Claim Settlement Ratio
The Claim Settlement Ratio (CSR) of an insurance company is a metric used to determine its credibility. It is computed by dividing the total number of claims settled by the number of claims it received. When buying a life insurance policy, it is important to consider an insurer with a high claim settlement ratio....Read More

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Claim Settlement Ratio can be understood easily by learning how insurance companies follow certain rules and regulations before settling an insurance claim, in case a policyholder passes away during the policy tenure.
Claims can be denied, especially when there are some red flags in the policy draft that might go against certain policy requirements. Therefore, when it comes to life insurance, you need to be sure that you fill out the necessary paperwork correctly and choose an insurer that has a proven track record of settling the major portion of the claims received on an annual basis.
Claim Settlement Ratio can serve as a reliable metric to determine if a certain policy and insurer is the right choice for you.
The primary purpose of a life insurance plan, especially term insurance, is to provide financial support to your family, in case something happens to you. When you purchase a term plan or any other insurance product with a high claim settlement ratio:
- You can be assured that the entire experience of claim filing to disbursal will be simple, convenient, and transparent.
- In case of an unexpected mishap, your loved ones will have the assurance of a quick disbursal of the life insurance benefits.
How is Claim Settlement Ratio Calculated?
First, you need to understand that the Claim Settlement Ratio is calculated for all the insurance products offered by the insurance company put together, rather than any specific product.
Consider the following example to understand the calculation of the Claim Settlement Ratio:
Let us say that a life insurance company receives 1,000 claims in a year, out of which it settles 993 claims by paying the insurance benefit (or sum assured) while rejects the remaining 7 claims.
The Claim Settlement Ratio for the company would be (993/1000) % or 99.3%
Claim Paid Ratio = (Total Claims Paid / Total Claims Received)
What is a good Claim Settlement Ratio?

Overall, the higher the percentage of settled claims, the better the chances that your life insurance policy claim will be accepted and settled by the insurance company. Another reflection of a high CSR is on the insurance company’s finances. With settlement percentages up and above the 95% mark, a prospective life insurance buyer can be sure that the insurers are secure as they are willing to pay the insurance claim amount to most of their customers.
For FY 2022-23, the claim settlement ratio of Max Life Insurance was 99.51%*. However, it is essential that you do not rely on this value as the only factor while determining your insurer.
You must consider other factors such as online reviews of the insurance company, the experiences of your near ones, and the features and benefits of the insurance plan before making a choice.
Why is Claim Settlement Ratio Important?
Buying a life insurance policy is a long-term endeavour. Not only do you have to pay a significant amount of premiums over a specific payment tenure to avail of the policy benefits but you also have to be sure that your insurance policy documentation is well-rounded so that it doesn’t get rejected.
Thus, you need to compare and purchase a life insurance plan from an insurer with a high claim settlement ratio. Claim Settlement Ratio is a reliable metric that can help you determine if a certain insurance company is trustworthy or not and that your family would not have to move from pillar to post in getting the insurance benefit after your untimely demise.
How Long does it Take to Get Claim Payout?

How swiftly your beneficiaries receive the claim benefit is impacted by how quickly they file a claim and fill out the correct forms. Assuming the information is accurate, an insurance company will pay the claim amount in as little as one to two weeks.
The ideal conditions include:
- The life insurance policy is in effect for three years or more
- The insurance policy has all premiums paid and
- The cause of death is not suspicious
Deferrals in filing a claim or getting the right documents together could stretch the payment date. In any case, the life insurance company should pay out a death claim within 120 days.
Reasons Why Our Claims Settlement Process is Unique?
At Max Life Insurance, our claim settlement process is personalised because of the following factors:

a) Speed:
Insta claim in 1 day- Claim settlements under InstaClaim™ are subject to the following conditions:
- The claim amount on eligible policies is up to Rs. 50 lakh
- The policy has been in force for a minimum of three years
- All the mandatory# documents shall be submitted before 3 pm at any Max Life Insurance office from Monday to Friday
- Nominee Title is clear
- The claim does not warrant field verification
b) Trust:
For the FY 2022-23, Max Life Insurance had a claim settlement ratio of 99.51%*, which is by far the highest number that Max Life Insurance has achieved till date beating its own records for previous years.c) Ease:
Our website's Claim Centre crisply offers all the necessary information. Your nominee can either download the claim from the website's claim section or walk into the nearest branch office.d) Dedicated officers:
We appoint a personalized service in the form of a dedicated Claims Relationship Officer (CRO) on the next working day of claim submission. Having a CRO is especially useful in the case of the settlement of a death claim, where your nominee receives every help to avail of insurance claim benefits in time.e) Support:
Our round-the-clock customer support services provide a speedy resolution to customer queries and grievances. Our customer support services aim to maintain one of the lowest customer incidences throughout the insurance industry.How are the Claims Processed?

