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Claims Process Simplified Just In Three Steps

Claims Process Simplified Just In Three Steps

1

Claim Registration & Document Submission

2

Claim Evaluation

3

Claim Decision & Settlement

You can submit your claims at

You can submit your claims at

Max Life Branch Offices
  221 Offices

Branches of our bank partners
  like Axis Bank, Yes Bank etc.

Claims and its importance

Claims and its importance

At Max Life Insurance, we understand how important it is to stay protected against the uncertainties of life. And we believe it is our responsibility to offer you the best support in every possible manner in your hour of need.

Purchasing term Insurance, know the importance of claims

Purchasing term Insurance, know the importance of claims

From the policyholder’s perspective, a life insurance ‘company’ must have a robust and streamlined claim settlement process in place. The sole purpose of a life insurance policy, especially term insurance is to provide financial support to the family in case of a mishap. Hence it is important that in case of an unfortunate event, your loved ones not just have the assurance of receiving the claim amount, but they also need to get it fast. In addition to the speed, the entire experience from the stage of applying for the claim to its payment should be convenient, simple and most of all transparent. Therefore, you must consider Claim Settlement Ratio and the claims experience of a life insurance company before making a decision to choose term insurance.

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Claims Settlement Ratio or Claims Paid Ratio of a company, how is it calculated?

Claims Settlement Ratio or Claims Paid Ratio of a company, how is it calculated?

The Claim Settlement Ratio or Claims Paid Ratio of a life insurance company is an indicator of trustworthiness in claims settlement. It tells you about the number of claims paid by an insurance company compared to the number of claims received by the company in the same year. 

 

Claim Settlement Ratio = Total Claims Paid / Total Claims Received

 

Reasons Why Our Claims Paid Is Unique

  • Max Life Insurance has a process called ‘InstaclaimTM’ to settle the death claims within one day from the claim receipt, subject to the following conditions:
    1. Claim amount on all eligible policies is less than INR 50 lakhs.
    2. Claims for policies completed three continuous years.
    3. All mandatory documents should be submitted before 3:00 PM on a working day
    4. Claims do not warrant any field verification
  • Endeavour to pay Fund value for death claims on all Unit Linked policies within 48 hours (in working days) from claim intimation.
  • The claim centre on the website crisply offers all necessary information. Your nominee can either download the claim from the website’s claim section or walk into the nearest branch office.
  • Max Life Insurance appoints a personalised service in the form of a dedicated Claims Relationship Officer on the next working day of claim submission. It is especially useful in the case of the settlement of a death claim to avail death benefit, where every possible help is provided to the nominee to recieve insurance money in time.
  • With around-the-clock customer support services, Max Life Insurance provides speedy resolution to queries and complaints. It aims to maintain one of the lowest customer incidences throughout the industry.
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How to Compare Claims Ratio While Choosing Life Insurance?

How to Compare Claims Ratio While Choosing Life Insurance?

When you buy life insurance, you make a promise to your loved ones to protect them financially, even when you are not around. Having Life insurance will allow your loved ones to maintain their lifestyle, should anything happen to you. And Claim is the commitment that life insurance company makes to honour your promise to your loved ones. An Insurance plan becomes all the more critical if you are the sole breadwinner for your family.

However, the sheer number of life insurance plans available in the market is enough to confuse you on which policy to buy. While it is crucial that you be very clear about your financial objectives before buying an insurance policy, you must also factor in your current income along with the present and future liabilities. Once you’ve done that, you will be sure about which policy best suits your needs and how much you can afford to pay as premium. Buying a policy that offers the cheapest insurance premium amount isn’t always the best approach. You must thoroughly assess the claims paid record of the insurer too. Otherwise, even if you purchase the most affordable insurance plan and your dependents experience inconvenience at the time of claim payment, it defeats the whole purpose of insurance.

You must compare the claims payment process of an insurance company along with other factors such as Turn Around Time, Average value of Claim and the presence of a dedicated Claim Relationship Officer before purchasing life insurance. Here’s why.

1. Claims Paid Ratio: It is the number of approved/ paid claims divided by the total number of claims received. The Insurance Development Regulatory Authority of India (IRDAI) publishes data on Claim Paid Ratio of various insurance companies from time to time. Max Life Insurance has a claim Paid ratio of 98.26% for the year FY17-18 as per IRDAI Annual Report.

2. Turnaround Time (TAT): It is the time taken by an insurer to process a death claim.

A shorter Turnaround Time implies that the: 

  • Insurer’s claim payment process is efficient
  • Policyholder had made full disclosure at the time of buying the policy
  • The nominee has submitted all the required documents on time


3. Max Life Insurance offers a unique proposition of ‘Instaclaim TM, which processes the death claims within one day from the claim receipt, subject to the following conditions: 

  • Claim amount on all eligible policies is less than INR 50 lakhs.
  • Claims for policies completed three continuous years.
  • All mandatory documents should be submitted before 3:00 PM on a working day  
  • Claims do not warrant any field verification


4. Personalised Claims Relationship Officer:
Personalised Claims Relationship Officers are appointed by insurance companies to facilitate the claim settlement process of life insurance plans.These officers assist the nominee throughout the claim’s settlement process taking care of the documentation and procedures to ensure the claim money is smoothly and timely withdrawn by the nominee.

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Frequently Asked Questions

How can you apply for claims?

You can register a claim with the Max Life Insurance through the following touch points. To help us process your claims faster, make sure that you submit the required documents along with the claim.

