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Types of insurance claims

Just buying insurance is not enough. You need to also understand what are the types of claims that you are eligible to make. Are you wondering what are the types of insurance claims? This article will provide you with a detailed understanding of the wide variety of claim types across various insurance verticals.

At the end of the article, you will have a proper understanding of all of the types of insurance claims, ranging from life insurance claim types to motor insurance claim types and everything in between.

  • Types of life insurance claims
  • Types of health insurance claims
  • Types of motor insurance claims
  • Types of property insurance claims

Types of life insurance claims

There are two primary types of life insurance claims. They are maturity claims and death claims.

Maturity claims

There are specific life insurance policies that provide a maturity benefit to policyholders. This is where the policyholder can file a claim with the insurance company when his policy term ends. He/she is eligible to get a maturity payment.
Example: Let us say Mr. Suresh has bought a ULIP Term Insurance with HDFC ERGO with a policy term of 30 years. Mr. Suresh’s term insurance policy now matures after 30 years. He can now file a claim to collect his entire maturity benefit.

Death claims

This is the most typical type of life insurance claim. This is where the policyholder’s family can raise a claim with the insurance company after the policyholder’s demise. The nominee mentioned within the policyholder’s policy shall get the complete death benefit specified within the life insurance policy.

Example: Mr. Manoj had a life insurance policy worth Rs.10 Lakhs with an insurance company. He meets with an unfortunate accident and passes away. His family can now raise a claim with the insurance company, and the insurance company will have to disburse the death benefit amount (Rs.10 Lakhs) to the nominee of the policy.

Types of health insurance claims

There are two types of health insurance claims that a policyholder can make—cashless and Reimbursement.

Cashless claims

A cashless claim is where the policyholder does not need to pay the hospital out of his own pockets. The insurance company will directly disburse the funds to the hospital. It is, however, necessary for the policyholder to get admitted to a network hospital. Thus, it is essential to know which are your closest network hospitals to avoid any last-minute confusion.

Reimbursement claims

A reimbursement claim is when the policyholder will need to initially pay hospitalization expenses out of his own pocket. He can later raise a claim with his insurance company upon discharge. It is essential to keep the original copies of all receipts, bills, statements, certifications, medical reports, etc.

Types of motor insurance claims

Two primary motor insurance claims are first-party claims and third-party claims.

First party claims

This is where your vehicle meets with an accident, and you raise a claim with your insurance company. The claim can be raised for damage to the vehicle, yourself, or a passenger.

Example: Mr. Jatin meets with a minor car accident and breaks his windshield. He is now eligible to raise a claim with his car insurance company for compensation. The insurance company will do their due diligence and pass the claim if everything is in order.

Third-party claims

Mr. Mohit bumps his vehicle into a bystander and causes minor damages to the bystander. The bystander sends a legal notice to Mr. Mohit to pay for damages. Mr. Mohit shares the legal notice to his insurance company, and the company appoints a lawyer for Mr. Mohit. The matter goes into court. The company will now pay whatever amount the court decides to the bystander.

Types of property insurance claims

There are a variety of property insurance claims that can be made. Let us understand all of them briefly.

Theft related claims

This is where the internals of the home (jewelry, expensive art, expensive furniture, etc.) are insured, and subsequently stolen. The insured can file an FIR and raise a theft claim with the insurance company.

Fire related claims

A fire can be devastating to a home. It is estimated that every 5th fire-related death originates in India. Over 35 Indian’s die every day of fire-related accidents. There were over 27 thousand fire-related casualties nationwide in 2019 alone. This is an alarming number. If a home is met with a fire, the policyholder can file a claim with the insurance company, provided his home has fire coverage.

Liability claims

This is where your guest, neighbor, or any other individual is hurt due to your negligence. For instance, a person may be visiting your home, and a wall falls on him and injures his arm. This kind of risk can be mitigated by purchasing a liability insurance rider.

Human related property damage

Acts of terror, outsider damage, vandalism, and mischief can be claimed against. For instance, a policyholder can file a property insurance claim if a thief entered his house, stole his valuables, and damaged his property through vandalism.

Natural damage

These claims arise out of acts of nature like earthquakes, tsunamis, forest fires, floods, tornadoes, etc.

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