Why timely claims are important
Life insurance is meant to cover families in times of adversity. But where a claim is delayed or rejected, it cancels out the exercise of having a policy in the first place. Families experience protracted delays or outright rejections from preventable mistakes or lack of knowledge about the claims processing process.
Non-disclosure of health conditions
The primary reason for claim rejection is improper or incomplete reporting of health facts at policy buying time. If the insurer finds that the policyholder has not reported pre-existing conditions like diabetes, hypertension, or smoking during the policy tenure, it can result in claim rejection. Proper disclosure of medical history is necessary so that the policy can become effective.
Lapse in premium payments
Another frequent issue is policy lapse due to missing premium payments. Even one missed payment after the grace period will cause policy lapse and therefore nullify any subsequent claim. While insurers now alert policyholders, it still takes remembering due dates and making constant payments to avoid issues.
Errors in documentation
Insufficient or defective documents often lead to delays. Timely and correct submission of records such as the death certificate, hospital documents, and identity proofs avoid unnecessary haggling with the insurer. Families should be aware of what documents are needed so that the claims process becomes smoother.
Disputes over cause of death
If the cause of death falls under exclusions—such as suicide in the first year of the policy, death due to participation in hazardous activities, or death due to involvement in an illegal activity—then the insurer is within its rights to reject the claim. Having exclusions explained at the point of sale and having nominees informed about them goes a long way in controlling expectations.
What you can do to ensure smooth claims
Policyholders are always required to provide proper information, maintain current premiums, and notify family members of policy details. Nominees should know the claims procedure of the insurer and maintain a ready file of documents. Choosing insurers with high claim settlement ratios also increases the chances of an instant and successful claim.
FAQs
How long does it take for a life insurance claim to be settled in India?
All the insurers are required by the Insurance Regulatory and Development Authority of India (IRDAI) to settle claims within 30 days of receipt of all documents. In case further investigation is needed, the period can be up to 90 days.
Can a rejected claim be appealed?
Yes. If the claim is rejected, the nominee can approach the insurer's grievance redressal mechanism, complain to the Insurance Ombudsman, or even sue it in consumer courts if necessary.
Does having multiple life insurance policies increase the chances of rejection?
No, as long as each of the insurers is informed of the other policies and all facts are disclosed honestly. Failure to disclose between policies, however, can be a ground for rejection.
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