At Max Life Insurance, we understand the importance of staying protected against life's uncertainties. We believe it is our responsibility to provide the best insurance coverage possible in your hour of need.
Our team of expert claim assessors are guided by the principle of being the 'Fairest, Fastest, and Friendliest' in terms of claims processing. Our life insurance claim settlement processes, thus, include the following three simple steps:
- Claim Registration & Document Submission
- Claim Evaluation
- Claim Decision & Settlement
For the FY 2022-23, Max Life Insurance had a claim settlement ratio of 99.51%*.
Furthermore, we assign a dedicated Claims Relationship Officer (or CRO), to guide your beneficiaries/ claimants at different steps of the claims process.
What Documents are Mandatory for Claims Settlement?
Mandatory Documents required for claims settlement ratio are:
- Original policy document
- 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 canceled cheque of bank account passbook and nominee's photo identity proof
- Discharge/ Death summary attested by hospital authorities of FIR & Post Mortem Report/ viscera report (in case of accidental death)
Max Life’s InstaclaimTM Promise - 24 Hours is All We Take
The grief of losing your dear one in the hands of destiny is beyond words. As your trusted life insurer, Max Life Insurance offers InstaclaimTM Service to settle your claims within one day, so you can deal with your responsibilities in the absence of your loved one.
We, at Max Life, recognise that claim is the ultimate moment of truth for our business. Therefore, we intend to make your claim settlement experience convenient and quick with the InstaClaimTM initiative.
Through the InstaClaimTM initiative, Max Life endeavours to pay eligible death claims up to Rs. 50 lakh in only 24 hours. Additionally, a dedicated Claim Settlement Officer facilitates a convenient, quick, and simple settlement process.
The 24 hours claim settlement is available for the following:
- Eligible policies that have completed three continuous years
- The claim does not warrant field verification
- All mandatory documents are submitted before 3 pm at any Max Life Insurance office from Monday to Friday
- Nominee Title is clear
- Claim amount on all eligible policies is up to Rs. 50 lakh
Furthermore, if you don't receive the payment within the time frame, you'll be entitled to additional payments in the form of ‘interest’ on the total amount of your death benefit. T&C apply
With the InstaClaimTM initiative, Max Life further aims to enhance customer experience by paying death claims within just 24 hours in eligible cases.
Moreover, in a country with a low protection quotient (as per the IPQ survey), Max Life’s claim settlement ratio of 99.51 percent gives a sense of security that their families will be financially safe during an eventuality, thus encouraging them to opt for life insurance products.
Selecting the adequate sum assured for Term Insurance
Along with checking the claim settlement ratio it’s important that you identify the adequate sum assured required to financially protect your loved ones. To make it easy for you, we have provided some of the sum assured options available below:
Disclaimer: Standard daily premium for 24-year old healthy male, non-smoker, 25 years policy term,25 year premium payment term (exclusive of GST) for Max Life Smart Secure Plus Plan (UIN:104N118V07).
ARN: C/SA/171023
Stay Safe, Stay Protected
As a policyholder or buyer, you can take a cue from the claim settlement ratio. However, the IRDAI advises that the claim settlement ratio should not be the only parameter that you consider when buying a life insurance policy. Instead, you need to ask whichever insurance company you have decided to purchase life insurance from, to provide all the material information about their policy undertaking and claim settlement process.
On the other hand, you must make sure that you are sincere and transparent while filling out the application form so that your family does not have any problems submitting a claim to the insurer in your absence.
*Source:
As per annual audited financials, FY 2021-22
Claims Settlement Ratio FAQs

You can register a claim with 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 nearby branch office by clicking here and switching to the ‘Locate A Branch Office’ tab
For any other claims support, call us on 1860 120 5577 or email us at claims.support@maxlifeinsurance.com (Individual Claim) or group.claimsupport@maxlifeinsurance.com (Group Claim). For Cashless health claims, call us on +91 70426 98853 or email us at phs.mli@paramounttpa.com
Our office address:
Max Life Insurance Company Ltd.
Claims Department, 5th Floor
90 C, Sector 18, Udyog Vihar,
Gurugram - 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:
- 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 submit the following documents to register a health claim:
- Health claim application form
- 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 Health 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:
Click here to download the Health Claim forms
Where can I get claim forms and a list of documents required for submission?
You can get claim forms by:
- Downloading from the website Claims Section
- Visiting the nearest Max Life Insurance company branch
- Talking to your Agent Advisor or insurance intermediary
All claims are examined and settled by the company through the information present in the documents submitted by you in connection with the claim.
It is advisable to provide complete information to us for faster and smoother claims processing.
It is advisable that the beneficiary or the nominee intimate us about the claim at the earliest after your untimely demise. In the case of Dread Disease and Critical Illness claims, intimidate us only after the end of the survival period (after 28/30 days of event occurrence).
A claim is declined on the non-disclosure of any material information made at proposal/reinstatement stage, which affects the issuance/reinstatement of policy/rider. Also, non-fulfillment of contract terms and conditions may also lead to claim being declined.
In the case of Employer-Employee & Non-lender borrower schemes, the nominee, as stated in the Provident Fund nomination form or registered at the time of coverage commencement, is entitled to policy benefits.
In the case of Lender-Borrower schemes, the 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.
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 conditions*.
- If the condition/surgery is not covered under the policy terms and conditions*
Accidental injury, which occurs due to self-inflicted injury:
- If the life assured commits suicide within one year of the policy issuance
- If the life assured is involved in any unlawful activity resulting in injury
- If the injury occurred is not as per the policy terms and conditions*.
* For complete details on exclusion, please refer to the policy pack
Life insurance holds immense value for a family that only has one earning member. Consider a scenario wherein the breadwinner loses their life due to deteriorating health or an accident. While the family has to deal with the emotional trauma of losing a loved one, they will also have to suffer financial stress, as they cannot rely on anyone else for support.
To make sure that your family doesn’t have to go through a similar chain of events, you need to create a contingency plan, with life insurance at its foundation, and various other investments making up the remaining portfolio.
Having a comprehensive life insurance plan, you can not only provide the right financial support to your loved ones in case of emergencies but also earn long-term tax-saving benefits among others for yourself. Before you purchase an insurance plan; however, you need to compare different life insurance plans from other insurers, on the basis of their Claim Settlement Ratio or claims paid ratio. This way you will be able to select an insurance cover that suits your present liabilities and life goals perfectly.
ARN NO: PCP/CSR/171023
Claims Process Simplified in just Three Steps
Step One
Claim Registration & Document Submission
Step Two
Claim Evaluation
Step Three
Claim Decision & Settlement
Awards & Achievements
Media Centre

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