Comprehensive Guide to Filing Life Insurance Claims in India: Types, Process, and Documents Required

Life insurance provides us with a safeguard against unforeseen events and when the policyholder dies, their beneficiaries can claim the death benefit. However, the process of filing a life insurance claim can be overwhelming, particularly when dealing with grief and uncertainty. This article aims to assist you by offering guidance on the life insurance claim process and the necessary documents in India. By being well-informed, you can better prepare for such situations.

What is a Life Insurance Claim?

A life insurance claim is an essential step in obtaining the financial benefits specified in the policy after the insured person’s passing. Whether filed by the beneficiary or the policyholder’s representative, it acts as a formal request to the insurance company. This process ensures that the policy benefits are paid out per the terms and conditions outlined in the policy. 

Having a reliable financial plan in place can provide some peace of mind amidst the loss of a loved one. Purchasing a life insurance plan ensures that your family will have some financial security and support after your passing, serving as a form of reassurance for them. The benefits received from the life insurance policy can help alleviate some of the financial burdens they may face during such a difficult time. 

What are the Different Types of Life Insurance Claims?

The three primary categories of life insurance claims are - 

• Death Claim: Death claims are the most frequent type of claim made by life insurance. When the policyholder passes away, the nominee must contact the insurance company to collect the death benefit. The policy type and its terms typically determine the amount of the death benefit. 
• Maturity Claim: When you buy life insurance, you are paying premiums for coverage during the policy term. If you survive this term, you can claim the maturity benefit, which can assist in meeting financial objectives like debt repayment, funding your child’s education or preparing for retirement. The specific amount paid out depends on the type of policy you have. 
• Rider Claim: Riders are add-ons to insurance policies that offer additional protection against specific events life accidents, critical illness diagnoses or death. The ability to make a claim depends on the type of rider chosen and the occurrence of the specific event.

Steps to Filing a Life Insurance Claim

As mentioned above, there are three different types of life insurance claims and the steps to filing a claim for each of the plans differ a bit. The same has been discussed in the following table - 

Type of Life Insurance Claim		Documents Needed
Death Claim	For Natural Death	Original policy document
		Death certificate copy
		Completed and signed claim form
		Any practical assignments
	Death Due to Accident	Hospital certificate
		Post-mortem report
		The deceased's medical records (test results, discharge summaries, etc.)
		FIR (original or copy)
		Additional documents as required by the insurer
	Death from Medical Condition(s)	Original policy documents
		Signed claim form
		Nominee's bank account details (bank statement or cancelled check)
		Death certificate from local authority
		Medical records
		Statements from the treating and attending physicians
Maturity Claim		Policyholder's photo ID
		Original policy document
		Policyholder's bank details (bank statement or cancelled check)
		Completed Policy Discharge Form
Rider Claim		As per rider documentation requirements

 

Let us now delve into the process of filing a life insurance claim according to the type of life insurance. 

1. Death Claim 

To initiate a death claim (which also includes a rider claim), it is essential to adhere to the prescribed procedure. By following four simple steps you can effectively file a claim and ensure a smooth process.

1.1 - Notify the insurance company with claim details promptly. Include policy number, insured’s name, date and cause of death, place of death and claimant’s name. Get the form from a local branch or website. 

1.2 - The claimant needs a statement, original policy, death certificate, FIR, post-mortem (for accidental death), doctor/hospital records (for death from medical conditions) and advance discharge form. Insurers may request more documents based on the risk, cause of death and policy duration. 

1.3 - To process claims faster, claimants submit complete documentation promptly. The insurer will only decide after receiving all the necessary documents. 

1.4 - Insurers must settle claims within 30 days of receiving the claim request. If an investigation is needed, it must be done within 90 days. 

2. Maturity Claim

Maturity claims in life insurance are typically easier to process than death claims. Here is a simple step-by-step guide to assist you in navigating the process efficiently. 

2.1 - Contact Your Insurance Company: Contact your insurance company’s customer service department to guide you through the claim process after your policy matures. 

2.2 - Gather Required Documents: Before contacting your insurer, it is essential to gather the necessary documents. The most common ones include:

• Maturity claim form (usually provided by the insurer)
• Original policy document
• Photo ID and age-proof
• Proof of bank account details (bank statement or cancelled cheque)
• Policy discharge form (a receipt acknowledging payment)

2.3 - Submit the Documents: Please make sure to fill out the claim form accurately and provide all necessary documents specified by your insurance company. This will help expedite the processing of your claim and ensure that you receive the support you need. 

2.4. - Verification and Processing: The insurer will review your claim and policy information to ensure accuracy. The processing time will vary based on their internal procedures. 

2.5. - Payment: Upon approval, the insurer will make the payment for the maturity benefit based on the selected payment method. Available options include direct deposit and cheque. 

3. Rider Claim

Life insurance riders offer extra protection compared to the standard death benefit. If a qualifying situation activates a rider, beneficiaries have the option to submit a claim for the supplementary payment. Here is a detailed guide to walk you through the process. 

3.1 - Initiate the claim process: You should contact your insurance provider’s customer service to start the claim process for your rider. They will provide you with instructions and inform you about the necessary documents to submit. 

3.2 - Compile Necessary Documents

• Policy details: Your life insurance policy documents, including the rider endorsement.
• Proof of claim: Documents that verify the triggering event. This could include:
  • Death certificate: In case of an accidental death rider claim.
  • Medical records: For critical illness rider claims, a diagnosis report from a qualified medical professional.
  • Disability documentation: For disability income rider claims, proof of disability is issued by a doctor.
• Beneficiary information: Proof of your identity and designation as a beneficiary on the policy.

