How to make a term insurance claim?

A term insurance plan is a critical element of every individual’s financial planning. Due to various uncertainties that surround our lives, one can never depend only on savings to meet various needs. A term insurance plan is like a financial cushion for an individual’s family in case of his/her untimely death. It protects the individual’s family against financial hardships in the future by offering death benefits as per policy terms. 

To avail benefits from a term insurance, a claim must be filed by the beneficiary or nominee of the policy in the eventuality of the policyholder’s death. Once a claim process is initiated, the insurance provider will verify and settle the claim. In normal cases, settlement of a term insurance claim may take about 30 days from the time of making the claim. So, how can one go about making a term insurance claim? Here, we will explain the process involved for the benefit of claimants.

What is the process for making a term insurance claim?

The process for term insurance claim can be divided into three parts as stated below:

Claimant informs the insurance provider: 

As a first step, a claimant must inform the insurance provider about term insurance claim. The insurance provider must be informed maximum within three months or 90 days from the policyholder’s date of death. For making a claim, the beneficiary or nominee must submit the claim settlement form, death certificate of the insured and other necessary documents to the insurance provider. Claimants can physically visit the insurance provider’s branch or fill the form online for claim settlement. Some details that are to be filled in the claim settlement form include policyholder’s name, date of birth, policy number, date of death, reason of death, place of death, etc.

Insurance provider evaluates the claim: 

Once a claimant has filed and submitted a term insurance claim form, the insurance provider will begin assessing the claim. As part of this process, the insurer closely scrutinizes all the documents and seeks additional details as needed. For additional details, some insurance providers may send a requirement letter to the claimant (nominee or beneficiary). If any suspicious claim is identified in this process, the insurer may investigate it further.

Claim settlement: 

Depending on the conclusion of the assessment, the insurance provider may approve or reject the term insurance claim. If approved, the insurer transfers the net sum assured in the nominee or beneficiary’s bank account. If rejected, the reasons for rejection will be shared with the claimant. As per the mandate of the Insurance Regulatory and Development Authority of India (IRDAI) insurance companies are required to settle claims within a maximum of 30 days. If a claim requires further investigation, the claim must be settled within a maximum of six months.

In case a term insurance claim has been made within three years of policy start date, insurance companies usually conduct additional investigation. The insurer may verify the claim with relevant authorities, such as doctors and accident investigators.

What are the common reasons for term insurance claim rejection?

A term insurance claim may be rejected if:

1. The claimant has not provided correct details in the claim form, 
2. The claimant has not submitted the required documents,
3. Nominee information is not updated in the insurance provider’s records,
4. Non-payment of premiums resulting in policy lapse,
5. Lack of complete information, such as incomplete medical history, incomplete details on lifestyle habits, such as tobacco or alcohol addiction.

Documents needed for term insurance claim

Listed below are some of the commonly sought documents for term insurance claim:

• Death certificate: Original and attested copy of the life insured’s death certificate that has been issued by government authorities.
• Claim form: Correct information must be filled by the nominee or beneficiary.
• Policy documents: The original policy documents given to policyholder while availing the term insurance policy must be furnished by the claimant.
• Identity proof: Claimant must provide self identity proof such as Aadhaar card, PAN details, etc. Insurance providers may also need passport-sized photos of the claimant.
• Policyholder’s medical records: In case the policyholder has been admitted to a hospital, the claimant must furnish proof of admission, doctor’s certificate, records of medical treatment, death or discharge summary from hospital, etc.. 
• Additional documents: In case the policyholder meets an untimely death due to an accident or murder, then the claimant must furnish a copy of FIR, panchnama and autopsy report to the insurer.

Conclusion

It is important for a term insurance holder to educate his/her family members or nominee about the claim process and policy terms. This is because at the time of making a claim, the insured may not be around to assist the claimant due to death or accident. Factors like sum assured and conditions to be met for making a claim must be communicated well in advance. The more transparent the life insured will be with the claimants, the more hassle-free the term insurance claim will be.

FAQs