100 Common insurance claims questions - How to make an insurance Claims - What are the legal Protections from IRDA?

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Top Questions on Insurance Claims


Q1. Can the claimant (Legal Heirs/Nominee etc.) have the option to receive claim money in form of annuity?


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Q2. What is Netting of Claim?


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Q3. If the premium is not paid on due date and the person got sick during the grace period, will the claim be payable?


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Q4. When I need to inform the Insurance Company when I got sick or illness or suffer a medical condition?


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Q5. What is the maximum period, that is allowed to be imposed as waiting period by an insurer as per IRDA regulations?


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Q6. What are excluded from a claim for day-care treatment?


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Q7. What is a usual Waiting Period for claims under a Health Insurance policy?


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Q8. What is the pre-condition for a claim to be payable?


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Q9. Does Multiple Hospitalisation is allowed under a single Health Insurance Policy?


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Q10. Why the claim amount that is paid by insurance companies, are in most of the time, less than the amount claim actually made?


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Q11. Who access the actual amount of loss sustained and help the insurer to decide what claim amount to be paid to the claimant, in case a claim is filed?


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Q12. Mr. A has taken two Health Insurance Policy, Policy A is for sum assured Rs. 2 lacs and Policy B has sum assured Rs. 3 Lacs. The medical expenses he has incurred is Rs. 2,75,000. How much he will get as claim?


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Q13. Within what time, an investigation of a claim should be completed by Insurance Company?


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Q14. What a loss or damage of a property is considered as Total Loss by the insurer?


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Q15. How losses will be settled if a property insurance policy written on a "replacement cost" basis?


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Q16. If an insurance policy is subject to a Deduction of Rs.115,000, how much would an insured who suffered loss of Rs. 120,000 would receive, as compensation?


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Q17. Which regulation deals with Claim procedure?


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Q18. What type of treatment undergone in a hospital is eligible for Insurance claim?


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Q19. In case of a vehicle under hire-purchase agreement, got damaged, who will get the claim amount?"


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Q20. In case of a vehicle under a Lease agreement, got damaged, who will get the claim amount?


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Q21. Which stand an insurance company will take, if there is dispute over the claim between two or more parties?


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Q22. What additional document is asked for in case of accidental death?


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Q23. In case the claimant is a declared insolvent, who will receive the Claim Money?


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Q24. What is "Early Death Claim", and how insurers deal with this type of death?


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Q25. Is Murder is considered as an Accident so as to entitle the benefit under Accidental Death Rider?


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Q26. When the policy money is due to a minor, to whom shall the payment be made?


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Q27. If the claims payment is delayed by the insurance company, what penal interest is imposed?


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Q28. Can I recover medical expenses incurred due to illness from a Life Insurance Company?


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Q29. Who cannot be a claimant in case of a claim in a Life Insurance Policy?


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Q30. In case of an insurer died leaving a will in favour of one of his relative, what is the process involved in paying the claim money?


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Q31. Identify where from a claimant can obtain the Claim Form for filing a claim?


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Q32. After the admission of a Death Claim in a Life Insurance Policy, who receives the claim money?


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Q33. What is the main features of a without-profit policy?


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Q34. In life insurance at what time or event, claims becomes payable?


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Q35. What constitute "Maternity Benefits" in Health Insurance?


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Q36. What is the usual waiting period for Maternity benefits in Health Insurance?


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Q37. Which types of deceases can be declined by an insurer from insurance cover?


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Q38. In case of a MWP Act Policy, if the spouse divorce before the death of the Policy Holder, who will get the claim money?


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Q39. What is the stipulated period, within which, a claim under a Life Assurance Policy, shall be paid by an insurance company?


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Q40. What will happen to a claim, if the claimant (Nominee or Legal Heirs) is unable to product identification documents?


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Q41. In case of un-natural death or accidental death, what additional documents required to be submitted for claim process?


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Q42. Intimation of death need to be given within how many days of death of the insured?


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Q43. When a claim is considered as Early Death Claim? And what additional documents required to be submitted for claim process?


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Q44. Is there a chance of getting the insurance claim in case of policy for which premium payment has been stopped ?


