How does the insurer pay insurance claims?

What is a surveyor and what does it do?

The most difficult and important aspect of property or insurance is the correct and accurate application of the Principle of Indemnity. This principle states that in case of loss of property or assets, the compensation should be equal to the amount of the loss. Neither less nor more. Giving a broader explanation of this policy, it is said that if there is any loss of assets or property and if the risk is accepted in the insurance policy, the insurance company will compensate the affected person or organization to the extent that the person or organization was in the same financial condition as before the loss. go back

The problem is who will decide the real value of the damage? Insurance company or policyholder. Both are interested parties. It is not unusual for the insurance company to want to minimize the loss and the insured to maximize the claim. The only way to solve this problem is through a third party or organization. Assigning the responsibility of determining the actual loss in case of question of claim to a person who is honest, impartial and experienced in determining the actual loss of the subject matter of general insurance and knows all the technical aspects thereof. This is what is done in general insurance business. Those who are entrusted with this responsibility are called surveyors.

Surveyors are experienced and skilled in all technical aspects of determining the actual loss of a general insurance subject. The government gives certificates to such persons or institutions and only the government certified surveyors submit their survey report or survey report to the insurance company in case of any loss of assets or property. The value of this survey report is very important in terms of settlement of claims. The role of surveyors is therefore important in general insurance business.

How does the insurer pay insurance claims?

As per the terms and conditions of the insurance contract, compensation is paid by the insurance company in return for the premium if any uncertain possibility or contingency occurs. Availability of claims is the legal right of the insured. Life insurance claims are paid only to the legal owner. As per the terms of the insurance contract, the insured amount is paid by the insurance company in 02 (two) types of cases.

   a) Death or accidental disablement of the insured within the stipulated period of the insurance contract.

b) After the expiry of the prescribed period, the sum assured is paid in part or in full to the policyholder or nominee or to the assignee of the property, depending on the type of insurance scheme.

Payment/Settlement of Death Insurance Claim: In case of death insurance claim the valid claimant of the policyholder has to submit the following documents to the insurer:

1) Death certificate, funeral/cremation certificate, original insurance document, age proof issued by the attending physician at the time of death of the insured.

2) Completed submission of claim form, identification card, employer’s statement and doctor’s statement form provided by the insurance company.

After receiving the documents stated by the valid claimant/nominee of the policyholder, the insurer follows its statutory post-mortem claim settlement process and conducts on-site investigation if necessary and if the investigation report is positive, an executive receipt is sent to the policy nominee with the approval of the appropriate authority. The policy nominee duly fills the executive receipt. On return to the insurer, the insurer sends an account payable check to the nominee’s bank account.

Post term insurance claim payment/settlement: Post term claim is when the sum assured is payable after the stipulated time limit/term of insurance as per the insurance plan during the lifetime of the policyholder. In case of term insurance claim the policyholder has to submit the following documents to the insurer:

1) Age proof (if age not proved earlier)

2) Proof of ownership (if ownership imposed)

3) Original insurance document.

In the case of maturity insurance claims, if the policyholder submits the specified documents to the insurer, the insurer sends an executive receipt to the policyholder. If the policyholder duly fills out the executive receipt and returns it to the insurer, the insurer sends an account payable check to the bank account of the policyholder. 

When does the insurer pay the bonus to the customer with the insurance claim?

the answer If the funds of the insurance company are more than the actual liabilities of the insurance company, then the excess is called surplus. After the valuation process conducted by the actuary, the insurance company distributes the surplus in the form of bonus along with the insurance claims to the insurance customers. However, bonus is paid only in profitable insurance plans. Besides, the declared bonus is paid along with the paid price.