Bajaj allianz

General Insurance Claim Process

All insurance contracts are based on the information provided by the insured in the proposal form. The proposal form forms the basis of insurance contracts. Some important points, which would help you in the claims procedure are:-

The loss or damage should be reported to the insurer immediately. On receipt of claim intimation, the insurer will forward a claim form. Submit the completed claim form along with an estimate of the loss to the insurer. It is preferable to submit an itemized estimate with separate values. The insurer will arrange for inspection of the damaged items to assess the loss. In case of major losses, a specialist-licensed surveyor is deputed. The insured has to provide the required documents to substantiate the extent of loss. In case the cause of loss is not established, it is for the insured to prove that the loss or damage has occurred due to an insured peril. On agreement of claim amount between the insured and the insurer, the claim is settled. Average Clause - As per the terms and conditions of the insurance policy. Excess as stated as per the Policy terms and condition will be deducted from the claim payable. In view of varied nature of policies, certain points distinct to individual policies, in addition to the above, are listed below (documents mentioned are indications and based on the circumstances of the claim, insurer may request additional documents). Top
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Claims under Fire / IAR Insurance

Firstly the insured should take all possible steps to minimize the loss. The fire brigade may be intimated immediately. Lodge a police complaint in case of a fire arising out of - rioting mob, striking workers, malicious damage by third parties or terrorist damage. Inform insurer as early as possible , in no case later than 24 hours. To co-operate with the surveyor appointed by the insurer by relevant information. Obtain a meteorological report in case of loss due to cyclone, flood & inundation. if the loss is localized like in the case of flood & inundation from a local water source, MRO report may be obtained. If the policy is on 'reinstatement basis', the claim is settled only after completion of repairs/replacement of the damaged items and submission of bills for claim payment. Top
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Burglary Claims / Money Insurance / Fidelity

Immediately report to the police and obtain a non-traceable certificate that the items are not found. Notify insurer as early as possible. The insurers will insist upon a letter of undertaking on a stamp paper of appropriate value - letter of Subrogation, for refunding the claim amount when the stolen property is recovered. Obtain a final report from Police. Insured has to provide the surveyor complete book of accounts and bills substantiating the loss on the day of incidence. Top
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Machinery Breakdown
Immediate notification to the insurer. Notice of claim and estimated cost of repairs should be filed with the insurers to arrange for inspection. In case of partial losses, no depreciation is charged but when the items are not insured for its present day replacement value, the items are treated as underinsured and the claim amount is proportionately reduced. Depreciation is only applied for Total Loss claims.

If an appliance is partially damaged, it should be repaired (on approval from insurance company) before it is put to use, as otherwise further loss is not covered. Top
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Electronic Equipment
Immediate notification to the insurer. Notice of claim and estimated cost of repairs should be filed with the insurers to arrange for inspection. In case of partial losses, no depreciation is charged but when the items are not insured for its present day replacement value, the items are treated as underinsured and the claim amount is proportionately reduced. Depreciation is only applied for Total Loss claims.

If an appliance is partially damaged, it should be repaired (on approval from insurance company) before it is put to use, as otherwise further loss is not covered. Top
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Household goods in transit

In case any damage is suspected in transit, open delivery should be insisted upon the carrier and their certificate should be obtained. In case of loss/damage in transit, a monetary claim should be lodged with the carrier within the time limit to protect recovery rights, without which, the claim may not be admitted.

Health Guard Insurance Claim (for non-cashless claims)

Notice of claim should be lodged within 24 hours. The insured should submit 'discharge summary' of the hospital/nursing home along with original hospital/medical bills,reports of the labs and investigation reports.In other words every item in the claim bill should be supported. Leave certificate from the employer, wherever needed. Fitness certificate from the Doctor.

