Health claim — cashless
- Choose a network hospital and show the health card at admission
- Hospital sends the pre-authorisation request to the insurer or TPA
- For planned admissions, apply at least 48 hours in advance
- Approval is for the covered amount; non-medical items are paid by you
- Keep the discharge summary and all bills even in a cashless claim
Health claim — reimbursement
- Intimate the insurer within the notified time, usually 24 to 48 hours
- Collect original bills, payment receipts, discharge summary and reports
- Submit the claim form with KYC and cancelled cheque
- Preserve copies of everything you submit
Life insurance claim — documents
| Document | Notes |
|---|---|
| Claim intimation form | Signed by the nominee |
| Original policy document | Or a declaration if misplaced |
| Death certificate | Issued by the municipal authority |
| Nominee KYC and bank proof | For direct credit of the claim amount |
| Medical or police records | As applicable to the cause of death |
Why claims get delayed or rejected
- Non-disclosure of medical history, habits or existing policies at proposal stage
- Claim falling inside a waiting period or an exclusion
- Policy lapsed because a renewal premium was missed
- Incomplete documents or mismatched names and dates
If you disagree with the decision
Ask for the rejection in writing, respond with evidence, escalate to the insurer's Grievance Redressal Officer, then to the Insurance Ombudsman if still unresolved. I assist with drafting and follow-up at each stage.
Frequently asked questions
Do you charge for claim assistance?
No. Claim support is part of the service for every policy issued through me, and I will also guide the family of a policyholder who bought elsewhere wherever I can.
How long does a life insurance claim take?
Insurers are required to settle or communicate a decision within timelines specified by IRDAI once all documents are received. Clean, complete documentation is the single biggest factor.
What if a claim is rejected?
You can ask the insurer for written reasons, escalate to its Grievance Redressal Officer, and then approach the Insurance Ombudsman. I help prepare and follow up on that representation.