PayBima brings a wide range of product offerings from multiple insurance companies under one roof thereby giving you a unique experience of comparing & buying insurance policy online in the simplest possible way. PayBima also helps you throughout your policy tenure and assists you at the time of a claim. So, you can not only buy a policy from us but also ensure continued service throughout your policy duration. For any claims assistance, you can always reach out to us by calling our toll free number 1800 267 6767 or dropping an email at firstname.lastname@example.org
Below is a brief information about the claim process for different insurance products which will help you in case of an emergency.
Motor insurance claim:
Claim process for your car or bike will depend on the type of claim you raise.
For own damage claims -
Inform the insurance company immediately of the claim and provide your policy number and other details like car registration number and driving license number
The company would inform you about the nearest networked workshop. The vehicle should be taken to that workshop for repairs if you prefer a cashless claim settlement. For reimbursement claims, the vehicle can be repaired at any workshop
Once the vehicle is at the preferred workshop, the insurance company’s surveyor would visit the workshop to assess the damages. The surveyor would then prepare a claim estimate and submit it to the insurance company
The policyholder would also have to submit a claim form and copies of the RC book, driving license and other documents as required by the insurance company
The insurance company approves the claim after which repairs begin
Once the repairs are completed, the company settles the claim directly with the garage and the policyholder can take the delivery of the vehicle
In case of reimbursement claims, the policyholder gets the vehicle repaired at any garage. Then the original bills of the repair are to be submitted to the insurance company along with the claim form, RC book, driving license and other documents. The insurance company analyses the bills and the documents and approves the claim. Once the claim is approved, the repair costs are reimbursed by the insurance company
In case of accidental damage, loss or theft of the vehicle, a police FIR needs to be filed and submitted to the insurance company as a supporting document at the time of claim. If the vehicle is not located by the police, a non-traceable report will be issued and the insurance company will pay an amount equal to the IDV of the insured vehicle.
For third party claims -
File an FIR with the police
The claim is taken to the motor accidents tribunal. Once the tribunal passes a judgement, the insurance company pays the claim to the third party
Documents required for motor claims:
Registration Certificate (RC copy)
FIR Copy-Required in case of theft, third party property damage
MOA (memorandum of association), AOA(Article of association) & COI(Certificate of Incorporation)- in case the vehicle is on company’s name
Inspection officer’s report, original bills and surveyor’s report to estimate the loss
Medical receipt in case of physical injuries
Health insurance claim:
Cashless claim process for health insurance will depend on the type of hospitalisation you are facing.
In this case, the insured is aware of the hospitalisation few days in advance. In such a scenario:
Please contact your Service provider or TPA help-line mentioned in the Health Identity Card
Fax /submit the required documents. E.g. Doctor's certificate, medical bills etc.
Obtain approval from the Service Provider or TPA
Unplanned or Emergency hospitalisation:
In this case, the insured meets with a sudden accident or suffers from illness that requires immediate admission to the hospital. In case of such emergency hospitalisation:
The patient is to be rushed to the hospital
Patient avails treatment
Family/Friends/Employer to contact Service Provider or TPA help-line as mentioned in the Health Identity Card
Cashless claim facility can only be availed at network hospitals of your respective insurance company. For non-network hospitals, claims can be availed in form of reimbursement upon submission of relevant bills.
The following are basic documents required for filing a claim:
Duly completed claim form
Original bills, receipts and discharge certificate/ card from the hospital
Original bills from pharmacy supported by proper prescription
Receipt and investigation test reports from a pathologist supported by the note from attending Medical practitioner / surgeon prescribing the test.
Indoor case paper
Nature of operation performed and surgeon's bill and receipt.
If it is an accident case, then the FIR or Medico Legal Certificate (MLC) is required.
Term insurance claim:
A death claim under term insurance requires the following documents to be submitted by the nominee to the respective life Insurance company:
The death certificate of the insured
Original documents of term insurance policy
ID proof of the nominee, beneficiary or the claimant
Bank account details of the nominee, beneficiary or the claimant
Age proof of the life insured if it was not provided at the time of buying the policy
Police FIR if death occurred due to an accident
Medical reports and hospital records for accidental death claim cases
Any other relevant required document as required by the insurance company
As per IRDAI guidelines, the life insurance company has to process the claim settlement within 30 days of receipt of claim form and all relevant documents. If any additional documents are needed for verification, the entire settlement process cannot exceed 6 months. Post this, the company has to start paying interest on the claim amount.
Travel insurance claim:
Every travel insurance company appoints a worldwide service provider who becomes your single point of contact during your trip. In order to make a claim, the insured needs to intimate the respective service provider of his travel insurance company and register the claim with them. Such claims need to be accompanied with the original tickets and boarding passes and a photocopy of the passport that indicates the travel dates of your trip. Every type of contingency like emergency medical assistance, loss of baggage or personal documents, passport loss etc. has its own requirement with respect to documents. They may need to be submitted immediately at the time of occurrence or maximum within 30 days of the end of your trip.
For claims related to medical emergency or hospitalisation, you can show your travel insurance policy copy to the hospital abroad and avail cashless treatment. Your service provider should also be intimated who will then get in touch with the hospital and settle bills directly. For claims related to lost baggage or documents, you need to contact the service provider and submit the necessary information regarding the contents. The service provider will validate the claim as per the policy coverage and make the payment to the insured after deducting the corresponding cover’s deductible amount.