An insurance claim is a formal request to an insurer asking for a payment based on the terms of the insurance policy. Insurance companies reject some insurance claims because of non-disclosure of important and related facts at the time of signing the contract. So if you want your insurance claim request to be successful, you should know the following three points.
1) Verified disclosure of facts:
Insurance contract includes additional provisions of insurable interest and duty of utmost good faith besides the provisions of the Contract Act 1872. The policyholder’s duty is to declare all the material facts affecting the risk under the insurance policy with utmost trust.
For example, at the time of getting insured, the person needs to specify the disease he’s suffering from, he is bound to mention any such facts. In case, the policyholder obtains a policy without stating this fact, he may be given the case based on his declaration, however, in case of an early demise, the insurer had the right to reject the claim as he has not disclosed related facts at the time of entering the contract. It is the duty of the insured to assure that non-genuine claims and claims arising due to non-disclosure of material facts are monitored.
You must know that an insurance contract is a unique contract where there is a duty of disclosure of material fact and one must give it a point to answer all questions of the proposal form precisely so that claims are paid on time without difficulty.
2) Rightful nomination:
Another important factor to claim insurance without any difficulty is authenticating to the insurance company that he is the rightful person authorized to receive the policy amount. An insurer has to pay to the rightful person entitled after validation.
- The insurer insists that the claimant is the legitimate person entitled to receive the policy money. Insurance law has a provision for nomination.
- The insurance company is discharged of its liability once it grants the amount of the insurance claim under a process established by the Insurance Act 1938.
- If there is no nominee, the claim can not be settled as the insurer can no grant the insured money. Every policyholder should make a valid nomination as per the requirements of Section 39 of the Insurance Act 1938.
- A nomination can be altered at any time while the tenure of the agreement and the life ensured is supposed to examine the nomination presented under several policies from time to time.
3) Submission of documents:
Timely and correct exact submission of documents to claim the policy payment is an added relevant aspect. The documents under any Life Insurance Claim come under the following three broad categories:
- Legal documents to prove the insured event happened.
- Documents to confirm that the event that happened is not excluded under the policy contract.
- Documents to confirm the identity and the fact that the claimant is the legitimate person to receive the policy money.
The insurer will only provide the request of a claim when all the documents are in place and verified. In case, original documents cannot be presented the process can be undertaken in which photocopies of all the documents are submitted.