The settlement of claims is a very important aspect of service to the policyholders. Hence, the Corporation has laid great emphasis on expeditions settlement of Maturity as well as Death Claims. The procedure for settlement of maturity and death claims is detailed:
Maturity Claims:
In case of Endowment type of Policies, amount is payable at the end of the policy period. The Branch Office which services the policy sends out a letter informing the date on which the policy monies are payable to the policyholder at least two months before the due date of payment. The policyholder is requested to return the Discharge Form duly completed along with the Policy Document, NEFT Mandate Form (Bank A/c Particulars with supporting proof), KYC requirements etc. On receipt of these documents payment is processed in advance so that maturity amount gets credited to the policyholder's bank A/C on the due date.
Some Plans like Money Back Policies provide for periodical payments to the policyholders provided premium due under the policies are paid up to the anniversary due for Survival Benefit. In these cases where amount payable is up to Rs.500,000/- payments are released without calling for Discharge Receipt or Policy Document. Survival Benefit under Jeevan Anand policies up to Sum assured Rs. 200000/- is also released without calling for policy bond or discharge form. However, in case of higher amounts these two requirements are insisted upon.
Death Claims:
The death claim amount is payable in case of policies where premiums are paid up-to-date or where the death occurs within the days of grace. On receipt of intimation of death the Life Assured the Branch Office calls for the following requirements:
Claim Form A – Claimant’s Statement giving details of the deceased and the claimant.
Certified extract from Death Register.
Documentary evidence of age, if age is not admitted.
Evidence of the date of the deceased’s estate if the policy is not in force, assigned or issued under M.W.P. Act.
Additional Forms (Within Three Years):
Claim Form B – Medical Attendant’s Certificate to be completed by the Medical Attendant of the deceased, during his/her last illness.
Claim Form B1 – if the life assured received treatment in a hospital.
Claim Form B2 – to be completed by the Medical Attendant who treated the deceased life assured prior to his last illness.
Claim Form C – Certificate of Identity and burial or cremation to be completed and signed by a person of known character and responsibility.
Claim Form E – Certificate by Employer if the assured was employed person.
Certified copies of the First Information Report, the Post-mortem report and Police Investigation Report if death was due to accident or unnatural cause.
Double Accident Benefit Claims:
Double Accident Benefit is provided as an additional benefit to the life insurance cover. For this purpose, an extra premium of Rs.1/- per Rs.1000/- S.A is charged. For claiming the benefits under the Accident Benefit the claimant has to produce the proof to the satisfaction of the Corporation that the accident is defined as per the policy conditions. Normally for claiming this benefit documents like FIR, Post-mortem Report are insisted upon.
Disability Benefit Claims:
Disability benefit claims consist of waiver of future premiums under the policy and extended disability benefit consisting in addition of a monthly benefit payment as per policy conditions. The essential condition for claiming this benefit is that the disability is total and permanent so as to preclude him from earning any wage/compensation or profit as a result of the accident.
Claims Review Committees:
The Corporation settles a large number of Death Claims every year. Only in case of fraudulent suppression of material information is the liability repudiated. This is to ensure that claims are not paid to fraudulent persons at the cost of honest policyholders. The number of Death Claims repudiated is, however, very small. Even in these cases, an opportunity is given to the claimant to make a representation for consideration by the Review Committees of the Zonal office and the Central Office. As a result of such review, depending on the merits of each case, appropriate decisions are taken. The Claims Review Committees of the Central and Zonal Offices have among their Members, a retired High Court/District Judge.