It is the duty of the agent to facilitate the policyholder’s family in completion of claim requirements at the time of the event. Life Insurance above all is a contract of trust where policyholder should facilitate correct decision-making by providing all the relevant information.
Insurance is the business of covering the probability of an individual getting sick or dying, higher the risk higher the premium. A person with high risk paying low premium by withholding critical information is liable for penalty.
Here are some guidelines a policyholder must follow:
Correct information: While filling up your proposal form and while signing a contract, you must furnish all information in good faith since you will be held accountable for making a wrong declaration. For example, if you are suffering from hypertension, mention this fact at the time of buying the insurance policy. If you conceal this fact, in case of untimely demise your nominee’s claim may be repudiated on the basis of non-disclosure of material facts.
Nomination: The insurance company is discharged of its liability once it pays the sum assured to your nominee(s) registered under a process established by the Insurance Act, 1938. Since a claim without a nominee cannot be settled, all insurers ask for evidence that the claimant is the rightful person.
In case life assured has nominated somebody to get the benefits at the time of death, claim benefits are disbursed in favour of that nominee unless there is a Will provided to us (that supersedes the nomination) or there is a legal dispute. In case there is no nominee, benefits are disbursed to the Class 1 legal heirs and/or the designated heirs as per the Will or Succession documents. In case of maturity claim, amount is disbursed to the policyholder
Documentation: Submit all documents to make a claim. The documents under any life insurance death claim fall under the following broad categories:
n Documents related to the policy.
n Documents to prove that the occurrence of the event does not fall under exclusions mentioned in the policy contract.
n Documents to prove the identity and that the claimant is the rightful nominee.
An insurance firm cannot settle a claim until all documents are in place. In case original documents cannot be produced, there is a process to get the documents certified. To avail maturity claims conveniently, the policyholders should continue to pay their premiums on time. During the course of their policy tenure, in case the contact details or the address changes, they should get it updated in the records of their company. While the insurer will communicate when the policy would be due for its maturity, the policyholders should also proactively track their maturity timelines and get in touch with the company prior to maturity, to close the documentation requirements, for convenient disbursement of the claims.
One should also keep in mind a few do’s and don’ts for speedy and smooth settlement. Submit all the required claim documents together. Details of documents for claims settlement as well as various claims forms are available with the policy pack, with agent advisor, insurer’s offices and on insurers’ websites.
Common issues that can lead to delay are nondisclosure of facts, nomination not done at application stage, dispute between claimant and other legal heirs, unconfirmed cause of death and murder cases. In case of maturity claims the delays can arise on account of incomplete documentation or the policyholder not being reachable or not approaching the insurance company for the maturity claim amount.
This article gives the light in which we can observe the reality. Key west claim adjuster I like this kind of blog. Thanks for sharing informative information with us
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