The insurance claim process in India varies slightly depending on the type of insurance (health, motor, life, etc.), but the general steps are fairly consistent across the board. Here’s a basic breakdown of how it works:

General Insurance Claim Process (Health, Motor, etc.)

1. Intimation of Claim

• Inform the insurance company about the incident (hospitalization, accident, theft, etc.) as soon as possible.
• Most insurers allow this through their website, mobile app, customer care, or even WhatsApp.
• For motor insurance, this should be done before repairs begin (unless it’s an emergency).

2. Submit Required Documents

• Common documents include:
  • Claim form (duly filled)
  • Policy documents
  • FIR (in case of theft/accident)
  • Hospital bills or repair estimates
  • Medical reports or discharge summary (for health)
  • Photos of damage (for motor)
• Each type of insurance has specific documentation needs.

3. Surveyor/Assessor Visit (if required)

• For motor and property claims, a surveyor may inspect the damage.
• For health insurance, especially cashless claims, the insurer deals directly with the hospital.

4. Claim Evaluation

• The insurer assesses the claim to determine if it is valid and how much is payable.
• They may request clarifications or more documents.

5. Claim Settlement

• If approved, the payment is made to:
  • The hospital (for cashless health insurance)
  • The insured (reimbursement claims)
  • The garage (in case of motor cashless repair)
• Timelines are usually within 7–30 days, depending on complexity.

Life Insurance Claim Process

1. Claim Intimation

• Notify the insurer of the policyholder’s death as soon as possible.
• Provide policy number, name of the deceased, and date of death.

2. Documentation

• Key documents:
  • Death certificate
  • Claim form
  • Policy document
  • ID proof and bank details of the nominee
  • Medical records (if applicable)
  • FIR/post-mortem report (for accidental/suspicious death)

3. Verification and Assessment

• The insurer verifies the claim details.
• May involve investigation, especially if the policy is new or death was within the first 3 years.

4. Settlement

• Once approved, the sum assured is paid to the nominee.
• IRDAI mandates settlement within 30 days of receiving all documents.

Tips to Ensure Smooth Claim Process

• Always read your policy carefully and know what's covered.
• Keep all premium payment receipts and policy documents safe.
• Notify your insurer promptly.
• Keep a checklist of required documents for different scenarios.