Insurance policies promise compensation for that financial loss that you suffer in the event of emergencies that are covered under the policy. You buy an insurance plan for this promise and so when the covered contingency occurs, you anticipate the insurer to fulfil its promise and settle your claims.

What is definitely an insurance claim?

Claim in an insurance plan happens when you are making a demand around the insurance company for payment from the policy benefits. A claim takes place when the event, that the policy covers, happens and the like happening leads to a financial loss. When the claim is covered under the insurance plan, the insurer pays the advantages promised underneath the plan and covers your financial loss.

When you are looking at insurance claims, you're supposed to consume a specific tactic to get the claim settled. This insurance claim process differs for various kinds of insurance plans. So, let's understand the insurance claim process for some of the most popular kinds of insurance plans –

Insurance claims under car insurance policy policies –

Motor insurance plans can be car insurance plans or bike insurance plans. The insurance coverage claim process for auto insurance and bike insurance is the same. Let's know very well what the operation is –

Under motor insurance policies, there's two kinds of claims – 3rd party liability claims or own damage claims. The insurance claim process for both these instances differs. Here's what is the process under each instance involves –

  1. Third party claims:Third party liability claims occur when any other individual is hurt or killed by your vehicle or if any third party property is damaged. The insurance claim process for third party claims is as follows –
    • You should inform the insurer immediately from the claim
    • File an FIR using the local police authority
    • The claim would be taken to the motor accidents tribunal which may pass a ruling on the financial liability that you face
    • Depending around the ruling from the tribunal, the insurer would settle the claim
  2. Own damage claimsOwn damage insurance claim means when your car or bike itself suffers damage. Own damage claims can, further, be subdivided into two sorts – damages suffered through the vehicle or theft from the vehicle. Here's the insurance claim process for each –
    • Damages suffered by the car or bike:
      1. Inform the insurer immediately of the damage
      2. The company would then provide you the details of the nearest preferred garage where you can take your vehicle
      3. Once your automobile is in the garage, the business's surveyor would visit and measure the damages. After assessing the damages the claim report could be prepared
      4. Depending around the claim report submitted by the surveyor, the insurer approves the repairs
      5. Once the repairs are approved, the vehicle is repaired. The company pays the repair costs directly to the garage and the claim is chosen a cashless basis
      6. If, however, you receive your vehicle repaired at a non-networked garage, you would need to bear the repairs and also the insurance provider would then reimburse the expense for you when you submit all of the bills
    • Theft of the car or bike:
      1. If your automobile is stolen, you need to immediately inform the insurance company of the theft
      2. A police FIR is also mandatory
      3. Once the FIR is filed, law enforcement try to locate your automobile. If they fail, they would issue a non-traceable are accountable to you
      4. You would need to submit this report to the insurer along with the claim form
      5. The insurance company would then pay you the Insured Declared Value of your insurance plan and also the claim would be settled

Documents necessary for vehicle insurance claims

In case of vehicle insurance claims, the next documents would have to be submitted –

  1. The RC book from the vehicle
  2. Driving license
  3. PUC certificate
  4. Claim form that ought to be duly filled and signed
  5. Police FIR, wherever necessary
  6. Identity proof of the policyholder
  7. Any other documents as needed by the insurance company

Insurance claims under medical health insurance policies

The insurance claim process under health insurance policies is really as follows –

  1. To avail a cashless claim you need to seek treatment in a hospital which is tied-up using the insurance company. Inside a cashless claim, the insurer settles your hospital bills directly using the hospital and you don't have to shoulder the financial burden
  2. You need to get the pre-authorization form, grow it and submit it to obtain cashless claim settlements. The shape is available at the hospital. You need to submit the shape within Twenty four hours of emergency hospitalisation and 3-4 days before planned hospitalisation.
  3. The insurance provider assesses the pre-authorization claim form and approves cashless claims
  4. The hospital bills are, then, paid through the insurance company directly
  5. After you're discharged, you need to fill up a claim form and send it in with the discharge summary and all the medical documents
  6. If you take treatments at a non-networked hospital, you need to bear the medical expenses yourself. You can then submit the claim form and all sorts of hospital bills and reports and the insurance provider would reimburse you for that expenses incurred

Documents necessary for health insurance claims

For obtaining a settlement of the medical health insurance claim, the following documents would be required:

  1. Claim form which should be completely filled and submitted
  2. Discharge summary from the hospital
  3. Police FIR
  4. All medical bills and receipts
  5. All medical documents and investigative reports
  6. Identity proof of the insured

How are health insurance claims handled?

Health insurance claims can be handled by either TPAs or the insurance company's in-house claim settlement team. Let's comprehend the difference –

  1. TPAsTPAs mean Third Party Administrators. TPAs are specific companies that really help facilitate any adverse health insurance claim between your company. You make a claim towards the TPA which may assess your claim and then forward it to the insurance company. The insurance company would then reject or settle your claim. TPAs are, therefore, middlemen in the claim process.
  2. In-house claim departmentIn case of in-house claim department, the insurance company does not engage the services of a TPA. Instead, the organization results in a dedicated claim handling department itself. You are able to, therefore, directly report your claim towards the insurance company through its in-house claim settlement department. The department would then assess your claim making a decision on it.
  3. Which is much better: TPA or in-house Medical health insurance Claim?In-house claim settlement departments are better as your claims get settled within a shorter time period when compared with TPAs. The organization may also provide you with value-added benefits for the claims through its claim settlement department. In case of TPAs, they're tasked only to act as middlemen. They cannot accept or reject your claim. So, if your large number of claims get piled with TPAs, your insurance claim process would become too long and time-consuming. That is why try and buy a health insurance policy from a company which has an in-house claim settlement department.

Insurance claims under life insurance coverage policies

Under life insurance coverage plans, insurance claims are categorised underneath the following two heads –

  1. Maturity claimsThis happens when the word from the plan comes to an end and you're simply alive to gather the program benefits.
    • Insurance claims process for maturity claims:
      1. Maturity claims are initiated through the insurance provider itself as the policy approached maturity
      2. You have to submit a maturity discharge form and the policy bond to get the claim
      3. Once the documents are submitted, the claim would be credited to your bank account
    • Documents required for maturity claims:
      1. Maturity claim form
      2. Policy bond
      3. Your identity proof
      4. Your bank account details for receiving the maturity proceeds
  • Death claimsIn case of death during the policy tenure, death claims occur. Death claims are collected through the nominee that you appoint in your insurance policy.
    • Insurance claim process for death claims:
      1. The nominee needs to inform the insurance company concerning the death of the insured
      2. A claim form ought to be filled and submitted and you would also have to submit various relevant documents
      3. The company would verify the claim and the documents submitted
      4. Once verified, the company would spend the money for claim directly to the nominee's bank account
    • Documents required for death claims:
      1. Claim form, filled and signed through the nominee
      2. Identity proof of the nominee
      3. Original Policy bond
      4. Death certificate
      5. Police FIR
      6. Medical reports
      7. Coroner's report, punchnama, post mortem report, etc.

So, these are the insurance claim processes of some of the most popular insurance plans. understand the claim process to ensure that if you face an insurance coverage claim you would know precisely how to get your claims settled and the documents necessary for the same. Alternatively, you can also contact Turtlemint's team for the insurance claim settlements. Turtlemint has a dedicated claims handling department which gets your claims settled for you. Turtlemint's claim department handles the insurance coverage claim process which makes it convenient for you personally. Just intimate the claim by calling Turtlemint's helpline at 1800 266 0101 or by sending an e-mail to claims@turtlemint.com . You'll be able to relax and Turtlemint would ensure that your claims are settled at the earliest.

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