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Claims Education Center

Comprehensive guides to filing insurance claims successfully. Know your rights, avoid common pitfalls, and ensure a smooth settlement process.

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Life Insurance Claims Process

Step-by-Step Guide
How to file a term life insurance claim
1

Intimate the Insurer Immediately

Contact insurance company within 24-48 hours

2

Collect Required Documents

Death certificate, Policy document, Claim form, ID proof

3

Submit Claim

Submit all documents and keep acknowledgment receipt

4

Investigation (if any)

Insurer may investigate for policies in first 3 years

5

Claim Settlement

Amount is paid via NEFT to nominee's account

Claims Process Flowchart

Health Insurance Claims Process

Cashless Claims
At network hospitals
Inform insurer before hospitalization (planned)
Submit insurance card at hospital admission desk
Hospital sends pre-authorization request to insurer
After approval, hospital directly settles with insurer
You only pay non-covered expenses & co-pay (if any)
Reimbursement Claims
At non-network hospitals
Pay hospital bills directly
Collect all original bills, discharge summary, prescriptions
Fill claim form and submit within 15-30 days
Insurer reviews and processes claim (30-45 days)
Approved amount credited to your bank account

Top 10 Claim Rejection Reasons (& How to Avoid)

1. Non-disclosure of pre-existing conditions

How to avoid: Always declare all health conditions honestly at purchase

2. Claim filed during waiting period

How to avoid: Know your policy waiting periods (30 days initial, 2-4 years PED)

3. Incomplete documentation

How to avoid: Submit all original bills, reports, prescriptions, and discharge summary

4. Treatment not covered under policy

How to avoid: Check policy wordings for exclusions before treatment

5. Policy lapsed due to non-payment

How to avoid: Pay premiums on time, use auto-debit for renewals

6. Incorrect information in claim form

How to avoid: Fill claim form accurately, cross-verify all details

7. Death due to suicide within 1 year

How to avoid: Life insurance suicide exclusion applies for first year

8. Alcohol/drug-related death

How to avoid: Ensure lifestyle habits are disclosed; some policies exclude substance abuse deaths

9. No police FIR for accidental death

How to avoid: Always file police complaint for accidental deaths immediately

10. Treatment at non-AYUSH hospital

How to avoid: Verify hospital registration and policy coverage before admission

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