  • > Your Agent Advisor, bank or corporate agent, from whom you purchased the policy
  • > Nearest Max Life Insurance company office. You can easily locate a branch office near you, by clicking here https://www.maxlifeinsurance.com/contact-us and browsing through the ‘Locate an Office’ section
     

For any other claims support, Call on toll-free number at 1800-200-5577 or email us at claims.support@maxlifeinsurance.com or write to us on

Max Life Insurance Operations Centre -
Claims Department,
Max Life Insurance Company
Operations centre - 2nd floor
90A, Sector 18, Udyog Vihar,
Gurgaon-122015, India

Documents Required: We will need certain documents to validate a genuine claim. Below are some mandatory documents required to be furnished for each category of claims:

Death Claims: These are claims pertaining to life insurance policies that offer payout on the death of the policyholder.

We request you to submit the following documents to register a death claim:

  • > Original policy documents
  • > Original/attested copy of death certificate issued by the local municipal authority
  • > Death Claim Application form (Form A)
  • > NEFT mandate form attested by bank authorities along with a cancelled cheque or bank account passbook
  • > Nominee's photo identity proof such as a copy of Passport, PAN card, Voter identity card, Aadhar (UID) card, etc.
     

 Additional documents required basis the cause of death

For a Medical or Natural death

  • > Attending physician's statement (Form 'C')
  • > Medical records (admission notes, discharge/death summary, test reports, etc.)
     

For an Accidental or Unnatural death:

  • > Copy of the First Information Report (FIR) or Panchanama/Police complaint
  • > Copy of Post Mortem report (PMR)/Autopsy and Viscera report
  • > Copy of the Final Police Investigation report (FPIR)/Charge sheet
     

Click here to download the Death Claim forms

Health Claims: These are claims pertaining to policies that offer health insurance or a critical illness component

We request you to submit the following documents to register a health claim.

  • > Health claim application form (Details of forms available under Claim Forms section)
  • > Attending physician's statement
  • > Attested copies of all medical records
  • > NEFT mandate form
     

Click here to download the Health Claim forms

Group Claims: These are claims pertaining to life insurance policies offered by organisations/institutions to their employees or group members.

We request you to submit the following documents to register a group claim under the following categories.

Employer-Employee Policies

  • > Claim form (GTL Employer-Employee, EDLI, and Gratuity) as applicable
  • > Original/attested copy of death certificate issued by municipal authorities
  • > EFT mandate form to be completed by nominee/policyholder along with a copy of a cancelled cheque wherein the name of the account holder is printed or a copy of bank passbook
     

Non-Employer Employee Policies: These policies pertain to Lender-Borrower& Non-Lender Borrower Relationships:

  • > Insurance certificate
  • > Original/attested copy of death certificate issued by the local municipal authority
  • > Claim form (Lender-Borrower/Non-Lender Borrower) as applicable
  • > NEFT mandate form attested by bank authorities along with a cancelled cheque or bank account passbook

 
Additional documents required basis the cause of death

For a Medical or Natural death

  • > Attending physician's statement (Form 'C')
  • > Medical records (admission notes, discharge/death summary, test reports, etc.)
     

For an Accidental or Unnatural death:

  • > Copy of the First Information Report (FIR) or Panchanama/Police complaint
  • > Copy of Post Mortem report (PMR)/Autopsy and Viscera report
  • > Copy of the Final Police Investigation report (FPIR)/Charge sheet
     

Click here to download the Group claim forms

Cancer Claims: These are claims pertaining to the cancer benefit in Cancer insurance policies

 We request you to submit the following documents to file a cancer claim: 

  • > Cancer Insurance Claim Form - Form CA
  • > NEFT Form
  • > Medical Records (Admission Notes, Discharge/Death Summary, Test Reports, etc.)
     

Click here to download the cancer claim forms

Where can I get claim forms and list of documents required for submission?

You can get claim forms

> Download from the website Claims Section

> Visit the nearest Max Life Insurance company branch

> Talk to your Agent Advisor or insurance intermediary

Why is it essential to submit all the records/documents as required by the company?

All claims are examined and settled by the company by information present in documents submitted by you in connection with the claim.

It is advisable to provide complete information to us for faster and smoother claims processing.

What is the time frame within which the claim mustbe reported to the company?

It is advisable to intimate the claim at the earliest after death has happened. In case of Dread Disease and Critical Illness claims, claim should be intimated only after the end of survival period (after 28/30 days of event occurrence).

When does the company decline a claim?

In case of Employer-Employee & Non-lender borrower schemes, nominee, as stated in the Provident fund nomination form or registered at the time of coverage commencement,is entitled to policy benefits.

In case of Lender-Borrower schemes, outstanding loan amount in favour of the master policyholder and balance claim in favour of the nominee is registered at the time of coverage commencement.

Who is entitled to receive the claim benefit in case of Group policies?

In case of Employer-Employee & Non-lender borrower schemes, nominee, as stated in the Provident fund nomination form or registered at the time of coverage commencement, is entitled to policy benefits.

In case of Lender-Borrower schemes, outstanding loan amount in favour of the master policyholder and balance claim in favour of the nominee is registered at the time of coverage commencement.

What are the documents required to file a claim with the company?

The documents required to file the following claims are:

> Death claim, please click here.

> Hospitalisation claim, please click here.

> Group claim, please click here.

What are the exclusions under the rider benefits?

Rider benefits offered by Max Life Insurance have the following exclusions:

  • In case the dreaded disease/surgery occurs within a waiting period (90 to 180 days) of the policy issuance, depending upon the contract terms and condition*.
  • If the condition/surgery is not covered under the policy terms and conditions*.

Accidental injury, which occurs due to self-inflicted injury. 

  • In case, the life assured commits suicide within one year of the policy issuance.
  • In case, the life assured is involved in any unlawful activity resulting in injury.
  • In cases where the injury occurred is not as per the policy terms and conditions*.

* For complete details on exclusion, please refer to the policy pack