One of the most crucial constituents for an insurance company to build credibility and trust with its clients remains the claim settlement process. That is the Moment of Truth for an insurance company and the reason for their existence. However, it is also the oft cited irritant and cause of concern for many already insured or those seeking to be insured. Having said that, the responsibility for a smooth claim settlement is as much on the customer as on the insurance company.
The common complaints that one hears about the insurance claim settlement are; “The insurer simply does not want to pay so is making excuses! My insurer took almost six months to settle my claim! It was really cumbersome and painful to claim insurance!”
The differences between the insurer and insured arise primarily due to lack of understanding of the policy purchased, or submission of incorrect information related to health, income etc. when filling up the proposal form at the time of buying the policy. Like in case of accidental death, specific proofs such as post mortem and police reports are required. For death due to illness, insurance companies need hospital records, test reports etc. It is therefore necessary for the insured or claimant to know about the legal documents and forms required to be submitted before making a claim.
All the information required to file a claim is available on company websites and you can also call up the call centre for details. There is very remote chance of your claim not being settled within the stipulated time of submitting requisite documentation.
Let me explain this better with an example. Mrs. Sharma aged 32 years, unfortunately lost her life partner in a road accident within 2 years of purchasing the insurance plan. Though she submitted all the required papers with the insurance company, the company turned down her claim. What went wrong despite her submitting the papers? While her other legal papers were fine, her husband had failed to mention an existing heart condition that was the cause for death as per the medical report submitted. So was the insurance company being unreasonable? A person has to remember that one of the parameters that the underwriters look at when deciding eligibility for insurance or the premium that should be charged is the health declaration. While any product with high life cover comes with a medical test, there are products which are issued basis ‘Declaration of Good Health’ also. Hence it is extremely critical that you declare your health, income status among other information honestly in the insurance proposal form.
Adhering to the procedure will ensure a smooth claim experience with the company.
The author is Director Bancassurance, PNB MetLife