Life Insurance Claim Procedure
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| Illustration of Life Insurance |
Discussions about insurance compensation so far have tended to occur from the point of view of customers who have taken insurance. In fact, information regarding these requirements is also very much needed for life insurance brokers. Even though the insurance agent has obtained product information from the company where he works, the insurance agent also needs more detailed information about the various benefits of life insurance, from understanding to procedures. In fact, insurance brokers do not only play a role in selling insurance products, but also act as partners and advisors for those involved, especially when customers make claims.
Understand Life Insurance Claims
Term insurance compensation is a request from the insurer (life insurance customer) for the commitment made by the insurer (life insurance company). Insurance claims are closely related to the payment of the sum insured. At the same time, it also answers the question "Can you pay for insurance?". In principle, life insurance can be paid if the insured dies. Then what is life insurance? Life insurance is a contract or evidence of a legally binding written cooperation agreement between the policyholder/insured and the insurance company as the insured.
Types of Life Insurance Benefits
- Ad maturity
Reasonable claims from life insurance products can arise during the lifetime of the policyholder until the end of the policy term.
The sum insured is paid if the policyholder lives until the end of the policy period or has never submitted a critical condition and the policy is still valid. -death claim
Claims for the cause of death are made if the policyholder/beneficiary dies during the policy period and can be recovered from the heirs or plaintiffs named in the policy. The cause of death is illness or accident.
This death claim can arise if the heir or plaintiff named in the policy dies while the policy is still valid. However, life insurance benefits may arise earlier if the insured dies within one year of commencement of coverage.
There are several documents needed to record the cause of death, including the following.
* Personal identity
* Certificate of family relationship
* Insurance document and policy number
So it should be noted that the document that is not required to make a death claim is an education certificate.
Life insurance can be paid in advance. The initial claim for compensation arises if the policyholder dies within one year of inception. This claim for compensation can arise if the insurance cash reserve has accumulated when the policyholder terminates the insurance contract. In other words, the beneficiary or insurer can make insurance or pay cash balances. - Survival benefits
For some types of life insurance, insurance benefits also include protection against the risk of permanent or partial disability of the insured. The benefits of this coverage also include protection against critical conditions (provided this is actually covered by the policy).
This right is a form of protection for the insured against various disaster risks in the future. Examples of life insurance benefits include, among other things, if the head of the insured family dies due to an accident, permanent or partial disability or loss of livelihood due to other reasons. Thus, the benefits of life insurance are useful for ensuring the survival of the family or heirs if the insured is abandoned or the insured loses his own livelihood.
From the list above we can see that bonus benefits and premium rates are not a right but a benefit that can be claimed by a lifetime policy.
The importance of the underwriter in understanding life insurance claims
- Simplify the work of insurance agents who arrange the compensation process between the insured/heir and the insurance company.
Alternatively, the insurance agent can help send this compensation process to the insurance company as the organizer and payer of the money or sum insured.
The insurer also has the duty and obligation to use official documents issued by the company in this compensation process. Thus, the entire life insurance claim process can run smoothly and comfortably for both parties, both the customer/insured/heirs and the insurance company itself.
- Able to formulate and convey clearly the requirements for document requests required by clients
When insurance agents really understand the entire claim process and procedure, they can certainly easily assist clients (eg the insured or legal heirs) in managing this claim process. This is because the insurer is very likely to find critical customers/insured/heirs in the claim process. The insurance agent must be able to fully explain the benefits of insurance coverage, the period of coverage, the compensation process, etc.
- Assist accountability to the insurance company where he works
Apart from sending documents and various claims from the insured/heirs who are entitled, insurance agents are fully responsible for various statements made by marketers to the insurance company where they work. This is because the use of insurance agent services must be in accordance with the company's instructions.
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| Illustration of Life Insurance |
The role of the life insurer in the insurance application process
* Describe product information and benefits you will receive
*siltana and support the application process
*says anything that makes it impossible to make an argument
*clarifies the role of the policy in relation to stated requirements
* find out what to do if you want to register
* Create front and dress photos
* Provide details of the hospital that the insurance company cooperates with (if required)
A few things you need to know when performing a die
The sum insured can be transferred to the heirs if the policyholder has died. However, when it comes to the process and how long it takes to take out life insurance in the event of death, each company has a different policy. The completeness of the required documents also affects the length of the complaint process.
Here are some things you need to know if you want to claim death:
* Submit application no later than 3 months after death
Generally, life insurance policies have a waiting period for claim processing. Life insurance companies can usually offer 90 days or 3 months on this type of death. During this period, the heirs must file a claim for damages no later than 90 days after the death of the insured is announced.
What happens if a claim is made after 90 days? In this case, the heirs must submit additional documents. Additional documents must provide a clear and logical chronology regarding the reasons for the delay in submitting an insurance claim.
