Claim Services

Claim Services

  • Home
  • Claim Services

What is an insurance claim?

An insurance claim is an official request that a policyholder makes to the insurance company for the compensation of the damage incurred by them. The compensation is provided as per the coverage guaranteed to the policyholder by the insurance company under the insurance agreement.

Normal claim process followed by General Insurers
  • The policyholder shall give notice to the insurer of any loss arising under contract of insurance at the earliest or within such extended time as may be allowed by the insurer.
  • The insurer shall respond immediately and give clear indication to the insured on the procedures that he should follow.
  • In cases where a surveyor is needed for assessing a loss/ claim, it shall be so done within 72 hours of the receipt of intimation.
  • The surveyor under the code of conduct shall communicate his findings to the insurer within 30 days of his appointment with a copy of the report being furnished to the insured, if he so desires. The surveyor shall under intimation to the insured, seek an extension from the insurer for submission of his report, if required.
  • The surveyor cannot take more than six months to furnish the report. On receipt of the report the insurer shall within a period of 30 days offer a settlement of the claim to the insured or in case of rejection of the claim do so within 30 days from the receipt of the survey report.
  • Upon acceptance of an offer of settlement by the insured, the payment of the amount due shall be made within 7 days from the date of acceptance of the offer by the insured. In the cases of delay in the payment, the insurer shall be liable to pay interest at a rate which is 2% above the bank rate prevalent at the beginning of the financial year in which the claim is reviewed by it.

Role of the Surveyor in the Claim Process

Insurance companies hire Surveyors, also known as Loss Assessors, to assess the actual loss/damages arising due to accidents, burglary, fire, etc. to settle claims. The surveyors’ main role is to act as an intermediary between the insurance company and the policyholder while settling claims. That being said, surveyors are not required for every claim. The surveyor has an important role to play to further process the claim. Below are the roles and responsibilities of the surveyor.

Investigate, Validate & Quantify

The Surveyor has to manage, investigate, validate, quantify, and deal with all losses (can be of the insured or a third-party) arising due to a contingency & furnish the report back to us.

Provide Unbiased Assessment

Provide professional and unbiased assessment and adhere to the strict code of conduct. The surveyor must keep the interest of both the insurer and the insured in mind.

Work in a Time-Bound Manner

Provide the complete assessment within the stipulated time frame as per the guidelines.

Thorough Investigation

A surveyor must identify whether the case comes under the category of under-insurance or excess-insurance. If there is any discrepancy in the wordings of the policy, the surveyor must point that out.

Provide Clear Update to the Policyholder

During the assessment, the surveyor needs to educate the policyholder about the claim process and the evaluation of the damages.

What is car insurance claim?

Vehicle insurance comes as a much-needed respite in the event of an accident that may cause damage to your vehicle. Insurance claims help pay for the repair of the vehicle and other financial losses incurred. The insured can ask the insurance company to represent him/her or intervene on his/her behalf when the insured is responsible for any unintentional damages caused to a third-party. Since one pay car insurance premium, it is one’s right to make a claim when he/she is involved in an accident.

Types of car insurance claims

Cashless Claims

Get your car repaired at any of the insurer’s network garages, and you don’t have to pay upfront for the repairs. The car insurer provider will settle the claim with the workshop on your behalf. we will pay the repair costs as per the policy terms, directly to the garage.
Note that this facility will only be available at the network garages of your insurer.

Reimbursement Claims

For claim reimbursement, an insured has to pay for the repairs of the damage. And later, depending upon the terms and conditions of the car insurance policy, a reimbursement claim is made. In this type of car insurance claim, an insured does not need to get his/her car repaired at a network car garages of the insurance provider. However, the insured needs to submit the bills and repair receipts with the policy provider.

How to Claim Car Insurance Under Different Situations?

For a quick and hassle-free claim settlement experience, we recommend you report the accident immediately to Bima Buy claim settlement team. Our experienced team will help you at the earliest to avoid the claim rejection.

Steps to File a Car Insurance Claim

To get compensation for the damage or loss to the car or in case of injury, the policyholder needs to file a vehicle insurance claim successfully. Here are the steps to follow to claim insurance for car accidents.

Claim Intimation

The claim has to be reported to the insurer or to us as soon as possible.

Documentation

The insurance company will let you know the documents needed to raise the claim.

