Step-by-step Procedure to File a Claim

Learn the step-by-step procedure to file an insurance claim. Check eligibility, gather documents, notify your insurer, submit the claim, track its status, and get your settlement with ease.
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3 mins
15 July 2023

Over the years, insurance has gained popularity because of its ability to provide financial support when required. It works as an umbrella that gives financial cover to you and your family during any emergency. You get a range of insurance policies from health insurance, vehicle insurance to life insurance to cover various risks. However, many dread the insurance claim process, assuming it as a daunting task. Here is a comprehensive guide to take you through the process in a simple and straightforward manner. So, you can easily file an insurance claim in just a few steps.

Having the right health insurance plan ensures that you are financially secure during medical emergencies. Whether it’s hospitalization, critical illness, or routine check-ups, a well-rounded health insurance policy offers extensive coverage to manage healthcare expenses with ease.

Step-by-step procedure to file a claim

  1. Contact your insurer. The first step of claim process is to contact your insurer and intimate about the claim.
  2. Fill your claim form and attach the relevant documents.
  3. A surveyor conducts damage evaluation.
  4. Acceptance of your claim.
  5. Get the claim amount.

Having adequate coverage ensures you are well-protected in times of need. If you’re unsure about your current coverage, consider enhancing it with a top-up plan or getting a new health insurance policy that meets your requirements.

Confused about which health insurance plan to choose? Compare health insurance plans from leading insurers and get instant quotes in minutes! Check Plans Now!

Contact your insurer

The first step of insurance claim process is to contact your insurer and intimate about the claim. Be it a life, health, or property insurance claim; it is essential to inform your insurer at the earliest. Generally, you need to inform the insurer within 48 hours from the incident if you opt for cashless health insurance. For reimbursement claim, you need to contact the insurer and submit the documents within 10-15 days. You will find the deadline for making a claim mentioned in the policy document, which may differ from insurer to insurer. A delay in claim intimation will only make the process more time-consuming and cumbersome.

Fill your claim form and attach the relevant documents

Once you notify the insurer about your claim, the company will provide you with a claim form. You can also log in to the insurer’s official website and download it. Ensure that all details are filled in accurately. Along with the claim form, you will be required to attach supporting documents.

For instance, in a health insurance claim, you must submit documents such as hospital bills, discharge summary, and doctor’s prescriptions. In case of a motor insurance claim, you may need to provide the repair invoice, a copy of the FIR (in case of an accident), and other evidence of the damages.

A detailed list of required documents is always mentioned in your insurance policy document. Referring to it will help you raise and settle your claim smoothly without unnecessary delays.

Pro Tip

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End Uses

A surveyor conducts damage evaluation

For life and health insurance, the insurer will start processing the claim settlement request upon receiving and verifying all the documents.

Acceptance of your claim

If everything is in order following the policy's terms and conditions, the claim will get accepted and processed quickly. However, the claim may get rejected if the insurer finds that the policyholder has given incorrect information or hidden any vital information.

Hence, it is essential to provide accurate information in the proposal as well as in the insurance claim process form. Any discrepancy in the claim form will lead to claim rejection and defeat the very purpose of insurance.

Get the claim amount

For cashless claim, the insurers will directly settle the bills with the network service providers. For reimbursement claim, insurance companies usually process claims within 10-30 days. You get the payment via NEFT into the registered bank account. In some cases, you may receive a check. You can also track your insurance claim status online. Make sure to give the correct phone number and email ID to receive regular updates.

Steps for third-party claim

Here are the steps you need to take to make a successful claim:

  • Exchange details with the other driver, including their registration number and insurance details.
  • Gather evidence, such as photos and witness statements.
  • Contact your insurer to begin the claims process. They will ask for the other driver's details and evidence of the accident.
  • The insurer will investigate the accident and determine who was at fault.
  • If the insurer decides that the other driver was at fault, they will pursue a claim against that driver's insurance company.
  • If the claim proves authentic, your insurer will cover the costs of any repairs up to the value of your vehicle.

