Cliam | Policies 365

How to File a Claim

Motor Insurance

Bike Insurance

Health Insurance

Life Insurance

Private Car Insurance

Secure the scene and notify Ensure safety first. Notify the insurer within 24–48 hours. Take photographs of the vehicle damage, accident scene, and third-party vehicles involved.

File an FIR if required FIR is mandatory for accidents involving third-party injury/death, theft, or vandalism.

Choose cashless or reimbursement Take the vehicle to a network garage for cashless settlement, or any garage if opting for reimbursement. Inform the insurer before repairs begin.

Surveyor visit An assigned surveyor will inspect the damage before repairs commence. Do not begin repairs without surveyor approval.

Repair and settlement Cashless: insurer settles directly with the garage minus any deductibles. Reimbursement: submit all bills and receive payment within the stipulated turnaround time.

Documents Checklist

Duly filled and signed Claim Form
Original policy document or policy schedule copy
RC (Registration Certificate) of the vehicle
Valid driving licence
FIR copy (mandatory for theft, third-party bodily injury, or total loss)
Repair estimate prior to repair commencement
Original repair bills and payment receipts (reimbursement)
Photographs of damage and accident scene
For total loss / theft: keys, Form 28/29/30, NOC from financer (if hypothecated), and RTO forms

How to Avoid Claim Rejection

Disclose accurately at the time of purchase. Non-disclosure or misrepresentation of material facts (pre-existing conditions, vehicle modifications, etc.) is the single most common reason for rejection.
Notify the insurer promptly. Every policy has a stipulated timeframe for claim intimation. Missing this window can result in rejection regardless of the validity of the claim.
Read your policy document. Understand exclusions, waiting periods, and sub-limits before you need to file. Surprises at claim time are avoidable.
Never sign blank claim forms. Fill all fields accurately and completely before signing.
Keep originals safe. Reimbursement claims require original bills and receipts. Losing these can make your claim unprocessable.

Two-wheeler Insurance

Notify immediately Call the insurer's helpline or log into the portal within 24 hours of the incident. Do not move or repair the vehicle before surveyor inspection unless absolutely necessary for safety.

File an FIR (if applicable) For theft, third-party injury, or major accidents, file a First Information Report (FIR) at the nearest police station and obtain a copy.

Intimate your dealer/garage Take the vehicle to a network garage for a cashless claim, or any garage if filing for reimbursement. Inform the insurer of the garage details.

Surveyor inspection The insurer will appoint a surveyor to assess the damage. Be present during inspection and provide all required documents.

Claim settlement For cashless: the insurer pays the garage directly. For reimbursement: pay the garage, submit bills, and receive reimbursement after approval.

Documents Checklist

Duly filled and signed Claim Form
Original policy document / copy of policy schedule
RC (Registration Certificate) of the vehicle
Valid driving licence of the person driving at the time of incident
FIR copy (for theft, third-party damage, or major accidents)
Repair estimate from the garage
Original repair bills and payment receipts (for reimbursement)
Photographs of the damaged vehicle
For theft claims: keys of the vehicle, NOC from RTO, and police final report

How to Avoid Claim Rejection

Do not get the vehicle repaired before the surveyor inspection — this is one of the most common reasons for rejection or reduced settlement.
Always drive with a valid driving licence. Claims can be rejected if the driver's licence was expired, suspended, or invalid at the time of the incident.
Do not drive under the influence of alcohol or drugs. DUI-related claims are categorically excluded.
Report the incident honestly — exaggerated or inflated damage descriptions can lead to fraud classification.
Use network garages where possible for cashless claims to reduce documentation burden.
Ensure the vehicle has a valid PUC (Pollution Under Control) certificate and road tax paid.

Health Insurance

Choose cashless or reimbursement For planned hospitalization, notify the insurer or TPA (Third Party Administrator) at least 48–72 hours in advance. For emergency hospitalization, notify within 24 hours of admission.

Cashless hospitalization Get admitted to a network hospital. The hospital's insurance desk will coordinate with the insurer directly. Fill and submit the pre-authorization form at the hospital.

Reimbursement claim If treated at a non-network hospital, pay the bills and collect all original documents. Submit the reimbursement claim within 15–30 days of discharge (check your policy for exact timeline).

Claim review The insurer or TPA reviews submitted documents. They may request additional information or clarification. Respond promptly to avoid delays.

Settlement Approved amounts are transferred directly to your registered bank account for reimbursement claims. Cashless claims are settled directly with the hospital.

