Insurance Claims Management Documentation

V.JAYALAKSHMI

Life Insurance Claims Documents

Claim settlement
Settlement of claim insurer fulfills his obligation Efficiency and effectiveness of insurers tested Speed, simplicity defines satisfaction Ensure payment to the designated beneficiary conflicting objectives

Claim settlement basic guidelines

Operative clause, schedule, term& conditions lay the guidelines Payment will be made at the office of the insurer to the persons subject to: submission of proof Correctness of age

Guidelines.
Schedule specifies: event amount payable To whom proceeds payable Period during which premium payable Dates when premiums is payable

Important Documents
Proposal Form Claims Form Assignment & Transfer Forms

Claims Documentation
Documents required Written Intimation of Claim / Claimant's Statement Original Policy Document, Death Certificate issued by the designated District officials of the State Government or Police Authorities or Hospital Authorities duly attested, Police / Hospital Report, if any.

Claims Procedure
Intimation DUTY OF INSURED The family of the deceased Life Assured should intimate the company about the death of the life assured through a Branch executive /Sales officer enclosing A written intimation Copy of the death certificate issued by the Municipal Authority/ Gram Panchayat

NOTIFICATION
On receiving the INTIMATION, a Notification letter is sent to the claimant by the Claims Department
with all required claim forms depending on the type of the claim

Normal Requirements in Case of a Death Claim:

Copy of Death certificate duly attested by the authorised person in the Branch Original Policy document / Indemnity Bond in case of Loss of Policy Document Claimants Statement Legal requirements (in case where title to policy monies is not clear) Death Abroad Questionnaire Medical Attendants Certificate Employers Certificate, if applicable Copies of Medical Reports of last and previous hospitalizations, if any Any other requirement as warranted by facts of claim

Documentation

Copy of Death certificate duly attested by the authorised person in the Branch Original Policy document / Indemnity Bond in case of Loss of Policy Document Claimants Statement Legal requirements (in case where title to policy monies is not clear) Death Abroad Questionnaire (if death has taken place outside India in a foreign country)

Accidental Death Claim with or without Rider

(In addition to the above requirements)

All copies duly attested by the authorised person in the Branch

First Information Report

Post Mortem Report Police Inquest Report Newspaper Cuttings, if any Submission of the claim requirements does not mean admission of the claim liability by the Company.

Classification of Benefit payments

Claims can be classified in the following ways Benefit payment on surrender of policy Benefit payment on maturity of the policy Benefit payment on death of life insured Supplementary benefit payments: Accident benefit Critical benefit Annuity payments

Questions
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