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Travel Companion Insurance Claim

The claim procedure varies from country to country and therefore the insured should get in touch with the overseas claim settling agents of the insurers immediately. The Insured should carry the policy document with him, which may be produced as evidence if necessary. The policy document also contains the full information as to how to get in touch with the claim settling agents for assistance. Top
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Personal Accident Claims

Immediate notification to the insurer. In case of accidental death, the capital sum is paid to the legal nominee/assignee of the insured. If the insured fails to provide the name of the nominee, succession certificate from a court of law is necessary. In case of other claims, the insurers may get the insured examined by a specialist or refer the matter to medical board as is necessary, the cost of which will be borne by the insurers. Top
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Hospital Cash
Discharge card from hospital to be submitted. Any additional information requested by insurer. Top
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Marine Transit Loss

Original Invoice & packing List - if forming part of Invoice. In case any damage is suspected in transit, open delivery should be insisted upon the carrier and their certificate should be obtained. Original LR/ BL - Qualified with remarks for the Quantity damaged or lost in the transit. In case of Declaration Policy - The consignment should be declared and the within the limit of balance Sum insured. In case of loss/damage in transit, a monetary claim should be lodged with the carrier within the time limit to protect recovery rights. Damage / Shortage Certificate from the carrier. A surveyor ( mutually agreed by the Insurer) must be appointed to determine the nature, cause and extent of loss/damage. Top
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Workmen's Compensation
Work / Job profile. Wage proof for last 12 months. Age proof. Employment proof. Injury details and Medical Certificate.

Disablement Certificate. Postmortem report in case of death. Top

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Rural Insurance (Cattle)

Ear tag. Post-mortem report with cause of death. Doctor's certificate for treatment. Photograph of deceased animal. For PTD claims - opinion of two doctors. Other additional proof for substantiating loss. Top
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Car and Two Wheeler Insurance Claim

Notice of an accident (not necessarily a claim) involving third parties should be reported to the insurers. The insured may be interested to pay compensation without going into whether he is liable to pay or not. It is therefore an express condition of the policy that no claim should be admitted or a compromise arrived at, without the approval of the insurers.

In case of major claims, the insurers may be willing to defend criminal case against the driver also on the basis of which compensation claims may be decided in the civil courts. Every accident involving third parties is required to be reported to police. . The M. V. Act provides that a third party victim can proceed against the insurers directly. If the alleged accident is not reported to the insurers, the insurers can consider this as violation of policy condition. In such circumstances, even if insurers are required to pay compensation by a court of law, they have an option of recovering such claim amounts from the insured for violation of specific policy condition.

The insured can proceed with repairs provided the insurers are submitted an estimate of repairs and the estimated cost of repairs does not exceed Rs.500 in case of Private cars and Rs.150 in case of two wheelers. Claims under Comprehensive policies Steps to be taken in case of an accident:-

Notice of accident should be filed with the insurers. If damage is a major one, the accident may be reported before the vehicle is removed from the spot so that the insurers can arrange for spot inspection of damage. The vehicle may then be moved to a workshop, preferably to authorized workshop, for estimation of repair charges. On receipt of completed claim form and estimate of repairs the insurers will arrange detailed inspection of damage and cost of repairs will be ascertained. The insurers will ensure that a person duly licensed drove the vehicle at the time of accident and that the vehicle is the one insured in their books. To that end, they will verify the Registration Certificate and the Driving license of the driver who drove at the time of the accident.

Upon completion of the above procedure, the repairers will be authorized to carry out repairs. The insurer may undertake to settle the repair bills directly with the garage or reimburse the insured. Insurers would like to collect the damaged parts for which replacements have been allowed, as salvage. To ensure that replacements with new parts, have in fact, been effected.

In case of theft of the car or its accessories, it has to be reported to the police and final report should be submitted. Top
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Life Insurance Death Claim

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Health Insurance Claim Process

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Health Insurance Reimbursement Process

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Claim Submission - FAQ

Click each FAQ listed below to learn about the life insurance claim process:-

What is the claim process of Bajaj Allianz Life Insurance Company? What parameters are considered by the company while asking the claimant to submit particular records/ documents? How can a claim be intimated to the company? Why is it essential to produce all the records/ documents as required by the company? Where can a claimant get claim forms and list of documents required for submission? Where can the claimant submit claim documents? Who is entitled to receive the claim benefit? What is the procedure when there is no nomination or in case of pre-deceased nominee at the time of death claim? How will the claimant receive the claim amount?

Under what circumstances is a claim declined by the company? How does a claimant communicate his/ her concerns in connection with a claim decision? What if there are two or more nominees, how will the Company settle the proceeds? Are the premiums returned to the beneficiary in the unfortunate event of life assured's death while the policy remains lapsed? What are the documents required for a settlement of claim?

