Life Insurance Claim Settlement Ratio

Following is the list of some of the mandatory documents required for life insurance claims:

• Claim Forms (Duly signed and attested)
• Original Policy Documents
• Death Certificate attested by the local authorities
• Copy of FIR/Post Mortem Reports/Punchnama
• Medical Records (including hospital discharge summary)
• Claimant's Photo ID Proof
• Claimant's Address Proof
• Copy of Cancelled Cheque/Bank Statement/Bank Passbook

Listed below is the process of life insurance claim settlement followed by most of the insurance companies. However, every insurance operates differently hence the claim settlement process for a life insurance claim can differ from insurer to insurer:

Step 1: Claim Intimation: The beneficiary is required to intimate the claim either in a written format or online (on the insurance company's official website) to the insurance company as soon as possible. The claim intimation should have the information of the policyholder and the claimant such as policy number, name of the policyholder, cause of death, place of death, and claimant details. The beneficiary can visit the insurance company for claim intimation or download the forms online from the insurance company's website.

Step 2: Submission of Documents: The insurance company requires some documents to settle the claim, which the beneficiary is required to submit within the stipulated time. With help of the relevant documents, the insurance company will be able to carry out an investigation if required or ask for any additional documents required. Submission of relevant documents at this stage is necessary to avoid any possibility of fraud.

Step 3: Claim Evaluation and Settlement: After all the documents have been submitted to the insurance company and the claim is thoroughly evaluated a settlement decision is taken by the insurance company. Usually, it takes 30 days for an insurance company to settle a claim upon receiving the documents submitted. If an investigation is required in any case the insurance company takes 120 days to settle a claim.

Note: Claimant must thoroughly go through the terms and conditions and submit all the required documents for the claim, failing to do so will affect the claim settlement process.

Here is some common reason for rejection of life insurance claims:

1. Mentioning false inaccurate or false information in the application for a life insurance plan.

2. Not paying premiums on the due date or during the grace period.

3. Causes of death that are not covered by the insurance policy such as suicide before the completion of the first policy term, accidental death caused by overconsumption of alcohol/drugs.

4. A fraudulent claim made by the beneficiary.