What is an insurance claim?

An insurance claim is a formal request to your insurance provider for reimbursement against losses covered under your insurance policy.

Insurance is a financial agreement between you and your insurer. You have to pay a fixed premium. And in exchange, the insurance provider offers financial cover for losses based on the policy terms.

When the event covered under your policy occurs, a claim must be filed. The purpose is to notify the insurer that the event for which you have opted for an insurance has occurred and the insurer should pay the claim amount.

How does an insurance claim work?

An insurance claim acts as a safety net against financial losses.

Unforeseen expenses like medical emergencies, accidents, and life’s uncertainties can cause immense economic distress. Insurance claims can provide relief in such unfortunate events.

The funds can cover medical bills, act as income replacements, and help your family meet their living costs. If you have financial dependents, claim payouts can serve as a lifeline if your family loses the support of your income.

Processing a claim involves the following stages:

  • When an unfortunate event occurs, the incident must be reported to your insurance provider. This process is known as raising a claim.
  • Filing a claim involves filling up claim forms on the insurer’s website or branch office.
  • Documents supporting the genuineness of the claim must also be submitted.
  • Then the insurance provider reviews the claim, assessing its validity.
  • If it meets the terms and conditions stated in your policy, the insurer approves the claim.
  • Once approved, the insurance company pays the benefits specified in your policy document. For life insurance claims, your beneficiary receives the payout.
  • The insurer might provide an upfront lump-sum amount or it might stagger the payout as regular payments based on the terms of your policy.

The time insurers take to verify and pay the insured sum varies on a case-to-case basis. If the documents are in order, claim settlement takes only a few days. To make sure claims are disbursed without delay in times of need, you must look into the insurer’s credibility and customer service record before buying insurance.

However, when you buy insurance, you must disclose all details about your health and lifestyle habits to your insurer. If you suppress or misstate any fact, the insurer can reject claims on your policy.

COMP/DOC/Oct/2020/610/4559

We settle your claim in 3 quick and simple steps

Step 1 – Claim Reporting

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The first step involves reporting your claims. You can report your claims online, at our branches, at our central office, on our central ClaimCare helpline, through SMS or e-mail~

Step 2 – Claim Processing

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Our special ClaimCare team will assess your claim, and inform you in case any further documents need to be submitted.

Step 3 – Claim Settlement

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Once your claim is intimated, and we receive all the relevant documents, we will settle your claim.^
 

For the first time we have launched Claim For Sure for customers like you

ICICI ClaimForSure

 

*Day 1 is counted from the day of receiving the last document. All due premiums in the policy have been paid and the policy has been active for a continuous period 3 years. Mandatory document to be submitted at Branch Office before 3pm on a working day- Original policy certificate, copy of death certificate by local authority, Nominee’s current address proof, photo identity proof, Cancelled cheque. Copy of bank passbook, Copy of medico legal cause of death, Medical records (Admission notes, Discharge / Death summary, Test reports, etc.). For accidental death – Copy of FIR, Panchanama, Inquest report, Driving license. Interest shall be at the bank rate that is prevalent at the beginning of the financial year in which death claim has been received. In case of breach in regulatory turnaround time, interest will be paid as per IRDAI regulations.

 

 

 

You can depend on us

We are committed towards the fulfilment of our promise to you and your family. We are happy to share that our claim settlement ratio is one of the highest in the industry.

At ICICI Prudential Life, we believe that every claim represents fulfilment of a promise made to our policyholders. We are committed to securing the future of your loved ones, in a manner that’s quick and efficient. Accessibility, sensitivity and efficiency are the values that drive our claims philosophy.

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Reporting a death claim

Report a claim in case of the unfortunate demise of your loved one. Please click the link below to view the documents required.

view documents for death claims
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Reporting a health claim

Report a claim in case of a medical emergency such as hospitalisation. Please click the link below to view the documents required.

view documents for health claims

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*Claim statistics are for Financial Year 2019-20 and is computed basis individual claims settled over total individual claims for the financial year. For details, refer to Public Disclosures in our Website.
~Claim will be formally registered after we receive us a written request of your claim at our branch or Claims Cell office.
^Provided no investigation is required.

#Day 1 is counted from the day of receiving the last document. All due premiums in the policy must have been paid and the policy must have been active for a continuous period of 3 years. Mandatory document to be submitted at Branch Office before 3pm on a working day- Original policy certificate, copy of death certificate by local authority, Nominee’s current address proof, photo identity proof, Cancelled cheque, Copy of bank passbook, Copy of medico legal cause of death, Medical records (Admission notes, Discharge / Death summary, Test reports, etc.). For accidental death – Copy of FIR, Panchanama, Inquest report, Driving license. Claim documents submitted prior to 3pm will be considered for ULIP policies. Interest will be paid on claim amount for every day of delay beyond 1 working day. Applicable only for non-investigative death claims. Interest shall be at the bank rate that is prevalent at the beginning of the financial year in which death claim has been received. In case of breach in regulatory turnaround time, interest will be paid as per IRDAI regulations.

COMP/DOC/Aug/2018/38/1499.

 

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