Claim Application

Get ready will all the documents & the proofs to raise the claim. Apply for the claim on the website of through the agent.

Claim Status

After the survey, insurer company will let you know the status of your claim. After report submission the insurer will have to revert you within 30 days.

Reasons for Claim Rejections

Every car insurance claim that is raised by the policyholder may not be settled. Some claims get rejected. An insurance company reserves the right to accept or reject a claim. So, it is advisable to take the necessary precautions to avoid getting your claim rejected.

  • Providing incorrect information while raising a claim.
  • Claims raised against damage that is not covered by the policy.
  • In case the claim is raised after the car insurance policy has lapsed.
  • Unreasonable delay in raising the claim request.
  • Driving the insured car without a valid driving licence.
  • The insurance of your second-hand car is still under the previous car owner.
  • The owner/driver uses the car for purposes other than those mentioned in the policy.
  • A false claim made with untruthful information. Such claims are known as fraudulent claims.
  • Driving the insured car under the influence of alcohol or other intoxicating substances at the time of the accident.
  • Damages to your car due to carelessness, such as starting the engine of a water-logged car.
  • Claims raised for reasons that are otherwise not covered as per the terms and conditions of the insurance policy.
Documents Required to File a Claim
  • Registration certificate of the vehicle
  • Duly filled & signed claim form
  • FIR copy might be needed in case of accident or theft
  • Insurance policy document
  • Valid driving license
  • Original repair bills & receipts

What Happens After the Claim Is Filed?

After you file your claim, the insurance company initiates the car accident insurance claim settlement process. A surveyor will be assigned to your case by your insurer. The surveyor will visit the garage where your car is being repaired for inspecting the damage. If everything is in order, your claim will be accepted, and you will be compensated for the accident.

Drive stress free with Bima Buy quick & hassle-free claim settlements

Claim Settlement Team

Dedicated claim settlement team to handle all your claims. With a Claim Settlement ratio of 97.2% we are experts in claims

Network Garages

Wide network of garages to give you a smooth cashless claim experience.

Quick Claim Settlement

Enjoy instant claim settlement for minor car damages.

FAQs about car insurance claims

There are chances of your claim being partially or completely rejected. It is important to intimidate immediately so that claims are handled according to the terms and conditions of the policy.

The term ‘totaled car’ refers to a total loss to the insured car. In case of a total loss, you will get the Sum Assured amount or the Insured Declared Value (IDV) as compensation against your insurance policy.

The regular comprehensive cover does not provide coverage for engine repair. However, you can opt for the Engine Protect add-on cover. ACKO will reimburse the repair cost of the engine due to water ingression or due to oil leakage if you purchase the Engine Protect add-on.

You can choose to place your car insurance claim in one of the two available methods which are provided by most insurance providers. They are – cashless claims and reimbursement claims. The cashless claim is one where the insurance provider settles the bill for repairing your vehicle with the network workshop where you get your car fixed. The reimbursement claim, on the other hand, is the form of claim wherein you will be responsible for settling the bill at the first place followed by which you will have to submit the relevant eligible bills of repair to the insurance provider. The insurer will reimburse the repairing charges on the basis of their terms and conditions.

No, you will not be able to claim insurance in this case. In case you place a claim for the damages incurred by your car, the insurance provider will reject the claim.

Yes, as per the generic terms and conditions of the insurance providers, you will be required to go through the step wherein a surveying inspector will be assigned for the inspection of your vehicle before the claim process is advanced. However, many insurance providers also allow you to make the process faster by allowing e-inspection. You can get in touch with your insurer to get a clear picture on the same and advance accordingly.

Yes, you can opt for the reimbursement claim process. You need to inform us before you repair your car at the garage of your choice so that we can make a note of the same. Submit the original invoices or cash receipts of the repair, and we will reimburse the bill as per the terms and conditions of the policy.

No, you do not need to report an FIR for your motor insurance claims except it involves injury to someone else, damage to someone else’s property, or in case your car is stolen.

Yes, you can raise a claim through the Own Damage cover, which is part of the comprehensive car insurance policy. Under this cover, you will be compensated for damages to your case in case of accidents, fire, theft, natural calamities, or riots.

What is a Two Wheeler insurance claim?

