What is an Insurance Claim

All the insurance companies are bound to pay claims if fallen within their policy’s terms and conditions. An insurance policy is an assurance of compensation to the policyholder due to occurrence of the insured event. So what is an Insurance claim?

An insurance claim is a compensation request made by the policyholder to the insurance company for loss suffered due to a specific event that is insured. For making a claim, the policyholder needs to intimate the insurer about the occurrence of the insured event.  The insurance company then registers the claim against the said policy and call for relevant papers or documents. The insurance company credits the claim amount to the policyholders account upon verifying and processing all the relevant documents.

Types of insurance claims are;

·         Health Insurance Claims

A formal request submitted by a policyholder to the health insurance company for payment of medical expenses incurred for hospitalization. There are two ways to settle a claim one is Cashless while the other one is Reimbursement. The process of Health insurance claims start from intimation regarding hospitalization by the policyholder to the insurance company, the insurance company preauthorizes cashless claim of the policyholder in case of admission in a network hospital. The policyholder has to make Reimbursement claim in case of hospitalization a non-network hospital.

 

·         Property Insurance Claims

Property insurance provides protection against risks such as Fire, Earthquake, Flood, Lightning, Theft, Burglary, etc. It pays compensation for replacement or repair of the insured property for loss incurred due to above-mentioned reasons. It may also provide compensation for reinstatement of the property as on date on which the insured event happened. Property Insurance policies are of different types such as Home Insurance, Shop Insurance, factory Insurance, etc. While these type of policies includes compensation for Fire, Burglary, Theft, Electrical breakdown, Natural Calamities and Accidental damages, expenses related to War, Natural Wear and Tear, Consequential loss, Willful misconduct and Cost of land are not paid by the insurance company.

 

·         Life Insurance Claims

Life Insurance Claims generally are of two types i.e. Maturity Claims and Death Claims. The policyholder gets Maturity Claims by the insurance company when the policy term is completed and the policyholder is alive. The policyholder needs to submit his original policy document and other required documents for getting maturity benefits. Maturity benefits include the Sum Assured as well as Accrued Bonus if any. Death Claims are of different types i.e. Natural Death, Accidental Death, Illness related and Suicide. In death claims, the beneficiary needs to intimate/inform the insurer about the claim of the policyholder. Duly fill the claim form and submit the same along with necessary documents. Death Claim related documents may include Death certificate of the insured person, original policy document, ID proof of the beneficiary, claim discharge form, Police FIR and/or Port Mortem report (in case of accidental or unnatural death), Cremation certificate, etc. The insurance company pays Sum Assured as well as bonus accrued if any to the beneficiary.

 

·         Travel Insurance Claims

The insurer pays travel insurance claims in different scenarios such as Total loss of checked-in baggage, delay of checked-in baggage, personal liability, personal accident, hospitalization, Flight missed, etc. There are Assistance Service Providers in almost every insurance company who provides help to the policyholders during travel related claims. The insured person needs to intimate the insurer regarding claim and submit relevant documents as per the company’s requirements.

 

·         Motor Insurance Claims (Third Party & Own Damage)

A claim related to any type of Motor vehicle is a Motor Insurance Claim. Motor insurance claim could be for Own Damage, Third party and Vehicle Theft. Generally, documents such as FIR copy, Driving License, Registration copy (RC book), copy of insurance policy, repair bills, etc. are required for vehicle insurance claim along with the claim form.