Claim

Definition:

A claim is a formal request made by the life insured or the nominee to the insurance company asking to compensate for the loss the insured suffered. The insurance company after taking the premium issues the insurance policy as an agreement to pay for the losses. The company pays the claim as a part of the contract at the time of the death or disability of the life insured. The claims are also paid at the end of the policy term when policy matures .

Description:

Under a life insurance policy, the insurance company is liable to pay the amount promised to the insured if the claim is admissible. The losses that arise must fall under the scope of coverage that the policy offers. A claim is paid if the policy is in effect at the time of loss and if the cause of loss is not beyond exclusions.

In life insurance there are two types of claims: maturity and death claims.

Maturity claims: The claim amount paid to the life insured when she/he survives the complete policy term falls under maturity claims.After the policy term is over, the life insured can file for the claim.

Death claims: The claim amount paid to the nominee on the death of the life insured are death claims. The unfortunate event must happen within the policy term.

Example:

Reena purchased a term plan of Rs.1.5 crores as she was the sole breadwinner in the family. She declared Nisha her nominee and chose a policy term of 20 years. Reena died after paying a premium for 15 years. The surviving dependent Nisha (Reena's daughter) filed for the claim with the insurance company. The claim was paid after the verification of the documents.

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ADV/4/22-23/120