No insurance coverage coverage can serve its actual function with no correct declare settlement course of. Be it well being, life, motor, property or any form of insurance coverage, the complete function of shopping for insurance coverage is futile if it can not give monetary safety throughout declare settlement.
Although the Insurance Regulatory and Development Authority of India (IRDAI) has made it mandate for insurance coverage firms to settle insurance coverage claims inside 30 days of receipt of the paperwork, some declare settlement processes take longer than anticipated.
Balachander Sekhar, Co-founder, RenewBuy, says, “Knowing the key do’s and don’ts of the claim settlement process can ensure people that their claim is settled on time and in a hassle-free manner.”
Contacting the insurance coverage company on the earliest: Whether it’s a life insurance coverage or medical insurance coverage, step one to making sure that the policyholder will get the declare on the proper time is to shortly appraise the involved insurer in case of any disaster scenario.
Sekhar factors out, “Consumers should adhere to the timeline for filing a claim in the insurance policy. If the request for claim settlement is not filed within the time frame advised, the process may become more time-consuming.”
Checking declare settlement ratio: Industry consultants say, customers usually skip this step; they don’t test the declare settlement and solvency ratio of the insurer. As per IRDAI, insurance coverage firms ought to keep a solvency ratio of 150 per cent, to attenuate the danger of chapter.
Sekhar says, “A good solvency ratio helps consumers identify if the insurance company is financially capable of settling claims in difficult situations. An insurance company should be capable of solving both short-term and long-term claim settlement issues.”
Submitting full data: It is vital to tell the insurance coverage firm, of all needed particulars like medical historical past, household historical past, and vital belongings whereas filling up the kinds.
“One should attach all the necessary bills, copies of insurance cards and other relevant documents while submitting the forms. Without proper support of documents, claims cannot be validated. The majority of the challenges are faced by the consumers, due to the non-clarity of documents,” explains Sekhar.
Stating right medical historical past and details: In the case of well being and life insurance coverage insurance policies, medical data play an important function within the underwriting course of and this underwriting is additional essential for due declare settlement.
Sekhar says, “A false medical status can lead to re-investigation of claim and an eventual rejection can take place, in case of any major discrepancy. Thus, consumers should disclose the correct information in case of buying an insurance policy.”
He additional provides, “There has been an ample number of cases where claims have got rejected due to false medical disclosure from consumers and this remains one of the major challenges that the industry is facing even today.”
Knowing insurance coverage rights: IRDAI gives policyholders with sure rights. For occasion, if a declare settlement request is just not accepted or rejected inside 30 days from the receipt of the final needed doc, the insurance coverage firm shall be liable to pay penalty curiosity to the insured individual.
Similarly, Sekhar factors out, “there are many other parameters that an insurer should be aware of, which will help them settle their claims on time, or receive compensation in case there is a slip by the insurance company. Consumers should be aware of their basic insurance rights.”
Conclusion
Settling claims has by no means been simple, both for insurers or customers. However, excerpts say by conserving just a few very important factors in thoughts, customers could make their declare settlement course of seamless.
Sekhar concludes, “Awareness and acting upon the awareness, are crucial for any insurer or consumer to avail of the best possible insurance services. It is always advised to take the route of a digitally enabled insurance advisor, who can guide consumers with the best suitable insurance products as per their needs and requirements.”
Source: www.financialexpress.com”