Insurance Claim Process
InsuranceFiling an insurance claim correctly and promptly ensures families receive what they are entitled to. For life insurance: death claim. For health insurance: cashless or reimbursement. For motor insurance: accident claim. Each has specific timelines and documentation.
In detail
Life insurance death claim process:n1. Inform insurer within 30-90 days of death (check policy)n2. Submit: death certificate, claim form, original policy, nominee ID, bank detailsn3. Insurer has 30 days to settle or seek more informationn4. If claim rejected: 30 days to appeal to insurer, then IRDAI OmbudsmannnHealth insurance cashless claim:n1. Call insurer's helpline before hospitalisation (for planned) or within 24 hours (emergency)n2. Hospital sends pre-authorization; insurer approves treatmentn3. Hospital directly bills insurer -- no upfront payment from patientn4. Any non-covered items: paid separately by patientnnHealth reimbursement: pay hospital, collect all bills, submit to insurer within 30 days.
Real-life example
Meena's husband dies. She calls HDFC Life within 15 days, submits documents. Insurer asks for additional medical records (husband had undisclosed diabetes). Since death was not diabetes-related and it was 4 years into the policy (Section 45 protection kicks in after 3 years), claim settled for Rs 1.5 Cr within 45 days. Documentation and Section 45 knowledge saved her claim.