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How to file claim


The death of a near one can leave the family facing a tough situation. While nothing can assuage the feeling of bereavement, financial security can help the family, to a small extent, cope with the situation. So, don't stop at buying a life policy. Be informed about the policy fine print and tell your family how to claim the insurance money. Here is a step-by-step guide to filing a life insurance claim.

Step 1. Inform the insurer. This can be done by calling up its call centre or walking into the nearest branch. One can also get in touch with the agent the policy was bought from. Keep the policy details handy.

Step 2. The nominee will be required to give a claimant's statement (a form provided by the insurer for giving details about the deceased and the claimant), original policy papers, death certificate and police first information report (FIR) & post-mortem report if the death is due to an accident. For medical-related claims, you will have to arrange for medical reports such as discharge summary and hospital records. The insurer can ask for additional documents based on the cause of death, policy duration and risk cover (See Documents To Be Submitted).

Step 3. The insurer starts the evaluation process. If it feels the need for a further examination, it conducts an external investigation to check the veracity of the claim.

Step 4. The claim is settled after all documents are received.

Step 5. Norms require that insurers settle all claims within 30 days of completion of all requirements. If there is need for a further investigation, according to norms, the insurer should complete the procedure within six months of the written intimation of the claim. If it fails to do so, it has to pay interest on the claim amount for the period the payment is delayed.

There can, however, be some complex situations such as late reporting or death in a foreign country.

We discuss a few such situations and how you should deal with them.

You came to know about the policy late and so told the insurer after a time lag:

Law gives you three years to file a claim in the event of death. But late claims may at times take longer to settle as gathering information is a challenge for the insurer in such a case. Hence, one should intimate the insurer as early as possible.

Insurers have started adopting mobile technology in a big way. Among other things, this will enable a policyholder to take pictures of his damaged car from a phone and upload them on the insurer?s system for smoother claim settlement. Vikas Gujral, executive vice president and head, customer service and operations, Max Life Insurance, says, "The procedure does not change for delayed reporting. But insurers do extra due diligence in such cases to ward off possible fraudulent claims."

If the person is missing and you do not have any proof of his death: In case of missing persons, the settlement is governed by Sections 107/108 of the Indian Evidence Act, 1872. Section 107 deals with presumption of continuance and Section 108 deals with presumption of death.

Experts say that as per Section 108, presumption of death can be raised only after seven years from the date the person has been reported missing.

Mayank Bathwal, deputy CEO, Birla Sun Life Insurance, says, "The Indian law prescribes that a missing individual is presumed dead seven years after he/she is reported missing. If the family or claimant does not have adequate proof of death, the nominee can submit as proof of death in lieu of death certificate an 'Order of Presumption of Death' obtained from a competent court of law under Section 114 of the Indian Evidence Act."

He says it is important to pay premiums through the duration of seven years to make sure that the policy does not lapse and is in force when the claim is filed.

If death has taken place in a foreign country: "The requirements are the same as for a regular claim. However, in addition, the insurer will ask for a death certificate attested by the Indian embassy along with the certificate authorising the transport of mortal remains. The nominee may also have to submit a copy of the deceased's complete passport," says Vighnesh Shahane, whole time director and CEO, IDBI Federal Life Insurance.

If you think the deceased had an insurance policy but you cannot find it: "The nominee can write to the life insurance company to this effect and provide an attested copy of the death certificate issued by the municipality/panchayat. The nominee should also submit a claim form along with the indemnity bond," says Shahane.

Tips for speedy settlement Submit the documents in one go. Doublecheck the list of documents required either from your agent or the nearest office of the insurance company.

After having said that, not all claim processes are hassle-free, even after the submission of all the documents.

Complicated situations such as dispute between the claimant and other legal heirs (for example wife and mother) and suicide and murder cases where the police may take time to certify the cause of death may take time for settlement.