Documents Checklist

For cashless:

Health insurance card / policy number
Government-issued photo ID (Aadhaar, PAN, Passport)
Doctor's prescription / referral letter advising hospitalization
Completed pre-authorization form (available at hospital)

For reimbursement (in addition to the above):

Original hospital discharge summary
All original bills, receipts, and payment proofs
Prescription and pharmacy bills
Diagnostic test reports and lab bills
Claim form duly filled and signed
Cancelled cheque or bank passbook copy for NEFT transfer

How to Avoid Claim Rejection

Complete the waiting period before filing claims for pre-existing conditions. Most policies have a 2–4 year waiting period for pre-existing diseases.
Do not claim treatments listed under exclusions (cosmetic procedures, fertility treatments, etc.).
Ensure the treating hospital is registered and meets minimum bed criteria as defined by your policy.
Submit claims within the stipulated timeline post-discharge. Late submission is a common, avoidable rejection reason.
Ensure pre-authorization is completed before elective procedures — missing this step for planned treatments often results in rejection.
Keep all medical records organized — incomplete documentation is a leading cause of claim delays and rejections.

Life Insurance

Notify the insurer The nominee or claimant should notify the insurer as soon as possible after the policyholder's death. Contact the nearest branch or the insurer's claims helpline.

Submit claim intimation form Download and complete the Claim Intimation Form from the insurer's website or collect it from a branch. Submit it along with initial documents.

Document submission Submit all required original documents (see Section 5). The insurer will provide an acknowledgement with a claim reference number.

Investigation (if applicable) For early claims (policy held for less than 3 years) or high-value claims, the insurer may conduct an investigation. Cooperate fully and provide any additional information requested.

Settlement Upon approval, the claim amount is paid to the nominee's registered bank account via NEFT. Standard turnaround is 30 days from receipt of all complete documents.

Documents Checklist

Completed Claim Intimation Form
Original policy bond / policy document
Death certificate issued by the Municipal Corporation / Gram Panchayat
Claimant / nominee's government-issued photo ID
Claimant's address proof (utility bill, Aadhaar, etc.)
Medical records and hospital documents (if death is due to illness)
FIR, post-mortem report, and inquest report (if death is accidental)
Employer certificate and leave records (if applicable)
Cancelled cheque or bank account details of the nominee for NEFT transfer

How to Avoid Claim Rejection

Pay premiums on time and keep the policy active (in-force). Claims on lapsed policies are not entertained unless revived.
Disclose all pre-existing medical conditions, smoking/drinking habits, and hazardous occupation details at the time of policy purchase.
For early claims (within 3 years of policy issuance), expect thorough investigation — ensure all original declarations were accurate.
Nominees should be updated regularly (especially after major life events like marriage, divorce, or childbirth) to prevent complications.
Suicidal death within 1 year of policy issuance is excluded under most life insurance policies — review your policy terms carefully.

Frequently Asked Questions About Claims

Get answers to common insurance queries

How long does it take for a claim to be settled?

Timelines vary by product. Motor claims: 7–15 working days. Health reimbursement: 15–21 working days. Life insurance: 30 days from receipt of complete documents. Cashless health claims are typically settled within hours at the hospital level.

Can I file a claim without a surveyor visit?

For motor insurance, surveyor inspection is mandatory except for very minor claims below a threshold defined in your policy. For health and life insurance, surveyors are not applicable — document submission drives the process.

What happens if my claim is partially approved?

The insurer will send a settlement letter explaining the approved amount and the reason for any deductions. You have the right to raise a grievance or escalate to IRDAI (Insurance Regulatory and Development Authority of India) if you believe the deduction is unjustified.

Can I reopen a rejected claim?

Yes. You can file a grievance with the insurer within 15 days of receiving the rejection letter. If unresolved, you can approach the Insurance Ombudsman or IRDAI's Bima Bharosa portal.

What is a cashless claim vs. reimbursement?

In a cashless claim, the insurer settles the bill directly with the hospital or garage. In a reimbursement claim, you pay first and are reimbursed later after document verification.

Is an FIR always required for motor insurance claims?

FIR is mandatory for theft, third-party bodily injury/death, and total loss cases. For minor own-damage accidents not involving third parties, an FIR may not be required — confirm with your insurer.

Can I switch from cashless to reimbursement mid-claim?

This is generally not permitted once cashless pre-authorization has been initiated. Contact your insurer immediately if you need to switch due to a change in circumstances.

Claims Information Center

Private Car Insurance

Two-wheeler Insurance

Health Insurance

Life Insurance

Enquire Now