1. What is the claim process of Bajaj Allianz Life Insurance Company?

Claimant to intimate Bajaj Allianz Life Insurance Co. Ltd. about the claim with a copy of death certificate and intimation letter. Bajaj Allianz Life Insurance Co. Ltd. branch issues the forms and informs the claimant to complete the documentation for faster claim processing. Claimant to submit the required documents at the earliest so as to ensure faster settlement. Top
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2. What parameters are considered by the company while asking the claimant to submit particular records/documents?
The company considers the cause, circumstances of claim and duration of the policy while asking for requirements, e.g. For accidental death, specific proofs such as post-mortem and police reports are required whereas for death due to an illness, the company calls for records from hospital, test reports etc. Top
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3. How can a claim be intimated to the company?

Claim can be communicated through a written intimation to nearest Bajaj Allianz Life Insurance Co. Ltd. branch

* Kindly note that claim will be formally registered only after receipt of written intimation and proof of loss at branch/
HO Claims team. Top
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4. Why is it essential to produce all the records/ documents as required by the company?
Claims are examined and settled by the company on the basis of all records and proofs in connection with the claim. Providing all the documents ensures complete scrutiny of the claims and enables us take faster decisions. Operations team at branch / HO can be contacted for any clarification/ assistance with regard to the claim. Top
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5. Where can a claimant get claim forms and list of documents required for submission?
The claimant can get the claim intimation form from any Bajaj Allianz Life Insurance Co. Ltd. Office. Top
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6. Where can the claimant submit claim documents?

The claimant can submit the documents at any of the Bajaj Allianz Life Insurance Co. Ltd. Office. Top
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7. Who is entitled to receive the claim benefit?

The nominee or the appointee (in case of minor nominee) last recorded under the policy in case of policy on own life. The proposer in case the policy is not on own life. Assignee in case the policy is assigned. Life Assured himself/ herself in case of policy on own life for living benefit claims i.e. claims under hospital cash, disability or critical illness rider. Top
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8. What is the procedure when there is no nomination or in case of pre-deceased nominee at the time of death claim?
In such circumstances, it is termed as "Open Title" situation. The company would require the proof of title/succession certificate issued by the competent court. The claim would be paid to the person specified in the said proof. If the company has accepted the claim but is waiting for such proof, then the company holds the money till the proof is submitted. Top
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9. How will the claimant receive the claim amount?

The company honors claim payments through cheque or ECS as instructed by the claimant. Top
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10. Under what circumstances is a claim declined by the company?

A claim will be declined if the claim made does not comply with:-

The terms and conditions as mentioned in the Policy Document. Declaration & Authorization agreed at the proposal stage in the application form. Top
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11. How does a claimant communicate his/ her concerns in connection with a claim decision?
The company has a dedicated Claim Review Committee which comprises of a team of Senior level managers. If the claimant wishes to represent his or her case, a letter addressed to the committee can be sent at the address given below:-

Claim Review Committee Bajaj Allianz Life Insurance Company Limited, 5th Floor GE Plaza Air port Road, Yerawada, Pune -411 006. If the response is not satisfactory to the claimant, he/ she can approach the Office of Insurance Ombudsman for reexamination of the matter. The Consumer Forums can also be approached by the claimant for redressal of grievances. Top
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12. What if there are two or more nominees, how will the Company settle the proceeds?
If there are two or more nominees, then a joint discharge will have to be given. The claim proceeds would be paid in favor of the designated nominee. Top
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13. Are the premiums returned to the beneficiary in the unfortunate event of life assured's death while the policy remains lapsed?
There is no provision to pay any amount in a lapsed Unit Link policy issued before 01-July-2006. For all policies issued on or after 01-July-2006 a/c value as on date of intimation is paid to claimant. Under all traditional policies if 3 annual premiums are paid then a paid up value is paid. Top
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14. What are the documents required for a settlement of claim?

The documents required depend on the cause of death. Mandatory documents required for settling a claim may be listed as follows:1. 2. 3. 4. 5. 6. Death certificate issued by Municipal Authority Original policy document Claimant's Statement Claimant Photo id Proof ECS / EPS forms Discharge form

The other documents that get triggered for natural death:1. Medical proof of cause of death 2. All Medical records The other documents that get triggered for unnatural death:-

1. First Information Report 2. Post - Mortem Report 3. Police Inquest Report 4. Newspaper cuttings The Company reserves the right to call for additional requirements as warranted. The Company reserves the right to call for additional requirements as warranted.

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