Helergon.com - There is a lot of drama, during the insurance claim process, be it death insurance, health insurance, and so on. Before you apply for insurance and claim it someday. You should read first, the type of insurance, the costs incurred for 1 year, as well as the policies of the insurance company. But don't worry, Helergon.com has summarized several "standard" methods when processing insurance claims good luck.

1. Formality for death claim

When a person who has a life insurance policy – referred to as the insured – dies, a notice of claim must be sent to the insurance company as early as possible. The beneficiary or candidate under the policy can do this. Likewise with close relatives or agents who handle the procedure.

The claim notice must contain information such as the date, place, and cause of death. The insurance agent is obliged to help the family/beneficiary of the insured deal with the insurance company to fulfill the claim formalities.

The insurance company will respond to this notification and will request the following documents :

Completed claim form (provided by the insurance company)

Death certificate

Policy document

Deed of Assignment/Reassignment if any

Legal proof of ownership, if the policy is not established or nominated

The form of release is carried out and witnessed

Other documents such as medical officer certificate, hospital certificate, employer certificate, police examination report, post-mortem report, etc may be requested, as applicable.

Formalities for claims due

When a life insurance policy is due, the insurance company will usually send a notice to the policyholder along with a debit voucher at least two to three months before the due date providing details such as the amount due.

The policyholder must sign a release voucher - like a receipt - with his signature witnessed and send it back to the insurance company along with the original policy bonds to allow him to make payments.

If the policy has been established for the benefit of another person or entity – such as a housing loan company – the claim amount will only be paid to the beneficiary who will grant the exemption.

2. How To Make a Claim - Health

Formalities for a health insurance claim

You can make a claim under a Health insurance policy in two ways:

Cashless basis and

Reimbursement basis

On a Cashless basis: For a claim on a cashless basis, your treatment must be only at a network hospital of the Third Party Administrator (TPA) who is servicing your policy. You have to seek authorization for availing of the treatment on a cashless basis as per procedures laid down and in the prescribed form. Please read the policy document as soon as you receive it to familiarise yourself with the process rather than wait for a claim to arise.

Claims on a reimbursement basis: Read the clause relating to claims in your policy document as soon as you receive it to ensure that you understand the procedure and the documents required for making a claim on a reimbursement basis. When a claim arises you should inform the insurance company as per the procedures required. After hospitalization, you must ensure that you obtain and keep ready documents such as claim forms, discharge summaries, prescriptions, and bills that you should submit for a claim.

3. How To Make a Claim - Car

Formalities for a motor insurance claim

A claim under a motor insurance policy could be

For personal injury or property damage related to someone else. This person is called a third party in this context) or

For damage to your own, insured, vehicle. This is called an own damage claim and you are eligible for this if you are holding what is known as a package or a comprehensive policy.

Third-Party Claim

In a third-party claim, where your vehicle is involved, it is important to ensure that the accident is reported immediately to the police as well as to the insurance company.

On the other hand, if you are a victim, that is, if somebody else’s vehicle was involved, you must obtain the insurance details of that vehicle and make an intimation to the insurer of that vehicle.

Own Damage Claim

In the event of an own damage claim, that is, where your own vehicle is damaged due to an accident, you must immediately inform the insurance company and police, wherever required, to enable them to depute a surveyor to assess the loss.

Do not attempt to move the vehicle from the accident spot without the permission of the police and the insurance company.

Once you receive permission for the removal of the vehicle and for repairs, you can do so.

If your policy provides for cashless service, which means you do not have to pay out of your pocket for covered damages, the insurance company will pay the workshop directly.

In either of these situations, you must inform the insurance company immediately.

Theft Claim

If your vehicle is stolen, you must inform the police and the insurance company immediately. In addition, you must keep the transport department also informed.

As soon as you receive the policy document, read about the procedures and documentation requirements for claims rather than wait for a claim to arise.

If you have to make a claim, ensure that you collect all the required documents and submit them along with the requisite claim form duly filled in, to the insurance company.

There may be certain specific documentation requirements for specific types of claims. For instance, in respect of a theft claim, there is a special requirement that you should surrender the vehicle keys to the insurance company.

4. How to File a Claim - Property

Formalities for making a property insurance claim

There may be several types of policies that cover property and the property itself can be stationary - such as a building, or movable - as your household items are transported.

When you receive your policy, familiarize yourself with the documents required for the claim as well as the procedures to follow.

Whether a claim arises or not, you must follow the dos and don'ts about your property during the policy term. These dos and don'ts are called warranties and conditions in your policy document.

In general, losses and damages, including those caused by theft, fires, and floods, need to be informed to the authorities such as police, firefighters, and so on. It is important to ensure that you notify your insurance company to allow it to send surveyors to survey and assess losses.

5. How To Make a Claim - Travel

Formalities for making a travel insurance claim

A travel insurance policy is generally a package policy that includes different types of covers like hospitalization, personal accident, loss/ damage to baggage, loss of passport, and so on.

The procedure and documents required for a claim would vary from cover to cover. All of them would be mentioned in your policy document.

For ease of the procedure and your convenience, insurers normally attach the claim form with the policy document. This will contain the list of documents required in case of a claim and also the contact details including the phone numbers of the claims administrator either in the destination country to which you are traveling or in another country that is designated to receive and process your claim intimation.

Since this is a package policy with various covers and procedures you must familiarise yourself with the procedures and documentation in case of a claim.

FAQ: How to Make an Insurance Claim

1. What is an insurance claim?

An insurance claim is a formal request made by a policyholder to an insurance company for compensation for a covered loss or damage as per the terms of their insurance policy.

2. When should I file a claim?

You should file a claim as soon as you experience a loss, damage, or event that is covered by your insurance policy. Prompt reporting helps ensure a smoother claims process.

3. How do I start the claims process?

To start the claims process, contact your insurance company. You can usually do this via phone, online portal, or mobile app. Provide them with your policy number and details about the incident.

4. What information do I need to provide?

You will typically need to provide:

• Your policy number

• A detailed description of the incident

• Date and time of the event

• Any police reports (if applicable)

• Photographs of the damage (if available)

• Witness statements (if applicable)

5. How long does it take to process a claim?

The time it takes to process a claim can vary widely depending on the complexity of the claim and the insurance company’s policies. It can take anywhere from a few days to several weeks.

6. Will my insurance premium increase after I file a claim?

Filing a claim may potentially impact your premium, depending on the type of claim and your insurance company's policies. It's best to discuss this with your agent.

7. What if my claim is denied?

If your claim is denied, you will receive a written explanation. You can appeal the decision by providing additional information or clarification. Review your policy to understand the reasons for denial.

8. Can I work with a claims adjuster?

Yes, in many cases, an insurance company will assign a claims adjuster to assess your claim. They will evaluate the damage and help determine the payout amount.

9. What should I do if I disagree with the claims adjuster's assessment?

If you disagree with the assessment, you can discuss your concerns with the adjuster or escalate the issue to a supervisor. You may also consider getting a second opinion from a professional.

10. Is there a deadline for filing a claim?

Yes, most insurance policies have a deadline for filing claims, often referred to as the "statute of limitations." Check your policy for specific timelines.