While you ride your bike on the roads, there are always chances of damages. These damages or losses can be due to an accident, natural calamities, fire, riots or theft. Such unfortunate incidents are always unpredictable. The worse thing is these damages can put a dent in your pocket.
By purchasing two-wheeler insurance policy, you can protect your bike from unforeseen situations. In simple words, the insurance policy states that the insurance provider will pay for the damages suffered because of the accident.
All you have to do is inform your insurance company about the losses/damages by raising a claim. Once you raise a claim, your insurance company will assess the impact and compensate you as per the terms and conditions

Types of Two Wheeler insurance claims

Cashless Claims

The whole process is cashless, and you won't have to pay anything except for the deductible you have agreed. When you make a cashless claim, you take your bike to a network garage for repairs & the insurance company settle the bill with the garage directly. A network garage is the one affiliated with your insurance company.

Reimbursement Claims

In Reimbursement Claims, you inform the insurance company about the accident & get your bike repaired at your own expenses. You just need to submit the original bills, payment receipts, etc. to the insurance company to raise a claim. After some verification, the insurance company disburses your claim amount minus the deductible.

How to Claim Two Wheeler Insurance Under Different Situations?

For a quick and hassle-free claim settlement experience, we recommend you report the accident immediately to Bima Buy claim settlement team. Our experienced team will help you at the earliest to avoid the claim rejection.

Steps to File a Two Wheeler Insurance Claim

To get compensation for the damage or loss to your bike or in case of injury, the policyholder needs to file a vehicle insurance claim successfully. Here are the steps to follow to claim insurance for bike accidents.

Claim Intimation

The claim has to be reported to the insurer or to us as soon as possible.

Documentation

The insurance company will let you know the documents needed to raise the claim. Lodge an FIR if your two-wheeler is stolen or there has been a major accident.

Claim Application

Get ready will all the documents & the proofs to raise the claim. Apply for the claim on the website or through the agent.

Claim Status

After the evaluation of the damage, insurer company will let you know the status of your claim. After report submission the insurer will have to revert you within 30 days.

Common Reasons for Two-Wheeler Insurance Claim Rejection

A substantial number of claims, including bike insurance claims, often get rejected by the insurer or delayed because of the improper claim settlement process followed. Sometimes, claims are held up in documentation resulting in delays and even rejection.
The truth is, your insurer maintains whatever authority is needed to accept or reject a claim. This requires your most extreme consideration while documenting a two-wheeler claim. In such manner, beneath are a portion of the normal reasons that lead to rejection for your two-wheeler claim.

  • In the event that the information given by you is false and if the insurer sorts it out, it will dismiss the claim demand immediately.
  • In the event that the mishap occurs while driving affected by alcoholic substances.
  • In case the claim is raised after the insurance policy has lapsed.
  • Claims raised against damage that is not covered by the policy.
  • If you are driving a vehicle as second-hand owner and the ownership is still in the name of the previous owner
  • Driving the insured two-wheeler without a valid driving licence.
  • If you ignore the rules and fail to inform about the accident within the stipulated time frame.
  • If you get your vehicle repaired without informing the insurer about the accident or damages
  • The owner/driver uses the two-wheeler for purposes other than those mentioned in the policy.
  • If the accident occurs due to your carelessness and if the insurers find it, then the claim will not be considered.
  • Claims raised for reasons that are otherwise not covered as per the terms and conditions of the insurance policy.

Essential Documents Required for Filing a Bike Insurance Claim

For Accidental Claims
  • Policy Document
  • Registration certificate of the vehicle
  • Police FIR
  • Driving license of the person driving the vehicle at the time of the incident
  • Estimation of total repair done by the garage
  • Original repair invoice, payment receipt
  • Discharge Cum Satisfaction Voucher obtained from the garage and signed by you with a Revenue Stamp
For Third Party
  • Original RC of the bike
  • Original Policy documents
  • Duly filled claim form
  • Police FIR copy
  • Driving license of the driver
Two Wheeler Theft Claims
  • Duly filled the claim form
  • Original registration copy of the vehicle
  • Original policy document
  • Previous insurance details if any including policy number, issuing company, tenure of insurance etc.
  • Set of keys/warranty card/service booklet
  • Original police FIR mentioning about the theft
  • Subrogation Letter
  • Photocopy of Acknowledgement Letter written to the RTO intimating about the incident and making vehicle ‘Non-USE’
  • Form 28/29/30 duly signed by the insured
  • Form 35 signed by the financer in case the bike is bought on loan
  • Consent from you and the financer on the agreed amount to be settled by the insurer
  • NOC from the financer in case the claim is to be paid to you
  • Claim Discharge Voucher signed across a Revenue Stamp
  • The insurer may ask for additional documents as well

What Happens After the Claim Is Filed?

