How to Make a Claim Quickly in Case of Personal Accident?

The employees are the greatest assets of an organization and the companies know this thing. That is why they offer various benefits to their employees such as paid leaves, the benefit of employee provident fund, group personal accident cover, etc.

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A group personal accident cover provides insurance coverage for cases like accidental death, disability in an accident, educational allowance of children in case of death or disability of the insured employee/member, etc.

In this way, by offering group persona accident insurance, an organization ensures the safety of its employees. However, if you do not know about the process of claiming this type of insurance policy, do not worry as here are discussing the steps for the same:

Claim Process of Group Personal Accident Insurance

One should follow the below-mentioned steps to get a claim under group personal accident insurance in case of an accident. However, the claim process differs for an injury claim and death claim:

Steps to Follow for Injury Claims:

You must follow the below-mentioned steps to file a claim in case of an accidental injury:

  • Step 1: You must notify the insurance company as soon as possible.
  • Step 2: After informing the insurer, you must submit the police report to it, if there is any.
  • Step 3:Submit the claim form and the medical certificate that certifies the disablement and its level.
  • Step 4: If the extension of the medical expenses is taken in this insurance policy, then the prescription and the bills should be submitted.

Documents Required:

In this case, the following documents have to be submitted:

  • Photo ID of the policyholder
  • Claim form – duly filled and signed
  • Letter from the HR of the organization wherein the employee is working
  • Salary slips
  • Certificate of disablement issued by a competent authority such as a medical practitioner that is approved by the insurance company or a medical practitioner who is empaneled with the insurance provider.

Steps to Follow for Death Claims:

You must follow the below-mentioned steps to file a claim in case of a death claim:

  • The assignee or nominee mentioned in the policy should instantly inform the insurance provider.
  • He/she should submit the claim form with the post-mortem report, death certificate, police report, and policy's original copy.

Documents Required:

The below-mentioned list of the document must be submitted to the nominee of the policyholder in case of death claim filing:

  • Duly filled and signed claim form
  • Photo ID of the policyholder
  • Death certificate of the policyholder
  • The post-Mortem report of the policyholder
  • Letter from the HR of the organization, and
  • Salary slip

The claims can easily get rejected if you submit the wrong or incomplete documents or the claim is filed in case of a condition that is specified in the exclusion section of the insurance policy. For knowing the exclusions, you must go through the list of exclusions mentioned in your group personal accident policy.

Examples:

Claim in Case of Disability:

An employee of AB corporation was returning from an event in a hotel in their city. On the way back to the office after this event, he met with an accident. Even though he survived this accident, but got some serious injuries due to which his right hand's limp was permanently impaired.

Since AB corporation has personal accident cover for its employees, he got financial help through it. This all was possible because he informed his employer and then the police and insurer on time and submitted all the required documents to the insurer.

Summing It Up!

By following the simple steps and submitting all the required documents to the insurer, you can ensure that your claim will be approved.

Written By: PolicyBazaar - Updated: 29 July 2021