Insurance Claim Process: Steps, Documents and Claim Filing Guide

Key Takeaways 
 

• When you go for any insurance policy, always read and understand the terms and conditions mentioned. It will help you while claiming and settling.
   
• Always choose policies that have a high claim settlement ratio.
   
• Ensure that all the documents are up-to-date for the claim. 

Bonus tip - According to the IRDAI (Policy holder's Interest), 2017, life insurance must settle simple and undisputed claims within 30.
 

You go for insurance when there are chances of damage or loss of that specific product. You can do many products, individuals’, assets’ insurance because there is a risk of loss and damage. You pay a monthly premium, and in case of adverse situations, the insurer pays you in compensation for that loss. In this article we are going to know about the process of insurance claims. 

What is an Insurance Claim Process?

If you have insured something that is now damaged or completely destroyed this time policyholders claim for the compensation in place of that item. To get a claim, insurers have to follow a process that is known as the Insurance Claim Process. 

You can claim insurance when an unexpected event occurs, like an accident, theft, or natural disaster. It recovers your financial loss. After your claim, the insurance company reviews details, documents, and evaluates damage. This is mandatory for the company to ensure that you have really borne a loss. If the claim meets policy terms and conditions, the company approves the claim. Companies can replace items, pay the repair cost, or pay in rupees. 

Example 

Pritam bought a car 2 years ago; he had an insurance policy. One day in the parking lot, another vehicle backed into the car and met with an accident. In this accident, Pritam's car was badly damaged. Then he applied for an insurance claim. He submitted all the required documents. The company reviewed and inspected this claim and paid for repairing the car. 

Types of Insurance Claims 

Insurance claims depend on the specific type of insurance. If the claim is approved, the insurer can pay cashless, which means the service provider gives you the service, or reimbursement, which means you pay upfront.
 

1. Car insurance claim - a car insurance claim is valid if there is an accident, theft, or damage. If in an accident your car caused injury, death, or property damage, a third-Party Claim can be processed. If your own car got damaged, you can go for Own Damage (OD) Claim. Other than this, if a car is stolen, you can claim Insured Declared Value (IDV). 

2. Bike Insurance Claim - A bike Insurance claim is similar to a car insurance claim. You can claim third-party claims for damage to others, and a comprehensive Claim for your own damage. Here, personal accident cover is important to the owner. 

3. Health Insurance Claim - Health insurance claims help an individual to manage financial stress in difficult times. Health insurance claims also come in different types. A first one is a cashless claim, which is available for only a few hospitals which are in the network. You must inform your insurer 48-72 hours before treatment and 24 hours before for an emergency. The second one is Reimbursement Claim, you can do this in any hospital. Here, you have to pay the hospital bill from your pocket and then submit all the bills and hospital documents to the insurer for a refund. 

4. Property Insurance Claim - you can go for property insurance claim in case of Fire, Natural Calamities like earthquakes, floods, hurricanes.

Eligibility and Conditions for Filing an Insurance Claim 

When you apply for an insurance policy, there are some terms and conditions mentioned. While claiming insurance, you have to meet that specific criteria. 
 

1. Your premiums should be paid up to date. 
2. The person who is claiming must have to suffer from financial loss.
3. The incidence that occurred must be listed in the policy.
4. Accidents must occur within the policy tenure.
5. In case of a medical bill, you must apply 48-72 hours before the treatment.
6. In health insurance, a minimum of 24 hours of hospitalisation is required.