After you file your claim, the insurance company initiates the bike accident insurance claim settlement process. A surveyor will be assigned to your case by your insurer. The surveyor will visit the garage where your bike is being repaired for inspecting the damage. If everything is in order, your claim will be accepted, and you will be compensated for the accident.

Two-wheeler Insurance Claim Settlement FAQs

A bike insurance claim wherein a policyholder raises a request with the insurance company to honour its promise to provide compensation for the damage incurred by the policyholder in relation to their bike. A bike insurance claim can be settled either in a cashless or reimbursement manner.

No, a genuine claim can be raised on limitless occasions. However, It is prescribed to try not to raise a claim for minor damages to enjoy No Claim Bonus discount advantage.

In case you do not raise a single claim in an active policy year, you enjoy a No Claim Bonus benefit. This allows you to enjoy a discount on your bike premium amount when you renew your insurance policy. The No Claim Bonus discount can go up to 50 percent if you do not raise any bike claim for five consecutive years.

A First Information Report (FIR) is required in cases wherein any person has incurred bodily damages or in cases of death and in case of a theft claim. Also, you can check the list of documents required on various occasions.

You can locate the nearest authorized garage of the insurer either by calling the customer service helpline of your insurance provider or look for it on their official website. This option is present in the claims section on the official website in the name ‘list of network garages’.

No, your two-wheeler claim will be rejected in the event that you get your bike fixed without intimating the insurance agency about the harms to your vehicle. This is on the grounds that your insurer will issue a inspection. The surveyor will evaluate the degree of two-wheeler harm. You should get your bike fixed once your receive a confirmation from the insurance company.

What is a Commercial Vehicle Insurance Claim?

Commercial vehicles convey either commodities or passengers, or both. Driving a commercial vehicle exposes the driver to constant and stressful conditions, increasing the risk of accidents, loss of cargo, or even death of the driver, passengers, or both. Expenses spent as a result of this, if not covered, might result in substantial financial and legal consequences for the business owner. This is where business vehicle insurance comes into play, as it protects the policyholder against bodily injury and death in the case of an accident, as well as third-party liability and property damage. All you have to do is inform your insurance company about the losses/damages by raising a claim. Once you raise a claim, your insurance company will assess the impact and compensate you as per the policy terms and conditions.

Types of commercial vehicle insurance claim

Cashless Claims

The insurance company will transport the car to the nearest network workshop for repairs to be completed within the time frame specified. If the neighbouring hospital has a contract with the insurance company, it will also arrange for a cashless medical treatment service.

Non-Cashless / Reimbursement Claim

If the cashless process cannot be completed for reasons beyond the insurance company's control, the policyholder must perform repair work on their own at the nearest site, which will be reimbursed by the insurance company. Make sure you obtain the original bill and payment receipt for all repair work performed, as these will be required by the insurance carrier in order to complete the claim process.

How to Claim a Commercial Vehicle Insurance Under Different Situations?

For a quick and hassle-free claim settlement experience, we recommend you report the accident immediately to Bima Buy claim settlement team/or inform the respective insurance company.

Process to file your commercial vehicle claim

Inform the Police:

In case of an accident, it is mandatory to file the police FIR which will be needed to initiate the claim process.

Record the incident:

Take some pictures or record the video of the accident. Note down the contact details of the people involved.

Inform the insurance company:

After filing the FIR, notify the insurance company about the accident or mishap.

Get thorough with the policy documents:

You must be aware of the policy inclusions & exclusions and various terms or the insurance policy to make the process fast.

File the claim:

After getting in touch with your insurance provider apply for the claim.

Document required to file a claim

In case of accidental damages
  • Duly filled claim form
  • Tax Receipt (Original for verification), Copy of Registration Book
  • Original policy documents
  • Estimate for repairs
  • Copy of the driver’s Driving License (original also for verification)
  • FIR (In case of third-party property damage/ body injury/ death)
  • Bills of repair as well as payment receipts once it is done
  • Any other document as required by the insure
In theft cases
  • Original Registration Certificate, with Theft endorsement from the concerned RTO
  • Tax payment receipt
  • Original Policy Document
  • Acknowledged letter addressed to RTO which intimates about the theft (copy)
  • Previous Insurance Details
  • All the sets of keys/ Warranty card/ service booklets
  • FIR and final investigation report
  • Any other document as required by the insurer

Frequently asked questions

The first thing you should do if your vehicle has been stolen is to contact the police. Then you can file a claim with the insurance company. Any delay in reporting to the police will have an impact on your claim.

