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Term Insurance Claim Settlement Ratio

Buying a term insurance plan is a wise decision. All’s hunky-dory when you buy the policy. But at the time of claim, the real chaos begins and you’re not around to witness that. To avoid your family from going through the mess, here is what you need to know!

Why Term Insurance Claim Settlement Ratio So Important?

Claim settlement ratios act as an important indicator of an insurance company’s credibility. As a rule of thumb, it is usually considered that insurance companies with a higher claim settlement ratio are considered to be more reliable than others.

What is the Claim Settlement Ratio?

Claim settlement ratio also commonly known as CSR is the percentage of claims that an insurer settles in one yr. out of the total no. of claims.

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Amount Covered: ₹ 1 Lakh
Deal Price: ₹ 2,094 / Year
Waiting period: 4 yrs
Disclaimer: Above mentioned premium is for a 25 years old Male. Premiums payable on a monthly basis.

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The Right Method to Make a Claim

Once the policy holder passes away, family members or the nominee under the policy can send a claim intimation to the insurance company as soon as possible. Although your family may be in sorrow, they must not delay in making the claim. This is to avoid any complications in the process. It is as simple as that!

How To File Term Insurance Claim?

Step 1: Inform your insurer about the claim:

  • The 1st step is about informing your insurer. A member of the deceased person’s family has to submit the claim form & the death certificate along with other essential documents. The insurer needs to be informed about this claim within 3 months from the death date of the policyholder. You can either do this by visiting the nearest insurer office or even do the same online.

Step 2: Claim assessment by the insurer:

  • After the claim form is submitted the insurance company then conducts the assessment of the claim. The entire assessment is carried out with in depth scrutiny. The insurer sends a letter to the policyholder’s family member in case any further documents are required for assessment.

Step 3: Claim settlement:

  • Based on the assessment, if the claim is approved, the cover amount is sent to the nominee’s bank account. If the claim is rejected, a rejection letter is sent to the nominee explaining the reasons for rejection. Please note, as per IRDAI, it’s compulsory for an insurer to settle a claim within a month. In case of any further investigation required, the insurer is required to settle the claim within 6 months.

Contents of a Claim Intimation

Critical details about the date, place, and cause of death is a must in the claim intimation made by the nominee. In their time of grief, we help the family members or nominee deal with the term insurance company and assist them in settling the claim.

The documents that would be required

For death that occurs after 3 years of taking the policy:

  • Filled-up claim form (provided by the insurance company)
  • Certificate of death
  • Policy document
  • Deeds of assignments/ re-assignments if any
  • Legal evidence of title, if the policy is not assigned or nominated
  • Form of discharge executed and witnessed
  • Last medical attendant's certificate

Also, if applicable, hospital certificate, employer's certificate, police inquest report may be required to be presented. For death that occurs within 3 years of taking the policy:

Apart from all the above documents, a Post Mortem report too would be needed. This gives the insurer some more time to investigate on the death case before finally settling your policy claim.

Factors That Will Lead To Term Insurance Claim Rejection

  • Incorrect details submitted
  • Failure to submit all documents
  • Failure to update nominee info
  • Policy lapse due to premium payment failure
  • Hiding important information

Essential Inclusions and Exclusions

Insurance is applicable to both natural and unnatural death. For suicide cases, claim will be settled after one year of taking the policy.

Inclusions and exclusions of your policy depend on the risk pool that you subscribe. So, a smoker’s benefits would be different in comparison to that of a non-smoker.

You will be glad to know that most benefits of term insurance remain the same in different plans. The length in coverage would vary from one plan to another.

Get in touch with our Coverfox advisory to get the right scheme.

Special Plans for Terminal Illnesses

Certain terminal illnesses like AIDS and Cancer may not come under general plans. They fall under exclusive plans. If diagnosed and verified, your insurer can pay you a partial percentage of the amount while you are still alive in the last stage of your illness. The major chunk of it is paid to your nominees after you breathe your last. Make sure you check the fine print of the policy document before opting for it.

Formalities for a Maturity Claim

Two to three months before the date of maturity, your insurer will send an intimation along with a discharge voucher giving details of the maturity amount payable.

You would have to sign and send it back to the insurer along with the original policy bond to enable it to make the payment. The claim amount would be paid to the assignee.

Inquire if your insurer has a Return on Premium (ROP) clause in their parameters. If your life expectancy overcomes the duration, you are entitled to get a 100% ROP on maturity. Not all plans include the ROP clause.

Tips to a Smarter Claim

The most significant tip to term insurance is –

EDUCATE your family members/nominee about the policy you take!

At the time of claim, you won’t be around to assist your members in fulfilling claim settlement formalities. Always inform them about the terms and conditions of your policy, the sum assured amount, and the steps to claiming it once you pass away. The more transparent you are to them, the more hassle-free claim settlement process they undergo!

Also, several riders are associated with term plans. By paying a slightly higher premium, you get extra advantages.

Still puzzled about which term plan you need to choose?

Get term insurance quotes on Coverfox.com

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