Rider Claims

Riders³ are bought along with a standard life insurance plan that covers the life insured for specific losses. Claims that arise or are admissible under the rider covers are called rider claims.

The scope of coverage provided under a life insurance policy may not always be sufficient for the life insured. Because specific types of risks may not be covered under the basic policy. So in order to get covered against some particular losses, life insureds often extend the protection by paying a nominal extra premium for a rider added to the life insurance.

If a life insured has basic life insurance + riders in force and happens to experience a loss that is covered by any of the purchased riders then they can file a rider claim. To raise a rider claim the policyholder needs to submit various documents for the claim processing. These documents may vary from rider to rider. Following are the documents one may need to file a rider claim for a particular rider.

• Accidental death benefit rider: Police FIR copy, post mortem report concluding accident as the cause of death of the life insured.
• Waiver of premium rider: Certificates of disability due to accident / critical illness, age certificate.
• Critical illness rider: Medical documents of diagnosis of the critical illness along with the date of diagnosis, supporting documents of surviving 30 days from diagnosis.
• Surgical care rider: Document of hospitalisation of at least 24 hours to perform the surgery.
• Disability rider: Medical documents declaring the permanent disability and life insured’s inability to work to earn money.

Let us understand this with an example.

Ankit purchased a term plan with a policy period of 20 years and the chosen sum assured was ₹1 Cr. Ankit has a family history of kidney ailments, so he did not want to take a chance. Hence, along with the base policy he purchased a critical illness rider of a sum assured ₹ 50 lakhs to prepare himself financially for a probable risk. In case Ankit is diagnosed with a critical illness covered by the rider, he can file a rider claim to receive the applicable rider sum assured to finance his medical treatment.