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Nov 22, 2023

A Step-Wise Guide on the General Insurance Claims Process

Inflation changes the way how you spend and save money due to the rise in cost of commodities. However, inflation impacts almost all industries. The medical industry, for example, also gets affected by inflation. The cost of equipment used for procedures, materials and other items may increase. This can mean paying out of pocket for medical treatment might burn a bigger hole in your pocket. Instead, buying a general insurance policy provides you with a much-needed financial cushion to handle such expenses. This assistance is provided after a claim has been filed by you. Let’s understand the claim process for different insurance policies under the general category.

General Insurance Claim: How Does It Work

Many people do not take into consideration how expensive hospitalisation is, especially during medical emergencies. Paying out of pocket for these expenses may cause financial burden for you. Having the cover of health insurance provides you with financial assistance, thus not requiring you to pay for it yourself. This financial assistance can be availed with the help of an insurance claim. Claims are subject to terms and conditions set forth under general insurance policy. Here’s how the claim process works for different insurance policies:

Motor Insurance

Be it a four-wheeler or a two-wheeler, it is a prudent choice to insure your vehicle with motor insurance. It offers financial assistance for damages and loss of vehicle. It also offers compensation for third-party damages and injuries. Claims are subject to terms and conditions set forth under motor insurance policy. The following is the claim process for your car/bike insurance:
  • Step 1: Contact the insurer

Contact your insurer after the accident has happened. This initiates the claim process. Reach out to them through their website or their helpline number.
  • Step 2: Register an FIR

The insurer may require an FIR in the event the damages are severe.*
  • Step 3:Document the damages

Take photos and videos of the damage caused to the vehicle/s. This is required by the insurer for verifying the extent of the damages you mentioned.
  • Step 4: Submit necessary documents

Along with the evidence, you need to submit necessary documents such as the policy, vehicle/s RC, and other documents. This is required in processing the claim as soon as possible.
  • Step 5: Get the vehicle surveyed

The insurer will send a surveyor to thoroughly inspect the vehicle and to get other details, all of which will be sent to the insurer.*
  • Step 6: Get the vehicle repaired

This is the final step of the claim process. You have two options for having your vehicle repaired:
  1. Getting your vehicle repaired at a network garage allows you to take advantage of cashless claim, where the insurer is directly billed for the repairs.*
  2. If you take your vehicle to a third-party garage, you are required to cover the cost of repairs, following which the insurer will reimburse you.*
Claims are subject to terms and conditions set forth under motor insurance policy.

Keep the following things in mind

  1. In case of third-party claim settlement, the third-party will be required to provide your insurer with an estimate of the cost of repair, following which they will be compensated.*
  2. IDV of the vehicle is considered in the event of total loss. Zero depreciation cover ensures the exclusion of depreciated value, and you get full compensation. If you wish to include this add-on in your policy, you can do so at the time of insurance renewal.*
  3. If you own a standalone own damage policy, no compensation will be provided for third-party damages by the insurer.*

Health Insurance

To deal with medical emergencies without the risk of financial burden, it is important to buy health insurance. The coverage secures you and your family from the inflated costs associated with medical treatment. Claims are subject to terms and conditions set forth under health insurance policy. Health insurance claim works in two ways:
  1. If admitted at a network hospital, the third-party administrator can assist you with the claim. With the help of your health insurance card, the claim process gets initiated sooner by the hospital. Bills are sent directly to your TPA, which are then sent to the insurer. After the process is complete, the hospital will be compensated by the insurer via the TPA.*
  2. If the patient is admitted in a regular hospital, you are required to bear all of the expenses, following which the insurer will compensate you.*
Claims are subject to terms and conditions set forth under health insurance policy.

Keep the following things in mind

  1. Disclose any pre-existing health conditions at the time of policy purchase to avoid any complications at the time of claim settlement.*
  2. If you smoke cigarettes, or consume any tobacco-related product, disclose your habit to the insurer.*

Travel Insurance

Travel insurance provides you with the financial coverage you deserve if you were to face any unwanted mishaps during your trip within the country or abroad. Travel insurance provides coverage for loss of baggage, documents, and medical expenses as well. Listed below are two instances where you can file a claim with your insurer: The compensation for loss of baggage will be dependent on the total declared value of the items and the number of items included in the policy coverage.* For medical expenses, you will need to inform the insurer to initiate the claim process. If you get treatment at a network hospital, the insurer will be billed directly by the hospital.*

Keep the following things in mind

  1. If you plan to participate in adventure sports during your trip, do check the policy document to see which sports are covered under the policy.
  2. If you have any pre-existing medical conditions, it would be wise to disclose the conditions beforehand to avoid any complications at the time of claim.
Claims are subject to terms and conditions set forth under travel insurance policy.

Conclusion

While these are the claim processes for some of the policy types, you can get in touch with an insurance advisor to know about the claim process for more specific policies. You can also get more information for queries such as what exactly is general insurance, and which policy is suitable for you.   *Standard T&C apply Insurance is the subject matter of solicitation. For more details on benefits, exclusions, limitations, terms, and conditions, please read the sales brochure/policy wording carefully before concluding a sale.

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