Life Insurance Claims

What are the situations when claims under life insurance arise? A Life Insurance Policy results into claim in the following situations: On maturity of the policy i.e. completion of the term for which the insurance was taken in case of endowment policies ; or On death of the life insured, if it occurs before maturity of the policy, provided policy is in force on the date of death or has acquired paid-up value.  What is the procedure to be followed in case of claims by maturity of a LIC policy? The processing of claims by maturity is normally undertaken by Divisional Office of LIC about two months before the date of maturity. The Corporation sends Maturity Intimation along with the discharge forms to the policyholder informing him about the requirements for the settlement of claim. The steps that a policyholder should follow to expedite the realisation of his claim are as under: In case the maturity intimation is not received by the policyholder till around 2 months before the date on which the policy matures, he should contact the concerned Divisional Office and obtain a copy of the maturity intimation. Policy Document (if not in the custody of LIC as security for loan) On receipt of the maturity intimation, the policyholder should send the original policy document along with the last receipt of insurance premium paid. The policy document needs to be submitted in original unless it is in custody of LIC as security for loan. Age proof document (if age has not been admitted earlier) The policyholder should also submit his age proof to the Corporation in case it has not already been submitted. In case, the policyholder has already submitted his age proof to LIC, the form of Discharge (Form No. 3825) to be executed by the policyholder, is also sent along with the Maturity Intimation. L.I.C. accepts following documents as valid age proofs: Horoscope of the assured Certificate relating to the baptism ceremony among Christians Birth certificate from the Municipal Corporation High School Certificate Service book. Discharge Form No. 3825 duly stamped & signed, attested by a witness The form of Discharge (Form 3825) should then be properly filled, signed and sent to the Office of LIC from which it was issued. The signature must be on a revenue stamp and must be attested by a witness. Assignment / Reassignment Deed, if any In case the policy or any Deed of Assignment or Re-assignment is lost by the policyholder, he has to submit an indemnity bond along with a reliable surety of sound financial standing acceptable to LIC. The indemnity bond has to be in a particular format (Form 3815). In such a case the claim is settled in the absence of the policy document. Existence certificates in case of children’s Deferred Assurance & Pure Endowment Policies. In due course, LIC sends a cheque to the policyholder for the money due to him as per the terms of the policy. What is the procedure to be followed in case of claim by death of the policyholder? The following are the main steps for receiving claims: Intimation of death The first requirement of the Corporation in the case of death claim is that an "intimation of death"’ should be sent to the branch office of the LIC from where the policy was issued. The intimation needs to be sent by the person who is entitled to get the proceeds of the policy. It may be: the nominee or the assignee of the policy or the deceased policyholder’s nearest relative. The letter of intimation of death should contain the following information: name of the life assured a statement that the life assured is dead; the date of death; the cause of death; the place of death; and policy number / s claimant’s relationship with the assured or his status (nominee, assignee, etc.). Soon after the receipt of the intimation of the death, the branch office sends the necessary claim forms along with instructions regarding the procedure to be followed by the claimant. Submission of Proof of Death The proof of death required to be submitted is a certificate by Municipal Death Registry or by a Public Record Office which maintains the records of births and deaths in the locality. Besides this some other statements or certificates are also required to be given in the prescribed Claim forms: Statement from the doctor who attended the deceased policyholder’s last illness. Certificate of treatment in the hospital where the policyholder died or was treated by the hospital authorities. Certificate of burial or cremation to be given by an independent person who attended the funeral and has seen the dead body. Certificate from the employer if the policyholder was in employment at the time of death. Submission of Proof of Age The claimant should submit age proof of the policyholder to LIC in case it has not already been submitted. L.I.C. accepts following documents as valid age proofs: (i) Horoscope of the assured (ii) Certificate relating to the baptism ceremony among Christians (iii) Birth certificate from the Municipal Corporation (iv) High School Certificate (v) Service book. Certificate of Ownership. When the policy is validly assigned, or a nominee has been designated in the policy, no further proof of title is necessary. In any other case, the certificate of title is necessary. In such a case the corporation would require legal evidence of title such as Succession Certificate or Letters of Administration or Letters of Probate or a Will. Payment and Discharge After completing all the above formalities, the insurance company issues a discharge form for completion, which is to be signed by the person entitled to receive policy money. That is, it should be signed by: the nominee, in case nomination was made under the policy; the assignee, in case the policy was validity and unconditionally assigned; the legal representative or successor. In due course, LIC sends the cheque for the amount due to the person entitled to receive the same. Early death claims: If death occurs in less than three years from the date of the policy, following requirements must be complied with : Policy Document Discharge Form 3801 Assignment / Re-assignment Deed, if any Age Proof Document (if age has not been admitted earlier) Certificate of treatment issued by the hospital authorities where the deceased policyholder was treated last, on Claim Form ‘B1’ (F No. 3816) Certificate by the employer if the deceased was an employee, on the Claim Form ‘E’ (F No. 3787 revised) Certificate of Death Legal Evidence of Title (if policy is not assigned / nominated) Claim Form ‘A’ (F No. 3783) Statement from the Doctor who attended last the deceased policyholder, on Claim Form ‘B’ (Form No. 3784 revised) Certificate of Identity and burial by a person who attended the funeral on Claim Form ‘C’ (F No. 3785 revised) Non early claims: If death occurs exactly or after 3 years from the date of the policy the following requirements must be complied with: 1) Policy Document 2) Discharge Form 3801 3) Legal Evidence of Title 4) Death Certificate 5) Claim Form No. 3783A 6) Assignment / Re-assignment Deed, if any (if policy not assigned /nominated) 7) Age Proof Document (if age has not been admitted earlier) Double accident benefit: When death take place due to accident (solely, directly independently or other intervening causes the claim must be lodged with LIC to get the Double Accident Benefit within 120 days from the date of death. Claim will be admitted after acceptance and verification of the Death Report (Postmortem Report / Spot Panchanama / Inquest Panchanama / Eyewitness Statement) by LIC & upon clearance by the concerned SDM.