Have you ever wondered what to think about before making an insurance claim? It is important to have insurance this helps protect you from unforeseen circumstances.
An Insurance claim is a formal request to an insurance company asking for a payment based on the terms of the insurance policy, this sometimes could be a third party. You can as well insure your car (property), life, health, etc
Let’s take a look at what an Insurance claim means and how we could possibly get insurance.
Definition of Insurance Claim
A claim is a formal request or demand which states that one owns or has earned (something). You can only make a claim, about the property being damaged, or you have been injured.
An Insurance Claim is a formal request to your insurance provider for reimbursement against losses covered under your insurance policy. Insurance claims cover everything from death benefits on life insurance policies to routine and comprehensive medical exams. In some cases, a third party can file claims on behalf of the insured person.
For instance, if you have property and casualty insurance and there is an incident or fire breakout you’ll want to file a claim with your property insurance company to cover (or reimburse) the costs that stem from the accident so that you don’t have to pay out of pocket.
Types of an Insurance Claim
There are mainly 3 types of insurance claims. They are
- Health Insurance Claims
- Property and Casualty Claims
- Life Insurance Claims
Health Insurance Claims
A health insurance claim is a demand put together for immediate payment or reimbursement for medical services that an insured person has obtained. Health insurance benefits or payments are obtained after the insured submits a claim to their insurer. There could be different situations when you may have to make a claim against your policy. This could be due to a planned or unplanned hospitalization.
Before making a claim, you need to know the procedure for filing one, and the documents and information required to file it.
Procedures
When you set up an online account to manage your health insurance plan and file your claims electronically, you get immediate access to the kind of benefits and refunds you will receive access to any expenses that you may have to settle out of pocket.
By initiating your health insurance claim online, you also get to see whether your insurer has received the documents submitted, the claim-processing status when payment will be issued, or whether it has been paid.
Property and Casualty Claim
This type of insurance is coverage that financially protects you if the property you own is damaged, lost, or stolen or if you are responsible for causing injury to another person or damage to his or her property.
Property and casualty insurance are typically bundled together into one insurance policy. For example
- Home insurance: Protect your house and possessions against perils (theft, fire, storm). For example, if your entire wardrobe was destroyed in a fire, your personal property coverage would help cover the cost of new clothes. Home insurance also covers liabilities.
- Car insurance: This helps protect you and your car in a few ways, depending on your coverage. It also covers your liabilities as a driver. If you hit another car, your liability insurance will help pay for the other driver’s damages, including vehicle repairs and medical expenses.
- Condo insurance: Helps protect against structural damage to the interior of your unit. However, because of the unique ownership arrangement, a master policy purchased by the condo association covers damage to the building itself while condo insurance has limited coverage for the interior walls and improvements to the condo, not covered by the master policy.
- Renters insurance: Commonly helps protect your personal property (furniture, clothing, and electronics, for instance). If an electrical fire burns some of your furniture, your insurance policy will help you replace the damaged items with new ones.
- Landlord insurance: The property portion of landlord insurance covers the building itself. If a windstorm damages the roof of an apartment building you own, you could file an insurance claim to finance the repairs. It also covers your liabilities if a tenant gets injured on the property and it’s your fault.
Also Read: How can I get Insurance on Tesla?
Life Insurance Claims
Life insurance is a contract between you and an insurance company. Essentially, in exchange for your premium payments, the insurance company will pay a lump sum known as a death benefit to your beneficiaries after your death. Your beneficiaries can use the money for whatever purpose they choose. Often this includes paying everyday bills, paying a mortgage, or putting a child through college. Having the safety net of life insurance can ensure that your family can stay in their home and pay for the things that you planned for.
Life insurance claims require the submission of a claim form, a death certificate, and oftentimes the original policy. The process, especially for large face-value policies, may require in-depth examination by the carrier to ensure that the death of the insured did not fall under a contract exclusion, such as suicide (usually excluded for the first few years after policy inception) or death resulting from a criminal act.
What are the Documents Required to Make a Claim?
- Proof of identity The insurer uses identity proof of the policyholder to maintain records. When you require the benefits of the plan, the given documents are used to verify your identity and provide the proper coverage. Those are acceptable identity proof documents required for health insurance, Aadhar Card, Passport, Voter ID Card, and Driving License
- Proof of Age You will have to provide the age proof of all the persons who will be getting covered with the health insurance policy opted by you. Following are the suitable document, Birth Certificate, Voter ID Cards, Passports, Driving licenses, Aadhaar cards, and Pan card
- Proof of Address At the time of procuring, the address proof is one of the indispensable documents required for health insurance. It may be used as the postal address by the insurer for communicating with you. These documents are, Electricity bills, Telephone bills, Ration cards, Passports, Aadhaar cards, Driving licenses, Voting ID
What is the claim process?
If you have insurance on your car and you are involved in an accident, you may want to start an insurance claim as soon as you can, the process is usually the same.
- Report your claim to your insurance company: It is important to report your claim to your insurer they should understand your situation and how to proceed. you should be ready to give detailed information about the incident and provide proof that will help explain the situation like photos or videos.
- Your adjuster will investigate the claim: After the claim has been reported, it will need to be investigated by an adjuster to determine the amount of loss or damages covered by your insurance policy
- Insurance coverage will be determined: After investigation, your adjuster will make the necessary determination according to your insurance policy
- Damage evaluation is conducted: After coverage is determined your insurance adjuster may hire appraisers, engineers, or contractors to lend their expert advice in other to provide repairs.
- Final payment: After repairs have been completed and lost or damaged items have been replaced, your adjuster will contact you regarding the settlement of your claim and payment. The amount of time it takes to receive payment will depend on the complexity and severity of your situation.
Bottom Line:
An Insurance Claim is a formal request to your insurance provider for reimbursement against losses covered under your insurance policy. It is important to have insurance this helps protect you from unforeseen circumstances, and this will help reduce costs.
FAQ on Insurance Claim
This can be done by phone, and increasingly online. Once the claim has been started, the insurer will collect relevant information from you and may ask for evidence (such as photos) or supporting documentation
Sometimes insurance claims might go up due to the nature of the accident but you can revoke this if the accident wasn’t really your fault. However, If you file too many claims over a very short period of time, the insurance company may not renew your policy regardless of fault.
It is not really necessary If the damage you experience is less than your deductible, it may not make sense to file a claim with your insurance company
There’s no precise answer to this question. This strongly depends on the insurer in each individual case
A bad faith insurance claim is any claim where the insurance company is not doing its duty to investigate your claim quickly or thoroughly, or refusing to pay a legitimate claim
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