Death Claim: Important tips before applying for a life insurance claim

It has been four months since Vinay (aged 39) died in an accident, leaving the family with an irreparable emotional void. He had a life insurance policy of Rs 50 lakh but the claim amount is still pending as Ankita, his wife is still trying to figure out the process of filing a claim and the required documents.

Here are a few points listing the specific process:

What is a Death claim?
When the Life Assured dies during the term of the policy i.e. before the date of maturity of his life insurance policy, the proceeds under the policy can be claimed by the beneficiary. This is called a Death claim.

How to intimate the insurance company about a death claim?
For physical policies, the claimant can get a claim intimation or notification form from the insurance company, while for online policies, the claimant can apply for a form online. The claim intimation should consist of information such as policy number, name of the insured, date of death, place of death, name of the claimant, and so on.

What documents need to be submitted?
The claimant will need to submit his/her statement, the original policy document, death certificate, police FIR and post mortem report (for accidental death), certificate and records from the doctor treating the deceased/hospital (for death due to illness). However, based on the sum at risk, cause of death and policy duration, insurance companies may also request for some additional documents.

How much time does an insurance company take to settle the claim?
As per an IRDA regulation, the insurer is required to settle a claim within 30 days of receipt of all the documents, including any clarification sought by the insurer. If the claim requires further investigation, the insurer has to complete its procedures within six months of receiving the written claim intimation.

Who is entitled to receive the Death claim benefit?
The Death claim is usually payable to the legal heirs or the nominee, as the case may be.

What happens if there is no nomination on death of the Life Assured person, or if both, the Life Assured and the Nominee die in the same event?
If the deceased policyholder has not nominated or assigned a benefactor, or if he/she has not made a suitable provision regarding the policy money by way of a Will, the claim is payable to the holder of a Succession Certificate or evidence of title from a court of law.

In case of any claim dispute, where can your case be represented?
In case of a claim dispute, the claimant has to first approach the customer care department of the insurance company to file for grievance, and if the response is dissatisfactory, he/she may write to the Grievance Redressal Cell of IRDA, which will then take up the matter with the concerned company.

If the complainant is looking for a judicial decision in respect of claims, he or she may approach the Insurance Ombudsman, which will help them settle their complaints in an out of court system.

Source: DNA India