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Q45. What is "foreclosure" and who can initiate this?


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Q46. In case of Marine Insurance Claim, what document/protocol establishes, who have the insurable insurest in the cargo?


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Q47. How the frequency of claim is measured?


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Q48. What is the decease called "Asbestosis"?


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Q49. What is "Co-pay" in Health Insurance?


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Q50. What is the Minimum and Maximum tenure of Health Insurance Product?


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Q51. What is the maximum age upto which, a health insurance request will be accommodated by an Insurer?


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Q52. Is it true that health insurance policies issued in India are lifelong renewable, and its annual renewal cannot be cancelled by an Insurer?


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Q53. What percentage of Allopathy Doctors (M.B.B.S and above) are practising in Private Sector in India?


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Q54. What are the requisites for an AYUSH Hospital?


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Q55. Does AYUSH treatments (Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy systems) can be claimed?


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Q56. Can I take a Health Insurance cover for any member of the family? Including parents-in-laws?


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Q57. What is "Super-TopUp Plan"?


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Q58. What is unique about a Senior Citizens plan, as compared to any other plan?


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Q59. In case of a "Combi-Product", who is going to handle any health claim?


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Q60. What is a "Combi-Product" in Health Insurance?


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Q61. What is the definition of "Health"?


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Q62. What is the meaning of Sedentary Life Style?


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Q63. Who should bear the cost of Medical Examination as per IRDA Regulations?


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Q64. How the sum insured is determined for each member in a group life policy?


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Q65. What is Free cover limit in Group Life Plan?


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Q66. In annuities, when annutization starts ?


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Q67. One of the criteria used in underwriting Group life policy is "Active-at-Work" what does it means?


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Q68. Which one is cheaper Group Life Policy or Individually sponsored Life Policy?


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Q69. Is gratuity become payable in case of dismissal of employment, fraud, theft, assault, rape, or molestation.


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Q70. Where or in which organisation Payment of Gratuity Act, 1972 is mandatorily applicable?


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Q71. Is gratuity is taxable?


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Q72. What is correct formula for gratuity calculation?


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Q73. In what type of Pension Scheme, the pension amount is known before-hand and does not effect due to volatility in the market?


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Q74. Does Top-Ups in ULIP will also attract Lock-in-Period of 5 years?


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Q75. What will happen if a ULIP Holder fails to pay premium in a year?


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Q76. With regards to ULIP, what does "Premium-Holiday" means?


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Q77. What is Net Asset Value (NAV) in ULIP?


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Q78. What is correct formula to calculate Total Fund Value?


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Q79. How Unit Price in ULIP is calculated in Expropriation Method?


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Q80. Does ULIP declare bonus?


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Q81. What happen if you fail to pay a premium in ULIP within stipulated time?


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Q82. Can Discounted ULIP can be revived?


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Q83. When is the Proposer is generally required to provide Age-Proof?


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Q84. What are usual Policy conditions in a Insurance Policy


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Q85. Is there a chance of getting the insurance claim in case of policy for which premium payment has been stopped?


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Q86. If a proposal received from a person with terminal cancer, what will usually be response of an underwriter


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Q87. Which one is cheapest form of Life Insurance?


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Q88. Does Subrogation principle applies in Life Insurance?


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Q89. When a Policy lapses, who gets benefited?


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Q90. What is special Revival Scheme (SRV)?


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Q91. Which policies, usually does Not have loan facility?


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Q92. What is Bancassurance?


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Q93. In what situation, fore-closure of a life insurance policy can be initiated by the Insurer?


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Q94. In case of un-natural death or accidental death, what additional documents required to be submitted for claim process?


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Q95. If an insured wants to cancel a policy, what documents required to submitted?


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Q96. Intimation of death need to be given within how many days of death of the insured?


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Q97. What is Settlement Option in Life Policy?


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Q98. What is usual death claim settlement ratio in India?


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Q99. When a claim is considered as Early Death Claim? And how such cases are considered by an Insurance company?


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Q100. Can I take insurance on the life of my parents even if they are not dependent to me?


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