Under life insurance plan, the insured has different conditions for receiving the claim payment. Conditions for payment of claims are determined on the basis of the facilities offered by the insured and the type of insurance policy.
The insured or the person or claimant desired by the insured must complete the pre-determined formalities and procedures to receive the claim payment.
Under such formalities, from the paperwork required for the payment of the claim to the time period is also fixed. Lack of adequate documentation or insurance claims made beyond the stipulated time may be rejected or put on hold by the insurer.
There are different types of claims made under a life insurance plan. Advance Payment Claim, Maturity Claim, Premium Discount Facility, Monthly Income Benefit, Educational Expenses Facility, Partial or Full Disability Facility.
Here's a look at some of the steps you can take to begin the process of preparation for mediation.
1. Formalities for maturity claim
The amount that the insured receives from the insurance company after the completion of the insurance period is the amount paid for the maturity claim.
Generally, the insurance company sends advance notice to the insured to come to collect the claim payment after the completion of the insurance maturity period. However, due to weak regulation, it has not yet been fully implemented in Nepal.
Therefore, the insured himself should be careful and claim for payment before the insurance company after the maturity of the insurance period.
A. Fill and submit the application form for claim payment.
B. When filling and submitting the application form, the insured should also mention the details related to his bank account in the application form or handwritten application.
C. To provide a photocopy to the insured by showing the original copy of his / her identity or passport.
D. To transfer the file with the original insurance policy by attaching the application to the branch or sub-branch office of the insurance company.
E. After all the necessary procedures have been completed, the insurance company will sign the claim formalize form with the insured before paying the claim.
F. In case of application along with all the paperwork, the insurer will provide the claim payment check within one hour or deposit the amount directly in the bank account of the insured.
2. Formalities for Death Claims
A person holding a life insurance plan is called an insured and when he dies, a written claim notice must be sent to the insurance company as soon as possible.
In the absence of the designated person mentioned in the insurance policy and in the absence of such person, the legally close heir can report the death of the insured or any close relative or agent can also give information.
Claim information about the death of the insured should include information such as date, place and cause of death. It is the duty of the insurance agent to facilitate the insured for this.
The following documents must be submitted for a death claim:
- Filled claim form (should be registered by filling all the details in the claim form provided by the insurance company)
- Death registration certificate of the insured
- Original documents of insurance policy
- Details of the Claimant
- Claimant's identity revealing (citizenship or passport)
- Documentary evidence to prove the relationship of the next of kin if the insured has not nominated anyone as the desired person in the policy.
- Police investigation report or post-mortem report in case of death, suicide or homicide due to accident.
- Documentary evidence of hospital treatment in case of death during treatment.
If the insured has transferred the power of insurance policy by taking a loan from an institution, it may have been transferred to another person or entity - such as housing loan, bank loan, loan from a company he works for. In this case, the insured will be the sole authorized company.
The company must complete the necessary investigation and pay the claim to the insured within 15 days of the death claim. However, in case of non-receipt of required documents for the claim or in case of doubtful claim, the company may conduct necessary investigation.
However, in case of unnecessary delay, the insured can file an application at the office of the Insurance Committee, Kupandal, Lalitpur, demanding payment of the claim.
Read this: How to Become an Agent of Life Insurance Company?