Car insurance claim process for a stolen car

Here are the steps to ensure a smooth insurance claim process in case of car theft:

  • Inform the police of the theft and obtain a crime reference number for your insurance claim.
  • Contact your insurance company immediately and provide all the necessary information, including the police report.
  • Your insurer will investigate the theft and assess the damage to your car.
  • If the car is found, the insurer will arrange for it to return to you. If the car is not found, they will determine the extent of your loss.
  • If the car suffers total loss, the insurer will pay out the market value of your vehicle at the time of the theft.
  • Complete any necessary paperwork and provide all the relevant documents required by your insurer.

Most insurers ensure hassle-free claim settlement process for the policyholders. However, you can check the insurer’s claim settlement ratio when buying an insurance policy to know the company’s efficiency in settling claims. Insurance companies also provide 24x7 customer services to assist policyholders to complete the insurance claim process correctly. However, you must ensure to provide accurate information and right documents to make the claim settlement procedure seamless and hassle-free.

Conclusion

Submitting the right documents along with a properly filled claim form is crucial for a smooth and hassle-free claim settlement. Whether it is health insurance, motor insurance, or any other policy, always refer to your insurance document for the exact list of requirements. Being well-prepared not only speeds up the process but also ensures that you receive your claim benefits without unnecessary hurdles.

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Frequently asked questions

How can I raise an insurance claim?

Contact your insurer for the insurance claim process. Inform about the incident and provide all relevant information and documents as requested. This includes your policy number, date, and location of incident. You also need to provide medical records or police reports if any, and other evidence. Your insurer will evaluate your claim and, if approved, provide compensation according to the policy terms.

How do I fill the insurance claim form?

The insurance claim process may differ from insurer to insurer, depending on the type of policy you have. Generally, you will need to provide personal details and policy information, as well as details about the incident. Your insurer will give instructions on how to fill out the form correctly. In case of any doubts, you can contact their insurer’s customer services team to seek assistance.

What documents do I need to submit for an insurance claim?

The list of documents required for making an insurance claim depends on the policy bought. Generally, you need to provide supporting documents for the claim, like repair estimates, police reports, invoices, or medical reports. You will get the list of documents required on the policy document. Read the policy details, terms and conditions when purchasing the policy to avoid any hassle when making claims.

How to choose insurance policy that provide easy claiming process

Selecting the right health insurance policy isn’t just about getting maximum coverage; it’s also about ensuring a hassle-free claim experience. Here’s what to look for when choosing a policy that simplifies the claiming process:

  1. Cashless Claim Facility – Opt for insurers that have a wide network of hospitals where you can avail of cashless treatment without the stress of reimbursement.
  2. Simple Documentation – Choose a policy that requires minimal paperwork for claim approval. Digital claim submission is an added advantage.
  3. Fast Claim Settlement Ratio – Check the insurer’s claim settlement ratio (CSR) to gauge their efficiency in processing claims. A higher CSR indicates a smoother claim experience.
  4. 24/7 Customer Support – An insurer with round-the-clock assistance can guide you through the claim process at any time.
  5. Transparent Terms & Conditions – Always read the policy details carefully to ensure there are no hidden clauses that could complicate claims.
  6. Pre-approved Claim Process – Some insurers offer pre-authorization for treatments, ensuring you get approval quickly without delays.

Having a health insurance policy with an easy and seamless claim process can save you from unnecessary stress during medical emergencies. If you’re looking for a plan that offers smooth claim processing, compare health insurance policies from top insurers and find one that suits your needs.

Confused about which health insurance plan to choose? Compare health insurance plans from leading insurers and get instant quotes in minutes! Check Plans Now!

What is the procedure for filing an insurance claim?

Here’s the insurance claim filing process:

  1. Notify the insurer – Inform your insurance company immediately after the incident (hospitalisation, accident, loss, etc.).

  2. Fill claim form – Download/collect and submit the duly filled claim form with accurate details.

  3. Attach documents – Submit required proofs (e.g., bills, FIR, certificates, ID, reports) depending on claim type.

  4. Assessment – Insurer verifies documents; may appoint surveyor/TPA.

  5. Settlement –

    • Cashless: Insurer pays directly to hospital/garage.

    • Reimbursement: You pay first, insurer reimburses later.

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