Step-by-Step Guide to Filing an Insurance Claim Successfully.

 Step-by-Step Guide to Filing an Insurance Claim Successfully

When purchasing an insurance policy; be it a health, motor, or life insurance, we tend to concentrate on the coverage and benefits only. When it is time to make a claim in reality, however, most individuals become confused or intimidated.

Such questions as Will the company approve my claim? What documents I need? or What in case my claim is not approved? are really widespread.

Don’t worry! This simple stepwise manual will assist you to learn on how to make an insurance claim successfully, prevent errors, and ensure your claim is handled without hassles.

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Step 1: Get a Good Command of Your Policy.

You can use a few minutes to read and comprehend your insurance policy first before you can make a claim. It might be considered boring but it comes in handy later.

Look for key details like:

• What is covered (accident, hospitalisation, theft etc)

• The claim limit/sum insured.

• Waiting periods (characteristic of health insurance)

• Exclusions the situations or scenarios that are not addressed.

Pro Tip: It is always good to have a soft copy of your policy on the phone or email. It is a life saver when there are emergencies.

Step 2: Notify Your Insurance Company as Soon as possible.

The first step to take when an incident occurs, an accident, robbery, hospitalization, etc. is to report these to your insurer.

Each company has time limit (24 or 48 hours) to report the occurrence.

You can do this by:

• Calling customer care.

• Sending an email.

• The insurer has its own web presence or a mobile application.

• Also ensure that you obtain a reference or claim number that you will use to keep track of this.

Step 3: Prepare and Gather All the necessary documents.

A successful insurance claim is based on proper documentation. The lost papers may also postpone or even dismiss an acceptable claim.

The following is what you can probably require:

For Health Insurance:

• Bills and discharge summary at hospital.

• Doctor’s prescription

• Diagnostic reports

• Policy copy and ID proof

For Motor Insurance:

• Driving licence and RC copy

• FIR (if applicable)

• Photos of damage

• Repair estimates

For Life Insurance:

• Death certificate

• Policy document

• ID evidence of nominee and insured individual

Store physical and electronic copies. You can even make a folder in Google Drive so that you can access it easily

Step 4: Complete the Claim Form Another step is to fill the Claim Form.

Then there is the claim form that is found on the office or the website of your insurer.

You have plenty of time to fill it out. Recheck all the details- name spelling, policy number, dates and contact details. Even the slightest error will lead to unnecessary delays.

Securely attach all documents to it and in case of an online filing, upload clean scanned copies.

Trick: Before submitting the details of your bank account, always review the details and particularly where it relates to reimbursement claims.

Step 5: File the Claim and Check in on it Frequently.

When you are ready, make your claim- either on-line or in the branch of the insurer. You will be given a reference number of acknowledgment or claims (unless you already have it).

Enter the number in the insurer web or app to monitor the status of the claim.

In case of missing any documents, the company will call you. Respond promptly.

Personal Note: I normally have an alarm to remind me to look at claim status after every few days. An apolitical follow up email or phone call can help in haste.

Step 6: Get an insight into Claim Assessment and Settlement.

Once you have submitted your claim, all documents will be reviewed by your insurer in order to determine whether your policy is valid. This is referred to as claim assessment.

In case all are good, your claim shall be approved, and the payment shall be made straight to your bank (reimbursement) or straight to the hospital/garage (cashless claim).

If it’s rejected, don’t panic. You will be provided with the written explanation. You may always make an appeal or a complaint in case you feel that the decision is unjust.

Pro Tip: E-mail communication as much as you can- this would make you be able to keep a proper track of all the communications that you receive