The following is the rundown of records that a policyholder must present to the motor vehicle insurance company in order to settle a claim.

  • Photocopy of the registration certificate of the vehicle.
  • Estimated amount of the loss incurred.
  • Invoice of the repairs carried out.
  • Receipt of payment.
  • Record of non-traceability in the event of theft claim.
  • Key of the vehicle in case of a claim.
  • The repair invoice of cashless service, if availed.

f you don’t make any claim in your current policy and wish to change vehicle insurance companies at the time of renewal, you need not worry about your No-claim bonus. The No-claim bonus for your current policy will be transferred to whichever insurance company you are opting for. You just have to provide the proof of the no-claim bonus along with your original policy papers. For proof, the insured person can ask their insurer for a letter that acknowledges the bonus accumulation in their policy.

No, your two-wheeler claim will be rejected in the event that you get your bike fixed without intimating the insurance agency about the harms to your vehicle. This is on the grounds that your insurer will issue an inspection. The surveyor will evaluate the degree of the losses & damages. You should get your bike fixed once you receive a confirmation from the insurance company.

Insurance companies settle the claim within 7 working days of receiving all the relevant documents from the insured. These documents include the original repair invoice, satisfaction voucher, discharge voucher, and necessary fund transfer details. However time many vary from insurers to insurers.

A claim can be made considering the mentioned criteria are satisfied:

  • The vehicle should have an active Insurance Policy.
  • If the car was driven by a paid driver whose premium has been paid by you.
  • A fully licensed individual should be appointed to drive the automobile as the premium is built on seating capacity and includes the driver as well.

  • Policy not in force/lapsed policy.
  • The incident occurred after the policy's expiration date.
  • The driver of the vehicle did not have a valid driver's licence at the time of the collision.
  • Driver was under the influence of alcohol at the time of incident.
  • The owner of the automobile had been changed without notifying the insurer within the mentioned period or 14 days.
  • Accident occurred before policy has started.
  • The incident not covered in the policy.
  • The vehicle is used for other motive as mentioned in the policy

What is Health Insurance?

A health insurance, also known as medical insurance, is a sort of general insurance that protects you against financial losses by covering you in the event of a health condition or medical emergency caused by a disease, illness, or even an accident.
This includes pre- and post-hospitalization expenditures, annual health check-ups, psychiatric support, severe illnesses, and maternity-related charges, among other things, depending on your specific health insurance plan.
They can be taken by a single person or by a group. It is necessary to have adequate coverage to protect against escalating medical expenditures and to be able to access high-quality healthcare services.

Why do you need a Health Insurance?

  • A health insurance coverage can cover hospitalisation charges, prescription and lab test charges, ambulance and doctor fees, and so on. Some health insurance plans additionally cover OPD costs up to a specified amount.
  • It aids in reducing your out-of-pocket payments by providing a cashless medical treatment facility in network facilities.
  • Nowadays, with the coronavirus outbreak, it is even more vital to have or purchase medical insurance that covers the expense of treatment, including PPE kits, masks, ventilators, ICU expenses, and so on.
  • If you do not have coronavirus health insurance, you can purchase Corona Kavach and Corona Rakshak health policies to alleviate your concerns.
  • Even people who are thinking about starting a family can purchase a health insurance policy that includes maternity and newborn infant coverage.
  • If you have a medical insurance coverage, the insurer will cover the costs of major surgeries such as liver transplantation, open-heart surgery, and day-care procedures such as cataract surgery, varicose veins, and the like.
  • A health insurance policy allows you and your family to have peace of mind without having to worry about future hospitalizations or medical emergencies, which can otherwise deplete a significant chunk of your savings.

Benefits of having a health insurance policy

A comprehensive health insurance plan will cover the cost of hospitalisation, including pre and post-hospitalization fees, medical care at home (also known as Domiciliary Hospitalization), childcare treatments, and ambulance charges, among other things.

