Life Insurance Claims FAQ
Life Insurance
Claims FAQ
We at ICICI Prudential Life Insurance are committed towards fulfilment of our promise to you and your family. Death claims arising due to corona virus COVID 19 will be covered and processed as per the terms and conditions of the policy.
Hospitalization claims arising due to COVID 19 will also be covered by the Company for below products
*ICICI Pru Health Saver, Hospital Care & Hospital Care II
To report a claim you can:
- Visit the claims section of our website for online claim intimation:
- Call us at our 24 x 7 ClaimCare number – 1860 266 7766:
- E-mail us at claimsupport@iciciprulife.com:
- Visit your nearest ICICI Prudential Life Insurance Branch. Please click here to check the list and timings of our active branches
We have a 3-step claim process:
Step 1: Claim Reporting
The first step involves reporting your claim. You can report your claims online, at our branches, central office, via SMS, e-mail or through our call centre as per your convenience. However, claims reported online, through SMS or e-mail will not be considered as intimation. Physical documents will be required to start the process.
Step 2: Claim Processing
Our special ClaimCare team will assess your claim, and inform you in case any further documents need to be submitted. Post receiving all the necessary documents, we will process your claim request.
Step 3: Claim Settlement
Once your claim is intimated and we receive all the relevant documents, we will settle your claim.
To report your claim you can:
- Visit the claims section of our website for online claim intimation
- Call us at our 24 x 7 ClaimCare number - 1860 266 7766^
- Visit your nearest ICICI Prudential Life Insurance branch
- E-mail us at claimsupport@iciciprulife.com
- SMS 'ICLAIM<space>Policy No' to 56767
Your claim will be formally registered only after receiving a written claim intimation at our branch/Claims Cell.
^For calls within India. Our overseas customers can call us on +91 22 6193 0777.
- To get a list of the documents required while reporting a Death Claim, please Click Here
- To get a list of the documents required while reporting a Hospitalisation Claim, please Click Here
Once we receive a written intimation and all the required documents, we assess, settle and communicate the decision. We transfer most of our pay-outs through electronic modes, to speed up the claim settlement process.
| Turn Around Time as mandated by Insurance Regulation and Development Authority of India (IRDAI) | Death claims | Health claims |
|---|---|---|
| Raising Claim Requirements | Within 15 days of receipt of claim | Within 15 days of receipt of claim |
| Settlement or Rejection or Repudiation of claims wherein Investigation is not required | Within 30 days from the date of receipt of last necessary document | Within 30 days from the date of receipt of last necessary document |
| Settlement or Rejection or Repudiation of claims wherein Investigation is required | Investigation should be completed not later than 90 days from the date of receipt of claim intimation and the claim shall be settled within 30 days thereafter | Investigation should be completed not later than 30 days from the date of receipt of last necessary document and the claim shall be settled within 45 days from the date of receipt of last necessary document |
A claim is rejected if 'non-disclosure' or 'misstatement' of facts is discovered during an investigation. When a fact that affects the policy issuance decision is not disclosed in the proposal, it is termed as, 'non-disclosure'. Similarly, withholding information or providing incorrect information while answering questions in the proposal form^^ is termed as, 'misstatement'.
For example, when an applicant suffering from kidney failure does not inform the insurer about the same in the proposal form, it is termed as non-disclosure. Similarly, when an applicant overstates his or her income, then it is called a misstatement.
^^Proposal form is the document in which you provide all the relevant details while applying for an insurance policy.
We consider the cause, duration of the policy and circumstances of the claim while asking for the requirements. For example, for accidental death claim, specific documents such as post-mortem and police report are required. Whereas for death due to an illness, records from the hospital and test reports will be needed to process the claim.
*Claimant is the person who reports the claim.
We examine and settle claims on the basis of all records related to the claim. Once you report a claim, we request you to submit the required documents. The sooner the documents are submitted, the faster your claim will be processed. In case you need any clarification or assistance, you can contact our officials by calling us on 1860 266 7766* or visiting the nearest ICICI Prudential Life Insurance branch.