* Fill in the application form
In connection with a claim request, you may request a claim form from your insurance company or insurer. Filling out the application form differs from company to company. There are companies that only provide offline forms. So the only way to get it is to check directly with the relevant insurance company. So it's better if you ask your marketer for this delivery because they know better. *Attach the required documents
Pay attention to the information required to apply for insurance. When you file a claim for damages, you must include several supporting documents. But keep in mind that each insurance company has a different policy regarding this matter. Other documents if needed
If additional documentation is required, the insurer will ask you to attach additional documentation that is not included in the list of requirements above. * Confirmation from the insurer
After all the required documents are ready, the insurer carries out the verification stage of the complementary documents submitted. This is followed by further research and verification of the information by the insurance company. Currently, all you have to do is wait for confirmation from the insurance company. Verification usually takes 14 working days, but can take longer if more complex research is required. The length of the review depends on the policies of each company. * Deposit payments
After the documents have been checked and complied with the regulations, the insurance company pays the insured amount to the heirs' account. The term for paying the sum insured is different for each insurance company.
How insurance companies help owners get their life insurance policy approved
One of the duties or roles of a life insurance salesperson is to assist clients in processing claims for their insurance products. Therefore, life insurance brokers must convey the requirements and encourage their clients to fill out the necessary documents for smooth insurance application submission.
Tips and procedural steps that can be given to clients so that life insurance claims are successful and not rejected.
Life insurance contract terms refer to an obligation to pay when all conditions are met. Following are the steps and requirements for applying for life insurance for customers as follows.
-Customers report to insurance companies or agents
The customer, in this case the insured's family or the heirs of the heirs, must notify the insurance agent of the death of the insured. If the deadline for claiming compensation is between 30 to 60 days after the death of the insured, this period must also be taken into account in this reporting period. However, the actuarial limits of each insurance company or product for insurance claim statements may also differ. Therefore, dependents/heirs who are insured and meet the requirements must know the terms agreed upon in their life insurance policy. - Fill out and send the appropriate documents
Below are some of the documents required to file a life insurance claim. However, please note that some company and product policies require different documents according to current policies.
• Original policy
• The beneficiary completes the death form
• the form of death performed by a doctor
• power of attorney to disclose the contents of the medical report - completed and signed by the heirs with a stamp duty
• a death certificate certified by the competent authority (excerpt from the death certificate).
• If you die as a result of an accident, attach the Minutes of Police Examination (BAP).
• If you die at home without medical attention, make a chronology of death and have your heirs sign it
• one or more copies of the results of the medical examination carried out by the Insured
• Account number notification form and copy of account book
• photocopy of the insured's identity
• photocopy of crown prince's identity
• copy of family card
• additional documents, if any
- The process of checking the accuracy of information and conformity with practicum conditions
After receiving the file or document, the insurer will check the correctness of the information and compare it with the applicable insurance provisions. This process usually takes 14 working days from the time the file is received in its entirety. However, this processing time also depends on the policies of the particular insurance company.
-Deposit process
If all documents are complete and the requirements are met, the life insurance party will pay the sum assured as cash compensation to the heirs' account.
Compensation payments can be made either in cash, interest, lump sum, fixed sum or one of the two forms in accordance with the applicable agreement.
Illustration of Life Insurance
Things that can lead to rejection of a life insurance application that must be explained by the insurer to the customer
There are several important reasons that can cause a life insurance application to be rejected. Therefore, the insurance agent must also inform the client of the reasons that may result in the non-existence of insurance compensation.
- Incorrectly filled out or unclear insurance applications
One of the causes of failed insurance claims is that family authorities or heirs do not complete life insurance claims as honestly and clearly as possible. Because it appears in the inspection of insurance companies. Therefore, the insurance company will not pay damages if the contents of the indemnification form contain demonstrable dishonesty.
-The insured died by suicide
Almost all insurance companies deny claims related to death by suicide. Many deed insurance agreements not only limit themselves to suicides, but also exclude self-inflicted deaths, e.g. B. reckless driving accident, willful rule violation, failure to use insurance, etc.
- The insured dies due to a crime
The insurance application will also be rejected if it is proven that the insured died due to a crime. For example, the police shot the insured in connection with a robbery or other illegal crime. This applies not only to the insured, but also if the heir commits a crime. For example, the heir intentionally kills the insured to pay the sum assured.
- Incorrect premium payment
In addition to the above, life insurance benefits can also be refused if insurance payments are missed. There is a validity period for this life insurance policy which the customer or policyholder must understand. Insurance lapse is a condition where insurance coverage ends due to non-payment of premiums and late premiums, or the remaining cash value is insufficient to pay premiums and other costs.
The termination of an insurance agreement deed has a significant impact on the success of a claim. This is because the insurance company is not obliged to pay the sum insured if something happens to the policyholder because the deed of insurance agreement stops paying premiums or defaults on them. Therefore, make sure your life insurance agreement is always valid.