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It is important for both the insured and the nominee to know the process of insurance claim settlement. A false step can lead to denial of the benefit for which life cover is bought.
What is a claim?
A life insurance policy is a contract between the insurance company and the insured in which the insurer agrees to pay a pre-defined sum upon the death of the insured.
This sum is claimed by the nominee of the policy -- the person designated to make a claim in the event of the death of the insured.
Making a claim
In order to make a claim, the nominee needs to submit a claim form that is issued by the insurer.
The nominee is also required to submit documents like the original policy papers, the death certificate of the insured and his death summary in case he died due to an illness.
If death was accidental, these documents need to be supported by an FIR and a post-mortem report.
In addition to these documents, the claimant also needs to provide an identity proof to establish that he is the nominee of the policy. The identity proof can be anything bearing the nominee's photograph and signature.
That makes the PAN card, driving licence and passport eligible as identity proofs.
The process of claim settlement begins once the insurer verifies these documents.
How long does take?
It usually takes a week to 10 days to settle a claim after all the relevant documents are verified by the insurer.
The Insurance Regulatory and Development Authority (Irda), the insurance regulator, has stipulated that claims should be settled within 30 days of receipt of all the relevant documents. The insurer can ask for clarifications or supporting evidence if he is dissatisfied with the documents.
If this happens, a deadline of six months from the date of intimation of the claim is laid down for its settlement. If the insurer fails to meet the deadline, he has to pay an interest on the sum assured.
The nominee can approach the insurance ombudsman if the insurer fails to pay the claim on time.
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