National Insurance Claim procedure
The following steps are involved in general for National Insurance Claim Settlement
- If any loss occurs normally intimation to be given to the Insurance company immediately.
- Before intimation a FIR should be lodged at the nearest Police Station , in case the loss has occurred due to any cause like Fire, Burglary, Theft, Damage to third party, Accident etc., i.e. for any reason other than Act of God Peril e.g. Flood, Earthquake, inundation etc.
- Collect relevant National Insurance claim form.
- Fill up the relevant National Insurance claim form correctly after reading it thoroughly.
- Submit National Insurance claim form to the Insurance company either directly or by an authorised Agent along with documents required such as Police Reports, Doctors Prescriptions, Reports of Pathological tests, Cash Memos from the Chemists Shop for the medicine purchased Admission and Discharge Certificates, Receipts from Surgeon, Doctors etc. as the case may be.
- The insurance company may appoint Surveyor or may refer the case to panel Doctors, if necessary.
- Claim is finally settled by the insurance company and payment is made to the Policy holder as a full and final settlement of claim.
- Please note in some cases provisional payment is also made to the Policy holder pending the final processing of the claim, depending on the merits of the case.
National Insurance Claim settlement can be done in two modes:
- National Insurance claim procedure through Reimbursement mode.
- National Insurance claim procedure through cashless mode.
Documents Required for National Insurance claim procedure
- Medical Expenses (for reimbursement claims)
- Bills / reports / discharge summary must mention name of the person treated, diagnosis, details and dates of medical treatment provided.
- All Scan / X-Ray reports, prescriptions and original bills. They must clearly show the medicines prescribed and price and the receipt stamp of the pharmacy.
- Letter from family physician confirming all the treatment the patient received in 12 months prior to issue of date of policy (if treatment received by the patient.).
- Expenses for Transportation for Medical Reasons:
- Medical statement from physician indicating cause of illness and Reason for necessity of the transportation.
- Dental Treatment:
- Bills & reports must give details of tooth /teeth treated and treatment performed
- Repatriation of Remains:
- Official death certificate
- Physician’s statement for cause of death
- Loss of Checked-in-Baggage by international Airlines:
- Property Irregularity Report issued by the carrier
- Proof of ownership of items valved in excess of US$ 100 purchased prior to the journey, receipt for item lost.
- A letter from the airline stating that the baggagE’ is totally lost
– New purchase, loss of camera, sunglasses, laptop, electronic items not payable
- Loss of Passport:
- Police Report obtained within 24 hours of becoming aware of the theft
- Copy of old & new passports, Embassy report
- Receipts for the expenses incurred in obtaining new passport or travel document
- Personal Liability / Third party property damage:
- Receipts of estimates for repaired or damaged items
- Copy / Proof of legal notice received to the insured by the third party
- Copy / Proof of judicial decision rendered by a court of law
- Personal Accident:
- Death Certificate
- In case 0f medical reimbursements, bills / medical reports / discharge note must mention hospital/medical bills with doctors prescription (in original) and all pathology reports / medical report form from attending doctors in original.
- Assignee’s name with relation
- Trip Cancellation:
- Covering letter from travel agent
- Death certificate (in case of death) or discharge summary from the hospital clearly mentioning the admission date and discharge date along with the diagnosis
- Original bills along with trip cancellation
- Delay of Baggage:
- Property Irregularity report issued by the airline
- Receipt 0f emergency purchases made during the period 0f delay
- Missed Connection:
- Airlines letter stating the reason for flight delay
- Expenses incurred details with related bills