3.3 - Complete claim forms: Fill out the claim forms provided by the insurance company, ensuring all information is accurate and complete. Be sure to attach all necessary documents as requested to support your claim. 

3.4 - Submit via preferred method: Follow the instructions provided by the insurer to submit your claim. This could involve mailing in your claim, uploading it online or delivering it in person. 

3.5 - Maintain communication: Stay in constant communication with your insurance company to stay updated on the status of your claim. Be prepared to provide any additional information that may be requested from you. 

3.6 - Review claim decision: Review the claim decision carefully, especially if it is denied. Understand the reason behind the denial and inquire about the appeal process if you disagree. 

Are There Any Additional Considerations for Filing a Life Insurance Claim?

Key additional considerations for filing a life insurance claim include - 

• Contestability Period: Life insurance policies have a contestability period of 2 years from the issue date. If the policyholder dies during this time, the insurer can investigate to check for misinterpretation of the application. Omitted or misstated facts may result in a denied claim. 
• Suicide Exclusion: Policies usually deny claims for suicide within 1 to 2 years but after that period, suicide is typically covered. 
• Accidental Death Benefits: If the policyholder dies in an accident, the beneficiary may receive extra accidental death benefits, usually a multiple of the base benefit. The policy outlines the criteria for accidental death. 
• Unpaid Premiums: Unpaid premiums at death may be deducted from the death benefit or cause policy lapse and claim denial. 
• Beneficiary Designation: Update beneficiary designations regularly to ensure benefits go to intended recipients if the named beneficiary passes away. Review beneficiaries periodically. 
• Claim Submission Deadline: Policies usually have a 1 to 2-year deadline from the date of death for claim submission. Late filing may lead to denied claims. 
• Claim Assistance: Insurance agents assist beneficiaries with the claim process and document submission after the policyholder’s death. Contact the agent promptly.  

Conclusion

This article provided you with the tools to confidently explore the life insurance claim process in India. It covers various claim types such as death, maturity and rider, ensuring that you are well-equipped to handle each situation efficiently. 

Understanding the necessary documents and processes for each type of claim is crucial for faster and smoother resolution. It is important to prioritize prompt claim notification, ensure complete document submission and maintain clear communication with your insurer to facilitate the process. 

It is important to remember that while this guide provides useful information, it is not a replacement for professional advice. It is essential to consult your insurance agent and thoroughly review your policy terms to ensure a successful claim. 

Frequently Asked Questions (FAQs)

 

Q1: What to do immediately after the death of a person covered by a life insurance policy?

A: Contact the insurance company promptly to initiate the claim. This can be done by phone, the insurer’s website, or mail. Provide necessary information about the deceased, including their full name, policy number and date of death. 

Q2: How long does the life insurance claim process take?

A: The processing time for a life insurance claim varies based on the case’s complexity. Claims with complete documentation are usually handled quicker, while additional information can extend the processing period. Typically, you can expect a life insurance claim to be settled within 30 to 60 days after the insurer has received all required documentation. 

Q3: What if my life insurance claim is denied?

A: If your claim is denied, the insurance company will give you a written explanation for the denial. It is crucial to review it and if you disagree, you can appeal the decision. The appeal process usually involves providing more documents or requesting a review by a higher-level adjuster. Consultation with an insurance law attorney may be beneficial for guidance in navigating the appeals process. 

Q4: Can I claim life insurance online?

A: It is great that insurance companies are offering the option to start and submit life insurance claims online, making the process more convenient. However, keep in mind that some companies might still require you to send in physical documents. So, it is important to confirm with your specific insurance provider about their preferred method for submitting claims. 

Q5: What if I can't find the original life insurance policy document?

A: Contact your insurance company and explain the situation in detail. They can usually provide you with a copy of your policy electronically or assist you in getting a duplicate sent to you. Stay calm and provide them with all the necessary information they require to help you. 

Q6: If I am not listed as the designated beneficiary on the insurance policy, what will happen?

A: Contingent beneficiaries serve s backups in case the primary beneficiary is unable to receive the death benefit. If the primary beneficiary is deceased or cannot be located, the contingent beneficiary may then become entitled to a portion of the death benefit. It is important for policyholders to carefully consider and update their beneficiary designations to ensure that their wishes are carried out effectively. 

Q7: Is it possible for me to receive an advance payment on the life insurance benefit?

A: Some insurance companies have a feature called expedited payment, which is also known as a “compassionate payment”. This allows a portion of the death benefit to be paid early in the claims process to assist with immediate expenses. 

Q8: After receiving the life insurance benefit, what should I do with it?

A: It is important to utilize life insurance benefits wisely. Discussing options like debt repayment, investing and creating an emergency fund with a financial advisor can be beneficial in making informed decisions. 

Q9: What are the consequences if the cause of death is considered suspicious?

A: If the cause of death seems suspicious or the insurance company starts asking questions, they might launch a deeper investigation. This could mean asking for more paperwork, an autopsy report or holding off on paying out the claim. It is important to stay patient and work with the investigation to prevent any unnecessary hold-ups. It might be helpful to seek advice from your insurance agent or a lawyer who specializes in insurance law at this time. 

Q10: Can I file a life insurance claim for death abroad?

A: yes, you can file a claim if the death happened abroad, but the insurance company might ask for more documents like a translated death certificate and reports from local authorities.