What is Claim Settlement?
Claim settlement means the insurance company pays you or your nominee for a valid claim—after checking all documents and conditions. Fast, fair settlement is a key factor to look for when choosing an insurer.
Common Claim Types
Health Insurance Claims: Hospitalization or medical bills
Life Insurance Claims: Payment to nominee on policyholder’s death
Motor Insurance Claims: Repairs after accident or theft
Property/Home Claims: Damage or loss from fire, flood, burglary
How to File an Insurance Claim
Step 1: Notify Your Insurer Promptly
Contact your insurer right away (ideally within 24–48 hours for health or motor claims) via phone, app, or website. For health insurance, inform the insurer/hospital TPA before admission for cashless claims.
Step 2: Collect & Submit Required Documents
Common documents: Claim form, valid ID proof, policy certificate, bills/receipts, FIR (if needed)
Health insurance: Hospital discharge summary, prescriptions, bills
Motor insurance: FIR (if theft or serious damage), repair estimate, photographs
Life insurance: Death certificate, nominee ID, medical reports (if needed)
Step 3: Follow Up
Stay in touch with the insurer. You’ll receive a claim number—refer to this in all communications.
Step 4: Claim Assessment
The insurer reviews your claim, investigates (if required), and checks documentation.
Step 5: Settlement or Reimbursement
Cashless Settlement:
Insurer pays the hospital directly (for health claims with network hospitals).
Reimbursement:
You pay first, then insurer reimburses after verifying papers.
Step 6: Resolution
Approved claims are paid as per policy limits.
If rejected, you’ll get reasons in writing. You can appeal or escalate via the insurer, IRDAI, or insurance ombudsman.
Pro Tips for Easy Settlement
Always provide truthful, complete information while filing proposals and claims.
Keep photocopies of all documents and bills.
Review policy inclusions/exclusions and claim timelines.