Cashless Treatment:

Cash is something that not everyone has access to all of the time, which is why cashless health insurance has gained popularity. If you are covered under a health insurance plan that offers cashless treatment, you will no longer have to worry about paying your medical bills because your insurance company will handle the payment through a cashless programme on your behalf, allowing you to focus solely on your medical treatment.

Covers Pre & Post Hospitalization Costs:

According to the terms and conditions of the insurance company, a health insurance policy covers all expenses incurred before the patient is admitted to a hospital and after discharge from the hospital for a set period if such expenses are related to the sickness.

No Claim Bonus (NCB):

For health insurance, a No Claim Bonus (NCB) is a set amount of money you'll save if you don't file a claim throughout the policy's term. This discount will be applied to your premium when you renew your health insurance

Ambulance Fee:

Once admitted to the hospital, the person is relieved of the burden of transportation costs, which are covered by the insurer.

Medical Check-Up Facility:

A medical plan entitles the covered to routine medical examinations. Some insurers offer a free check-up service, or you can purchase it as an add-on benefit.

Co-payment:

When purchasing a medical insurance policy, you will come across the word "co-pay." When you make a claim, a co-pay is a pre-determined amount that you must pay before your health insurance company will cover the balance of your medical expenditures.

Tax Benefits:

Under Section 80D of the Income Tax Act of 1961, you may be eligible for tax benefits for premiums paid on a health insurance policy. Tax benefits are available up to a particular level depending on the policyholder's age and the age of his or her parents (if any).

Family Discounts:

Various health insurance companies in India give this discount for registering any family member or individual in a health insurance policy. This is a type of incentive offered by health insurance to existing policyholders who refer others to them.

Types of Health Insurance Plans

1. Individual Health Insurance Plans
This is one of the top health insurance plans in India, and it is something that almost everyone is familiar with. Individual Health Insurance Plans, as the name implies, are specifically designed to safeguard a single person's health against a variety of severe illnesses for a single sum insured. Although family members might be covered under the finest Individual Health Insurance Plan, you will need to select a different Sum Insured for each family member. The Sum Insured is usually exactly proportional to the premium you pay for this health insurance online policy.
2. Family Floater Health Insurance Plans
Family Floater Health Insurance policies provide comprehensive medical coverage for all members of your family against a variety of illnesses and ailments for a single Sum Insured. This medical plan can cover your parents, spouse, and children under the age of 18. Individual mediclaim plans taken by each family member have a higher premium than a family floater health insurance plan. The importance of a family floater health insurance plan is that it covers all members of the family and also offers a fixed Sum Covered for all insured members for single or multiple claims filed throughout the policy term.
3. Group Health Insurance Plans
A Group Health Insurance policy is created for a group of co-workers. If you own a small business or a large corporation, you should purchase such plans for your employees. It is a type of benefit that is provided to employees. You can purchase the cover as an employer to increase employee retention. The Group Health Insurance Plan has a reasonable premium. If the sum covered is depleted, certain insurance companies allow you to refill it an unlimited number of times. Hospitalization due to an accident, illness, severe illness, psychiatric illness, or maternity is covered under a group health insurance plan.
4. Senior Citizen Health Insurance Plans
Senior Citizen Health Insurance Plan is a health insurance policy that is specifically tailored for persons over the age of 60. This is a wonderful option if your parents or grandparents are over the age of 60. A Senior Citizen Policy will cover the cost of drugs, hospitalisation due to an accident or disease, and therapy both before and after the hospitalisation. Before selling a Senior Citizen Health Insurance Policy, certain insurers may require a comprehensive physical examination. The maximum admission age has been raised to 70 years old, with the opportunity to renew for the rest of one's life.
5. Maternity Health Insurance Plans
Nowadays, almost all of India's finest health insurance firms offer maternity health insurance policies. This health insurance policy covers the costs of childbirth, prenatal and postnatal care, and even vaccinations for new born babies in some cases. To put it another way, a maternity health insurance policy covers all of your maternity expenses. However, the features and advantages of this specific health insurance plan may differ from one insurer to the other.
6. Critical Illness Insurance Plans
The critical illness plan, which is one of the best health insurance policies, is meant to give medical coverage to insured persons against a variety of critical illnesses that are defined in the policy. Getting treatment for critical diseases & surgeries is an expensive affair. The Critical Illness Plan will pay you a predetermined sum as soon as you are diagnosed with the sickness, regardless of the actual cost of treatment. Purchasing a Critical Illness Policy is the smartest decision you can make because it protects your savings. The policy can be renewed indefinitely. It includes diseases such as cancer, heart attack, kidney failure, paralysis, aorta graft surgery, stroke etc.
7. Top-Up Healthcare Insurance Plans
If you need more coverage, you can purchase a top-up policy. However, such plans include a "Deductible Clause." In the event of a claim, payment will be provided over and above the policy's stipulated limit.

