CLAIM GUIDANCE

Settlement of any insurance claim within proper time and for the proper amount have the same importance as taking the insurance.

Some time unnecessarily delay  and undue deduction in claim amount  defeated the  object of Insurance

Proper guidance , sufficient knowledge and right procedure is the only way to come out  from any adverse  situations in claim settlement.

Insured being the policy holder know your Right.

The IRDA provided in his guidelines for settlement of grievances of policy holder with in prescribed time limit .This all process comes under PPHI Regulation 2002 and regulator has given the detail guidelines and time limit w.e.f. July 2010.

  1. The time limit For settlement of grievance  is TWO WEEKS.

  2. Insured if not satisfied with the reply of Insurer , can go to Insurance Ombudsman . The Ombudsman has the authority to settle the case up to 20 Lakh.

  3. Still the Insured is not satisfied he can go to the Consumer Forum and he  need not to contact Ombudsman before going to Consumer Forum.

We being the claim consultant provide you the consultancy in your time of needs through our expert and experience consultant.

  Our main services are as under

Procedure & guidelines on all type of  claim .

Expert Advise on your routine and specific claim.

Legal  and grievances proceeding on claim with Grievance Department of Insurer, IRDA ,Insurance Ombudsman and Consumer Forum.

Guidance in Court case through our  advocate and Legal Expert.

We also provide you Corporate Consultant for your day to day , regular and routine requirement in claim and insurance .

 Different Important documents required for different Claims

  1. Intimation / Claim Notice
  2. Claim bill / Estimate
  3. F I R / Final Report
  4. Claim Form
  5. Fire Brigade Report
  6. Inspection Report
  7. GR / Bill of Lading / AWB / Bill of entry  etc.
  8. Damage Certificates / Technical Report
  9. Bill / Cash Memos
  10. Survey Report
  11. Accounts Book / Stock Register
  12. Doctor’s Report / Post Mortem Report

Important and valuable rules about Different Personal line Claims

FIRE CLAIM:-

Fire claim may be on Building , Stocks or Contents.

Normally deduction in claims is due to under insurance , average clause or excess clause.

The Claims are not payable happens due to excluded perils.

MOTOR CLAIMS :-

The amount in claims may be deducted f due to depreciation and excess clause.

The claim is not payable in case of wrong declaration to avail NCD

PERSONAL ACCIDENT

The amount of claim may be deducted for medical expenses over the limit of policy. Weekly expenses are paid only for the period required and the rest is deducted from the claim.

The claim are rejected if misshaping due to other than accident.  

HEALTH INSURANCE

The amount of claim in Health Insurance may be deducted for Admission Charges , Excess Clause , Consumable and the amount exceeds in a particular Head.

The claim may be rejected for deceases excluded from the coverage of policy , For Pre exesting Deceases and claim during the first 30 days of the policy.

HOUSEHOLDERS INSURANCE

Being the different section in the householders insurance , the claim may be deducted as per the different clause applicable  in the  different section for excess , depreciation ,average and under insurance.

Life Insurance

Leave A Reply

Your email address will not be published. Required fields are marked *