Kathmandu: Under the life insurance plan, the insured has different conditions for receiving the claim payment. Conditions for payment of claims are determined on the basis of the facilities opted by the insured and the type of insurance policy.
The insured or the person or claimant of the insured must complete the pre-determined formalities and procedures to receive the claim payment. Under such formalities, from the paperwork required for the payment of the claim to the time period is also fixed.
Lack of adequate documentation or insurance claims made beyond the stipulated time may be rejected or put on hold by the insurer. There are different types of claims made under a life insurance plan. Claims should be made in writing to the insurer to get payment of advance payment claims, maturity claims, premium waiver facility, monthly income benefit, educational expenses facility, partial or complete disability facility, treatment expenses against fatal disease etc.
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1. Formalities for maturity claim:
The amount that the insured receives from the insurance company after the completion of the insurance period is the amount paid for the maturity claim.
Generally, the insurance company sends advance notice to the insured to come and collect the claim payment after the completion of the insurance maturity period. However, due to weak regulation, it has not yet been fully implemented in Nepal. Therefore, the insured him/herself should be careful and claim for payment before the insurance company after the maturity of the insurance period.
A. Duly fill and submit the application form for claim payment.
B. When filling and submitting the application form, the insured should also mention the details related to bank account in the application form or handwritten application.
C. Provide a copy of the copy of his/her identity or passport.
D. Submit the file with the original insurance policy attached to the branch or sub-branch office of the insurance company along with the application.
E. After all the necessary procedures have been completed, the insurance company will ask to sign the claim discharge form before paying the claim.
F. In case of application along with all the paperwork, the insurer will provide the claim payment within one hour or credit the claim amount directly in the bank account of the insured.
2. Formalities for Death Claims:
When a person holding a life insurance plan – called an insured – dies, a written claim notice must be sent to the insurance company as soon as possible. In the absence of the designated person mentioned in the insurance policy and in the absence of such person, the legally close heir can report the death of the insured. Or any close relative or agent can also give information.
The claim information about the death of the insured should include information such as date, place and cause of death. It is the duty of the insurance agent to facilitate the insured for this.
The following documents must be submitted for a death claim:
•Duly filled claim form (should be registered by filling all the details in
the claim form provided by the insurance company)
•Death registration certificate of the insured
•Original documents of insurance policy
•Claimant’s details
• Proof of Claimant’s identity (citizenship or passport)
• Documentary evidence to prove the relationship of the next of kin if
the insured has not nominated anyone as the nominee in the policy.
•Police investigation report or post-mortem report in case of accidental death, suicide or homicide.
•Documentary evidence of hospitalization in case of death while
undergoing treatment.
The company must complete the necessary investigation and pay the claim to the insured within 15 days of the death claim. However, in case of non-receipt of required documents for the claim or in case of doubtful claim, the company may conduct necessary investigation. It may prolong the claim process. However, in case of unnecessary delay, the insured can file an application at the office of the Insurance Board, Kupondole, Lalitpur, for the claim settlement.