If you think you don’t need a health insurance, read the fact below:

  • Health costs in India are rising at double the inflation rate and making the treatment unaffordable.
  • India’s COVID situation is amongst the worst in the world.
  • 95% of young Indians’ food habits are bad & unhealthy.
  • Increasing pollution level is increasing the critical diseases.
  • According to WHO, in next 10 years over 60 million people will die from a chronic disease in India.
  • Overweight people percentage has increases in last 10 years.
  • Heart Disease is the number one killer disease in India.
  • Mental Health Issues are on rise in India.

What is covered under a health insurance policy?

A health insurance policy's coverage is determined by the type of policy and the insurance provider. An excellent policy is adaptable to your needs and meets them to the greatest extent possible.

Some of the common inclusions of a health insurance policy are:

  • Expenses for inpatient hospitalisation
  • In case organ transplant, the donor's expenditures
  • Overnight stay in a hospital due to an injury
  • Pre-existing illness or disease
  • Pre & Post Hospitalization expenses
  • Ambulance Charges
  • Regular health check-ups
  • Maternity cost & childcare
  • Day care procedures
  • Treatment availed at home

Few things to keep in mind while buying a health insurance policy

When there are so many health insurance companies to choose from, it can be difficult to find one that meets your needs. However, before you select your insurance plan, here is a simple checklist to consider.

  • Make certain that the Sum Insured is correct. Consider whether or not it will suffice for you or your family.
  • Set the proper Sum Insured limit for your parents who are financially dependent on you.
  • Choose the plan with the shortest wait time.
  • Examine the maximum age-renewal rate.
  • Purchase health insurance from firms with a high claim settlement ratio.
  • Choose the insurance plan with the largest hospital network on their list.
  • Check the coverage a plan is offering, don’t just compare the premium.
  • Choose a health insurance company that offers health insurance portability

How to file a health insurance claim?

Our dedicated claim assistance team is there to help you with all what you need to file a claim. With the legacy of 12+ years we have a claim settlement ratio of 97%. Call our claim settlement team or apply for the claim by signing in into your account. You can email us at claims@zoominsurancebrokers.com

Frequently asked questions

If you choose the cashless option, your health insurance will either pay your hospital bills immediately or refund any payments you make toward medical expenditures incurred as a result of an illness or injury.

TWhile the age of eligibility for health insurance policies varies, adults generally have to be between the ages of 18 and 65. Children must be between the ages of 90 days and 18 years to be eligible.

You must clarify with your insurer whether your policy covers you across the country or only within certain limitations before purchasing the insurance. In most cases, a health insurance policy will cover you throughout India. Unless otherwise stated, the policy may not cover claims that occur beyond of India's geographical boundaries.

For a set period at the start of the insurance term, your insurer will not cover pre-existing illnesses. The waiting period is what it's called. Various pre-existing conditions have different waiting periods, so contact your insurer to learn more about your illness's waiting time. Certain pre-existing conditions are not covered by health insurance.

In a given year, you may file an unlimited number of claims. However, the claim amount should not exceed the policy's assured sum. For example, if you have a health plan of INR 2 lakh, you can only collect INR 2 lakh from your insurance.

At the time of emergency, you can get yourself treated at any non-network hospital and pay for the expenses. Later on, you can file a reimbursement claim from your insurance company. The insurer will ask for certain documents that you need to provide to get your claim.

Yes! Purchasing health insurance entitles you to tax benefits under Section 80D of the Income Tax Act of 1961.

Yes, you can do so at the time of policy renewal.

What is a Term Insurance Claim?

A term insurance plan is a significant part of your financial planning. Due to the uncertainty of life, you can never depend just on your reserved funds to accommodate your family's dreams. A term insurance plan goes about as a financial back-up for your family on account of any unfortunate event. A term insurance claim is filed by the policy beneficiary to the insurance company in order to avail the death benefit in case of the policyholder’s unfortunate demise. A majority of insurance companies offer a seamless claim processing facility so that the beneficiary can file claim and avail insurance coverage seamlessly.

