What is a Life Insurance Claim?

Insurance is a financial contract between you and your insurance company. You pay a fixed premium, and in return, the insurer offers financial coverage for losses based on policy terms. In case the event mentioned in your policy occurs, an insurance claim should be filed. The main purpose is to inform the insurance company of an unfortunate event and the insurer should pay the life insurance claim amount.

What are the Different Types of Insurance Claims?

Insurance claims are categorized into 3 different types:

• Health Insurance Claims
  A health insurance claim helps pay for medical bills that come up when you get sick or hurt. The policyholder can choose a cashless facility at any hospital they want. The insurer will then pay the hospital the amount of the bill. The policyholder must, however, tell the insurance company about the hospitalization within the time limit set.
  Suppose the cashless claim is rejected or the insurer is not informed on time. In that case, the policyholder can file a reimbursement claim with the insurer by submitting the required documents and recovering the out-of-pocket medical expenses.

• Life Insurance Claims
  The nominee files a life insurance claim in case the policyholder dies. The beneficiary may need to submit documents such as a copy of the death certificate, PAN, FIR, and other documents, along with a claim application form. After the insurer verifies all the information, a payout is made to the beneficiary's account. Below are some types of life insurance claims:

  • Death Claim: The most common type of claim in life insurance. It is filed when the life assured passes away, and the nominees wish to receive the death benefit.

  • Maturity Claim: In some types of life insurance, such as endowment policies, the policyholder receives a payment if they are alive at the end of the policy term. This is referred to as a maturity claim.

  • Rider Claims: In some life insurance policies, there are additional benefits referred to as life insurance riders. For instance, a critical illness rider pays out if the life assured is diagnosed with a named critical illness.If you have opted for a life insurance rider, you can file a rider claim if the covered event occurs.

• Group Life Insurance Claims
  A group life insurance plan is for employers to offer their employees life insurance benefits. In case of the unfortunate death of an employee, the nominee can file a death claim and receive the life cover.

How Does a Life Insurance Claim Work?

• Buying a Policy: The person who is covered by the life insurance policy must have bought it and paid the premiums before they can make a claim. The insurance policy says how much the death benefit will be and how it will be paid.
  In life and term insurance, the "insured event" is the death of the person who is covered. In such a case one needs to file a Term Insurance Claim.

• Filing the Claim: The beneficiaries (or their legal representatives) must file a claim with the insurance company after the life assured dies. Usually, this means filling out a claims form and sending it in with supporting documents, such as the death certificate, the original policy document, and proof of the beneficiaries.

• Claim Processing: Once the claim is filed, the insurance company reviews the submitted documents to verify the details and ensure that the claim is legitimate. The insurer may also conduct an investigation to confirm that the claim complies with the policy's terms and conditions.

• Claim Approval and Payout: If everything is verified and accurate, the life insurance company approves the claim and pays the death benefit to the nominees. This payout is usually made in a lump sum, though some policies may offer alternative payout options, such as monthly installments or monthly income plus a lump sum.

Why is Filing a Claim Important?

The only way to get the policy payout from the insurance company is to file a life insurance claim. Insurance companies don't automatically know about the policyholder's death, so the claim must be made to let them know. After the claim is filed, the nominee can get the death benefit and use it to pay for things like daily expenses, loan EMIs, and other financial needs. It is usually easy to file a claim, but you need to send in the right papers. In a lot of cases, filing a claim is also required by law to make sure the money goes to the right person.

What are the Steps Required to File a Life Insurance Claim?

The steps to file a life insurance claim are usually as follows:

• Inform the Insurance Company: The first step is to notify the insurance company that the policyholder has died. You can do this by phone, email, or the insurance company's website.

• Get the Necessary Documents: Get the death certificate, the original policy document, proof of identity for the beneficiaries, and any other documents the insurance company has requested.

• Fill out the Claim Form: The insurance company will provide the beneficiaries with a claim form to complete. Most of the time, this form asks for information about the insured person, the policy, and the people who will receive the money.

• Submit the Claim: Submit the filled-out claim form and any additional documents that are needed. You can do this in person at a branch office, by mail, or online.

• Follow-Up: Call the insurance company after you submit your claim to confirm they are working on it and address any questions they may have about additional information or paperwork.

• Get the Money: The insurance company will pay the death benefit to the people named as beneficiaries once the claim is approved. The payout can take different amounts of time, but it usually happens within a few weeks if all the paperwork is in order.

How do you file a claim with Policybazaar for life insurance?

Here are the steps to take to file a claim with Policybazaar:

Step 1: Inform Policybazaar

If you require assistance with the process, you can use the Claim Assistance Card to contact your assigned RM directly. You should also inform Policybazaar about this by calling 1800-258-5881, sending an email to claims@policybazaar.com, or submitting a request on the Claims page of the Policybazaar website or mobile app. This will ensure that the claim process begins immediately.

Step 2: Share Policy Details

The nominee needs to give information like the policy number, the name of the policyholder, the date of death, and the reason for death.

Step 3: Upload Documents

We can help you figure out which documents you need for your claim.In general, the insurers permit you to upload scanned documents directly to their official claim website or mobile application. In case this facility is not available, you can submit the hard copies of the documents at the nearest branch office of the insurer or personally deliver them to the claim settlement officer dealing with your claim.

Step 4: Review and process the claim

Policybazaar will talk to the insurance company on your behalf. They will check and verify the documents and then approve and process your claim.

Step 5: Settle the claim

The amount of the claim will be paid directly to the nominee's bank account.

Reasons Why Life Insurance Claims Are Often Denied.

Here are some situations that can make life insurance claims take longer or be denied:

• Incomplete paperwork: If you don't have all the paperwork you need, your claim may take longer to process. It is very important to check that all the information is correct.

• Policy Lapse: If the policyholder doesn't pay their premiums and the policy lapses, the claim could be turned down.

• Mistakes or fraud: If the information given is wrong or there is fraud, the insurance company may need to look into it more, which can slow things down.

• Not Sharing Information: If the policyholder didn't tell the insurance company about any health problems they had before they bought the policy, the claim could be denied.

Final Thoughts

Filing a life insurance claim on time and sending in the right documents can feel overwhelming during a difficult time, adding extra stress. Knowing the process ahead of time gives nominees clarity and confidence during a time of emotional difficulty. If you bought your policy through Policybazaar, you also get free, dedicated help with your claim. Our claims team is there for your family every step of the way, from gathering documents and following up with the insurance company to settling the claim.

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