Personal Accident Insurance Claims

There are three types of claims for personal accident: Death, Permanent & Partial Disablement, Temporary disablement claims.

  • In case of any accidental claim, intimate the claim to the insurer in writing or give a call at the toll free number of the policy giving full details of the claim. A claim number will be generated.
  • Depending on the nature of the claim, documents are to be submitted to the insurance company for processing.
  • On receipt of documents, the claims scrutiny is done by the insurer as per policy coverage.
  • For approved cases, settlement letter is mailed/couriered to the insured/proposer and payment is released through NEFT/RTGS by the insurance company.
  • For queried cases, query letter is sent to the client requesting for additional documents/information. Reminders are sent to the client and if the requested documents are not received after reminders, the claim closure letter is sent to the insured.
  • For rejected cases, rejection letter is sent to the insured mentioning sufficient reasons as per the terms and conditions of the policy.

Documents for Claim

The following is an indicative list of documents required for processing a claim:

Death Claim

  • Policy copy
  • Claim form
  • Attending doctor’s report with Medico Legal Certificate (MLC)
  • Original death certificate
  • Original / attested post mortem / coroner’s report
  • Attested copy of FIR /Panchnama
  • Police Inquest Report, where applicable

Disablement Claims

  • Policy copy
  • Claim form
  • Attending doctor’s report with Medico Legal Certificate (MLC)
  • Original disability certificate from the doctor
  • Investigation / laboratory reports and other medical case papers
  • Original discharge summary if hospitalised
  • Attested copy of FIR /Panchnama
  • Police Inquest report, where applicable
  • In case of permanent total disability, disability certificate from competent authority

Weekly Benefit Claims

  • Policy copy
  • Claim form
  • Attending doctors report with Medico Legal Certificate (MLC)
  • Attested copy of FIR /Panchnama
  • Original disability certificate from the doctor
  • Investigation / laboratory reports and other medical case papers
  • Employee leave certificate with grade / designation from the HR of the company.

  The above is a brief summary of the claims process and documentation, and not to be taken as exhaustive. The surveyor/Insurer/TPA may call for additional requirements on case to case basis.