The document outlines the steps for processing a personal accident insurance claim, including verifying that the loss occurred within the policy period and was due to an accident rather than sickness. It also lists the required claim documentation for a death claim, such as a completed claim form, death certificate, police report, and legal heir certificate containing an affidavit and indemnity. The claims handler should register the claim, create a reserve, maintain turnaround times, and keep the customer informed of the claim's progress.
The document outlines the steps for processing a personal accident insurance claim, including verifying that the loss occurred within the policy period and was due to an accident rather than sickness. It also lists the required claim documentation for a death claim, such as a completed claim form, death certificate, police report, and legal heir certificate containing an affidavit and indemnity. The claims handler should register the claim, create a reserve, maintain turnaround times, and keep the customer informed of the claim's progress.
The document outlines the steps for processing a personal accident insurance claim, including verifying that the loss occurred within the policy period and was due to an accident rather than sickness. It also lists the required claim documentation for a death claim, such as a completed claim form, death certificate, police report, and legal heir certificate containing an affidavit and indemnity. The claims handler should register the claim, create a reserve, maintain turnaround times, and keep the customer informed of the claim's progress.
d) Loss has arisen out of “Accident” and not sickness
e) Check for any fraud triggers and assign investigation if need be
f) Register the claim and create reserve for the same
g) Maintain the turnaround time (claim servicing time) and keep the customer informed of the development of the claim.
Claim documentation - Personnel Accident :
a) Duly completed Personal Accident claim form signed by
the claimant‟s nominee/family member
b) Original or Attested copy of First Information Report.
(Attested copy of FIR / Panchnama / Inquest Panchnama)
c) Original or Attested copy of Death certificate.
Death claim
d) Attested copy of Post Mortem Report if conducted.
e) Attested copy of AML documents (Anti-money laundering)
- for name verification (passport / PAN card / Voter's ID / Driving license) for address verification (Telephone bill / Bank account statement / Electricity bill / Ration card).
f) Legal heir certificate containing affidavit and indemnity
United States v. Pasquale Panza, Seymour Ringle, Charles Fruscione, Gregory Cappello, Gregory Boutelle, Christopher Merlino, 750 F.2d 1141, 2d Cir. (1984)