IRDA Guidelines for Claim Settlement

• Any additional requirement in death claim should br raised within 15 days of receipt of claim
• Any decision in the claim shall be intimated to the customer within 30 days of submission of all relevant papers.
• If a claim requires a detailed investigation,such intensification would be completed within 6 months from receipt of claim.
• If there is a delay in paying claim due to" Payee not Identified",insurer shall provide an additional amount  equivalent to interest of savings bank on such claim amount.
• If the delay in claim is from insurer's side,insurer shall pay 2% more than savings bank interest on claim amount.
• Section 45 - Indisputability clause
• In the first two years of the policy, if the insurance company comes to know that some material fact has not been disclosed by the proposer, it can declare the policy to be null and void. the insurance company can also keep all the premium paid.
• After 2 years fraud  must be established by the insurance conpany it it wants to declare the policy void.

Death Claim

A death claim is where the life insurance company pays the sum insured to the nominee/beneficiary on the death of the insured during the terms of the plan.

If the policy is a participating policy, the insurance company will also pay the bonuses accumulated until then.

If the policy holder had taken out any loans, then the outstanding amount of the loan, the interest and any outstanding premium and interest thereon will be deducted before the final amount is paid.

There are certain policies where the benefit is not paid on death but on  a specifies date as chosen by the life insured when taking out the policy.

Maturity claim

• Par Plan :The amount payable on maturity = sum assured + any accumulated bonuses any outstanding and interest thereon.
• In some cases the premiums paid over the tenure of the plan are returned on maturity. These plans are termed as "return of premium" (ROP) plans by some insurers.
• In the case of ULIPs, the insurance company pays the fund value (or on some cases the fund value and the sum insured) as the maturity claim, at the end of the plan's term.
• In the case of a money-back policy, the sum insured - survival benefits + bonuses are paid at the end of the policy