Filing an insurance claim can seem daunting, especially if you’ve never done it. But it doesn’t have to be scary or confusing. This comprehensive guide will explain the step-by-step process for filing a general insurance claim in India. You must follow similar steps, whether it’s health, vehicle, or travel insurance.
Step 1: Notify Your Insurer Promptly
The first step is the most important one. You must notify your insurer about the loss/damage immediately! Accidents, thefts, or health issues can happen at any time of the day or night, and many providers now offer 24-hour helplines for intimation and support.
Call or email your insurer about the loss/damage. A delay in intimation can lead to claim rejection or partial settlement.
Some key things to include in your initial intimation are:
- Your policy number
- Claims/reference number provided by the company
- Date & time of loss
- Reason for loss – accident, hospitalisation, theft, etc.
- Estimated claim amount, if known
- Police complaint number, if available
Step 2: Gather All Relevant Claim Documents
Once you have informed your insurer about the loss or damage, the next step is gathering applicable documents. These documents will fall into three main categories:
- Identity & Policy Proof: This will include policy bonds, premium receipts, KYC documents, etc.
- Incident Proof: Documents about the accident, theft or hospitalisation for which you have filed a claim.
- Loss Valuation Proof: Documents verifying the extent of financial loss, damage evaluation, etc.
The exact set of documents can vary depending on your policy, but here are some common ones required:
- For Health Claims: Hospital bills, prescriptions, test reports, discharge summary.
- For Motor Claims: Driving license copy, FIR, estimate of repairs, invoices.
- For Travel Claims: Flight tickets, hotel bookings.
It’s not necessary to submit all documents at the beginning. You can send documents in batches as you arrange them. Just make sure the final set is complete before claim processing begins. For example, when filing a health insurance claim with ACKO, you can first send over preliminary hospital bills and a discharge summary. Then, send pharmacy receipts, diagnostic reports, etc., after getting them organised.
Click here to read more details on ACKO.
Step 3: Fill out the Claim Form Accurately
Along with the initial documents, you must also submit a duly filled claim form to the insurance provider. The company will send you this form or download it from their website. Filling out this form completely and accurately is crucial for proper claim processing. Ensure you take advantage of any vital claim details. The standard sections in a claim form are:
- Claimant’s Details
- Policy Details such as number, start/end date
- Incident Details covering reason, date, location, sequence of events
- Witness Details, if any
- Previous Claim Details, if applicable
Attach additional sheets to provide details of all critical incidents and losses, if necessary. Double-check the form before submission to avoid back-and-forth.
Step 4: Submit Documents to the Insurer
As for the document submission part, once you have gathered all the required papers and filled out the claims form, make copies for submission. There are a few ways in which you can submit:
In Person Submission
Hand over hard copies of documents to the company office, where the claim will be processed. You will receive an acknowledgement indicating the date/time of submission. This method allows you to get any needed clarification directly.
Online/Email Submission
Many companies now offer online submissions through email or a portal. You can safely upload scanned copies of documents and receive faster processing than physical documents.
When submitting, include a cover letter with claim details, a total loss estimate and a list of documents you’ve attached. Follow up after a few days to ensure it has been received and logged for processing. With the submission done, your main job is finished. Now begins the waiting part!
Step 5: Track Claim Status and Provide Updates
The next crucial step is to follow up and monitor your submitted claim. In most cases, general insurance claims in India are settled within 7-15 days from the date the document is submitted. Processing can take longer in complex cases.
To get regular status updates:
- Call the insurer helpline, quoting your policy/claims number
- Email your claims officer for updates
- Check the status online, which is available on the portal
This allows you to understand the stages—receipt, processing, investigation (if done), approval, and final settlement.
Step 6: Receive Claim Payment
The final step is the claim settlement once approved! You will get payment once the insurer accepts claim liability after verification. The payment can be received via:
- Cheque: Sent to the mailing address on the policy
- NEFT/Online Transfer: Direct credit to your bank account
When you receive payment notification, match the claim-sanctioned amount with your estimate and documents. If you have issues, get clarification from the company immediately.
Conclusion
Filing an insurance claim involves prompt intimation, document collection, accurate form filling, submission, and follow-ups. While it may seem complicated, breaking it down into stages and completing all protocols makes the process smooth. The key is understanding your policy and insurer guidelines and managing paperwork systematically.
