submit the relevant document. He should further cooperate with the insurance company in case of any query.