How to File an Insurance Claim

Filing an insurance claim for the first time can be stressful, especially if you are dealing with a hospitalisation or the loss of a loved one. The process is more straightforward than it looks — the key is acting quickly, keeping documentation organised, and following each insurer''s stated procedure. This guide covers the essentials for health, life, and motor claims.

General Principle: Intimate the Insurer Immediately

Almost every policy requires you to notify the insurer within 24–72 hours of the event (hospitalisation, accident, death). Missing this window can lead to claim rejection on procedural grounds even if the claim itself is valid. Save your insurer''s helpline number in your phone before you ever need it.

Filing a Cashless Health Insurance Claim

• Visit a network hospital and go to the insurance desk or helpdesk.
• Present your health card / policy number and a valid photo ID.
• The hospital submits a pre-authorisation request to the insurer or their TPA (Third Party Administrator).
• Approval typically comes within 2–6 hours for planned procedures; for emergencies, treatment begins and authorisation follows.
• At discharge, review the final bill — you pay only the non-admissible items (items excluded by your policy).

Filing a Health Insurance Reimbursement Claim

If you were treated at a non-network hospital, you pay the bills and claim reimbursement:

• Collect all original bills, receipts, discharge summary, doctor''s prescriptions, and lab reports.
• Complete the insurer''s claim form (available on their website or app).
• Submit within 30 days of discharge (check your specific policy — some allow 45 or 60 days).
• Keep photocopies of everything you submit.

Filing a Term Life Insurance Death Claim

• The nominee contacts the insurer and requests a claim intimation form.
• Documents required: original policy document, death certificate, nominee''s ID and bank details, and any cause-of-death evidence required by the insurer.
• For accidental death, include the FIR and post-mortem report if applicable.
• IRDAI regulations require insurers to settle a death claim within 30 days of receiving all documents.

Filing a Motor Insurance Claim

• Do not move the vehicle before documenting damage with photographs.
• File an FIR if there is third-party injury or theft.
• Intimate the insurer within 24 hours and take the vehicle to an authorised garage for a cashless repair, or get it repaired and claim reimbursement.
• The surveyor''s assessment is the basis of settlement — be present if possible.

Documents to Always Keep Ready

• Policy document or e-policy PDF
• Health card (for health policies)
• Insurer''s claim helpline number and TPA number
• Nominee''s KYC documents (for life policies)

Common Pitfalls to Avoid

• Delaying intimation — always notify first, gather documents second.
• Submitting photocopies when originals are required.
• Assuming the hospital will handle everything — verify that the pre-authorisation has actually been approved.

Conclusion

The claim process rewards those who are prepared. Store your policy details digitally and share the insurer''s helpline with a trusted family member. If a claim is delayed or disputed, TruePolicy advisors can guide you through the escalation process and help you get what you are entitled to.