*For calls within India. Our overseas customers can call us on +91 22 6193 0777 (call charges as applicable)
To report a claim, you have to fill in the required details that are listed in the claim form. You can get this claim form and the list of required documents by:
- Taking it from the policy document in the welcome kit provided to you when your policy was issued
- Visiting your nearest ICICI Prudential Life Insurance branch
- Reaching out to our advisor
- Checking the Claims section of our website
The claim benefit can be received by:
- The nominee* or the guardian (in case of minor nominee), if you are the Life Assured
- The proposer, in case you are not the Life Assured^
- Assignee, in case the policy is assigned
- Life Assured, in case of living benefit claims such as, claims under disability, critical illness and major surgery rider.
* Nominee is the person you appoint at the time of purchase for receiving the benefits of your insurance policy in your absence.
^Life Assured is the person for whom the life/health insurance policy has been issued.
We honour claim payments through cheque or Electronic Clearance System (ECS)^ as per your convenience.
Cheque Payments:
- A cheque is drawn on ICICI Bank
- It is sent to you at the address mentioned in the intimation form* or statement
- In non-serviceable areas, the cheque is sent to a local branch with an instruction to forward it to you
Electronic Clearing Service:
- You need to submit the ECS instructions along with a cancelled cheque
- The claim amount will be transferred directly to your bank account
^Electronic Clearance System or ECS is the mode to transfer your money electronically from one bank account to another. It can be used for debit and credit purposes.
*Claim intimation form is the document in which you provide all the relevant details required while reporting the claim.
A claim will be declined if it does not comply with:
- Declaration and Authorisation agreed at policy inception, as mentioned in the application form
- Terms and Conditions in the policy document
During FY2021-22:
Our average turn-around time for settling a claim is 1.5 days>
We have a Claim settlement Ratio of 97.8%~
>Average turnaround time for non-investigated retail death claims from receipt of last requirement as per Annual report for FY2022
~Claim statistics are for Financial Year FY2021-22 and is computed basis individual claims settled over total individual claims for the financial year. For details, refer to our Annual Report for FY2022
The percentage of claim settlement ratio is computed as follows: Number of individual claims settled ÷ Total number of individual claims (outstanding at the beginning of the year + intimations for the year) × 100.
Please find the list of documents required for a Critical Illness^ Claim here.
^The critical illness benefit is an accelerated benefit and the death benefit will be reduced by the critical illness cover paid to the policyholder. The future premiums payable for the residual CI Benefit will reduce proportionately. In case the CI Benefit equal to the Death Benefit, the policy will terminate on payment of the CI Benefit. Only doctor’s certificate confirming diagnosis needs to be submitted. On payment of Angioplasty, if the CI Benefit is more than `5,00,000 the policy will continue for other CIs with CI Benefit reduced by Angioplasty payout. To know more about the illnesses covered, please refer to the Sales brochure. Available under Life and Health and All in One options.
Please find the list of documents required for an Accidental Death Claim here.
+Accidental Death benefit is up to `2 Crores. Accidental Death Benefit is available in Life Plus and All in One options.
We offer Claim For Sure. It guarantees death claim settlement in 1 day*. It offers quick and hassle-free claims service when your family needs it the most. It also pays interest# on claim amount on every day of delay beyond one working day.
To avail Claim For Sure
- Policies that have been active for 3 consecutive years^
- All Mandatory claims documents** are submitted at branch
- Total claim amount of all the life policies held by the Life Assured <= ₹ 1.5 Crore
- Claim does not require any on- ground investigation
- Working day will be counted as Monday to Friday##
COMP/DOC/Jan/2023/271/2138
* 1 Day is a working day, counted from the date of receipt of all relevant documents from the claimant, additional information sought by the Company and any clarification received from the claimant. The Company will be calling the claimants for verification of information submitted by the Claimant which will also be considered as part of relevant documents..
## Working day will be counted as Monday to Friday and excluding National holidays /Bank holidays/Public holidays.
# 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.
** Mandatory documents to be submitted at Branch Office- Claimant statement form, Original policy certificate, Copy of death certificate issued by local authority, AML KYC documents- Nominee’s recent photograph ,Copy of Nominee’s pan card, 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, Panchnama, Inquest report, Postmortem report, Driving license.
^ All due premiums in the policy have been paid and the policy has been active for 3 consecutive years preceding life assured’s death.
Under ULIP policies, if claim is submitted prior to 3 pm then the claim will be considered under Claim For Sure on the same day. If claim is submitted post 3pm or if the policy is inactive at the time of claim notification then the claim will be considered under Claim For Sure the next day as per availability of NAV.
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