The Right Process to Make a Claim

When the policy holder passes away, family members(dependants) or the nominee under the policy can send a claim intimation to the insurance company as soon as possible. In spite of the fact that your family might be in distress, they should not defer in making the claim. This is to stay away from any complexities in the process.

However, prior to intimating the insurance company, the beneficiary should keep in mind some important facts.

  • Insurance policy should be in force and all the premiums should be duly paid.
  • The situation for which you are filing the claim is filed should be covered under policy.
  • The things which are not covered in the policy.

Term Insurance Claim Process

Step 1: Inform the insurance company about the claim

The initial step is to inform the insurer about the claim. The nominee needs to present the claim settlement along with a death certificate & other required document. The required details for the intimation of claim are the name of the policyholder, policy number, date of birth of the insured, place of death, the cause of death, the name of the beneficiary, etc. You should inform the insurance company about the death of the policyholder within three months of the demise. You can either physically visit the branch for submitting the claim form, or fill the form online, and submit it for claim settlement.

Step 2: Assessment of claim by the insurance company

Once you have applied for the claim, the insurer will now assess your claim request. The documents are scrutinized & thoroughly checked. The insurance company can ask for more details & documents if needed.

If a claim is made within the 3 years of policy issued, the insurer does an additional investigation in order to ensure the genuineness of the claim. The insurer can:

  • Verify with the hospital whether the demised person was admitted in the hospital or not.
  • In case of a flight crash, the insurer can verify with the airlines whether the policy holder was the passenger of the flight or not.
  • If the death is due a critical illness, the insurer will ask the hospital the details like medical records, doctor’s certificate, etc.
  • In case of suicide, murder or accident then panchanama, police FIR report and post mortem report will be required.
Step 3: Documents Submission

The nominee should submit all the required documents as early as possible to accelerate the claim process and avoid and delay.

Step 3: Claim settlement

On the basis of the assessment & investigation, the insurer will now either accept or reject the term insurance claim. In the case of approval, the insurer will compensate the sum assured of the nominee. Alternatively, a rejection letter will be provided in the case of claim rejection, stating the reasons for rejection. The Insurance Regulatory and Development Authority of India (IRDAI) has mandated that insurance companies must complete the claim settlement within 30 days. As per IRDAI rules, in the case of the claim requiring further investigation, the claim has to be settled within six months.

Required Documents for term insurance claim submission (icons)

  • Duly filled claim form
  • Death certificate of the policy holder
  • Original policy documents
  • Identity proof documents of the nominee
  • Medical records of the policyholder
  • Last medical attendant physician certificate
  • Deeds of assignments/ re-assignments if any
  • Any other documents related to claim (such as FIR, Post mortem report etc)

Essential Inclusions and Exclusions

Term Insurance is applicable to both natural and unnatural death. For death by suicide cases, the claim settlement will be done after one year of taking the policy. Inclusions and exclusions of your policy depend on the risk factor that you possess. So, the policy benefits of a smoker’s would differ in comparison to that of a non-smoker. However, different plans of term insurance mostly offer the same benefits. The length of coverage would vary from one plan to another.

Term insurance claim rejection reasons

  • There are some chances of your term insurance claim if you have not provided the correct information in the claim form, or failed to submit the required documents.
  • Failure in updating nominee information
  • A lapsed insurance policy being lapsed because of non-payment of premiums.
  • Concealment of information, like not disclosing the correct medical history, or hiding lifestyle habits like tobacco or alcohol consumption

Tips to Avoid Term Insurance Claim Rejection

The following are the list of things you can do to avoid getting your claims rejected-

1. Making sure that the beneficiaries/nominees are well aware of the policy claim process.
2. Ensuring accurate information is being provided to the insurer at the time of buying term insurance. It includes everything from your existing medical condition, income, age, previous/existing policy details, etc.
3. Avoiding policy lapse due to non-payment of the premiums.
4. If the insurer is asking you to undergo a medical examination, you should.
5. Be well aware of the coverage of your term plan and its exclusions.
6. Mention the beneficiaries/nominees if you haven’t done that already.

Coming Soon

Coming Soon