We welcome you as a policyholder and as a prospective customer to our customer service section. This section will guide you through the various intricacies of a life insurance contract and the facts that you must know to make the best out of your life insurance policy. Please read our guidelines immediately. A grace period of one month but not less than 30 days is allowed where the
mode of payment is yearly, half-yearly or quarterly and 15 days for monthly payments. If death occurs within this period, the life assured is covered for full sum assured. If the policy has run for atleast 3 full years and subsequent premiums have not been paid the policy shall not be void but the sum assured will be reduced to a sum which will bear the same ratio as to the number of premiums paid bear to
the total number of premiums payable.The concessions regarding claim in the above case is explained in the appropriate section. In case of untrue or incorrect statement contained in the proposal, personal statement, declaration and connected documents or any material information with held, subject to the provision of Section 45 of the Insurance Act 1938, wherever applicable, the policy shall be declared void and
all claims to any benefits in virtue thereof shall cease. The policy shall be void, if the Life Assured commits suicide (whether sane or insane at the time) at any time or after the date on which the risk under the policy has commenced but before the expiry of one year from the date of commencement of the policy. After payment of premiums
for at least three years, the Surrender Value allowed under the policy is equal to 30% of the total premiums paid excluding premiums for the 1st year and all extra premiums. The rate of installment premium shown in the schedule of the policy will remain constant as long as the employee continues with the employer given in the proposal. On leaving the employment of said employer the policyholder should intimate the
Corporation. In case of the Salary Saving Scheme being withdrawn by the said employer, the Corporation will intimate the same to the policyholder. Thereafter the 5% rebate given under Salary Saving Scheme will be withdrawn. After the policy is issued, the policyholder in a number of cases finds the terms not suitable to him and desires to change them. LIC allows certain types of alterations during the lifetime of the policy.
However, no alteration is permitted within one year of the commencement of the policy with some exceptions. The following alterations are allowed. A fee for the change or alteration in the policy is charged by the Corporation called quotation fee and no additional fee is charged for giving effect to the alteration. A duplicate policy confers on its owner the same rights and
privileges as the original policy. The following are the requirements for issuing a duplicate policy: However, in following cases Policyholder has to visit to Branch Office to know the requirements: The Proofs of age, which are generally acceptable to the Corporation, are as under:
Alternative Age Proofs which are accepted:
Nomination:The nominee is statutorily recognized as a payee who can give a valid discharge to the Corporation for the payment of policy monies. Nomination will be incorporated in the text of the policy at the time of its issue. After the policy is prepared and issued and if no Nomination has been incorporated the assured can ordinarily affect the nomination only by an endorsement on the policy itself. A nomination made in this manner is required to be notified to the Corporation and registered by it in its records. A nomination is not required to be stamped. Any change or cancellation of nomination should be given in writing only by the Life Assured. Nomination under Joint Life Policy can only be a joint nomination. Nomination in favour of a stranger cannot be made as there is no insurable interest and moral hazard may be involved. Nomination in favour of wife and children as a class is not valid. Specific names of the existing wife and children should be mentioned. Where nomination is made in favour of successive nominees, i.e., nominee “A” failing him to nominee “B” failing whom nominee “C”, the nomination in favour of one individual in the order mentioned will be considered. Where the nominee is a minor, an appointee has to be appointed to receive the monies in the event of the assured’s death during the minority of the nominee. No nomination can be made under a policy financed from HUF funds. In the case of first endorsement of nomination the date of registration of nomination will be the date of receipt of the policy by the servicing office and in case of any other nomination or cancellation or change thereof, the date of receipt of the policy and/or of notice whichever is later, will be the date of registration. Assignment:An assignment has an effect of directly transferring the rights of the transferor in respect of the property transferred. Immediately on execution of an assignment of the Policy of life assurance the assignor forgoes all his rights, title and interest
in the Policy to the assignee. The premium/loan interest notices etc. in such cases will be sent to the assignee. In case the assignment is made in favor of public bodies, institutions, trust etc., premium notices/receipts will be addressed to the official who has been designated by the institutions as a person to receive such notice There are two types of assignments: 1. Conditional Assignment whereby the assignor and the assignee may agree that on the happening of a specified event which does not depend on the will of the assignor, the assignment will be suspended or revoked wholly or in part. 2. Absolute Assignment whereby all the rights, title and interest which the assignor has in the policy passes on to the assignee without reversion to the assignor or his estate in any event. Re-assignment:An assignee may during the term of policy reassign the interest in the policy to the assignor. Such reassignment would have the effect of cancelling the assignment in favour of assignee and after the reassignment is executed on policy document, the right, title and interest under the policy would revert to the assignor. Concessions for claims during the lapsed period:1. If the policyholder has paid premiums for atleast 3 full years and subsequently discontinued paying premiums, and in the event of death of the life assured within six months from the due date of the first unpaid premium, the policy money will be paid in full after deduction of the unpaid premiums, with interest upto date of the death. 2. If the policyholder has paid premiums for atleast 5 full years and subsequently discontinued paying premiums and in the event of death of the life assured within 12 months from the due date of first unpaid premium, the policy money will be paid in full after deducting the unpaid premiums, with interest upto date of the death. Revivals:If premiums under a policy are not paid within Days of Grace, the policy lapses. A lapsed policy can be revived as per the plan conditions on submission of proof of continued insurability to the satisfaction of the Corporation and payment of all arrears of premiums together with interest at such rate as fixed by the Corporation from time to time. The Corporation however reserves the right to accept at original terms, accept with modified terms or decline revival of a discontinued policy. The revival of the discontinued policy shall take effect only after the same is approved by the Corporation. The cost of Medical Reports, including Special Reports, if any, required for the purpose of Revival of the policy shall be borne by the Life Assured. Policy Loans:The Corporation can grant a loan to the policyholder against his policy as per the terms and conditions applicable to the policy. The requirements for granting a loan are as under : a) Application for loan with an endorsement of terms and conditions of the loan being placed on the policy. c) A receipt for the loan amount "Provision has also been made on Customer Portal for registration of request for Loan for the policyholders registered for Premier Services. After registration of request, the Loan documents can be submitted to any nearby LIC Branch Office."
The minimum period for which a loan can be granted is six months from the date of its payment. If repayment of loan is desired within this period the interest for the minimum period of six months will have to be paid. Claims settlement procedure:The settlement of claims is a very important aspect of service to the policyholders. Hence, the Corporation has laid great emphasis on expeditious settlement of Maturity as well as Death Claims. The procedure for settlement of maturity and death claims is detailed below : Maturity Claims:1) In case of Endowment type of Policies, amount is payable at the end of the policy period. The Branch Office which services the policy sends out a letter informing the date on which the policy monies are payable to the policyholder at least two months before the due date of payment. The policyholder is requested to return the Discharge Form duly completed along with the Policy Document, NEFT Mandate Form (Bank A/c Particulars with supporting proof), KYC requirements etc. . On receipt of these documents payment is processed in advance so that maturity amount gets credited to the policyholder’s bank A/C on the due date. 2) Some Plans like Money Back Policies provide for periodical payments to the policyholders provided premium due under the policies are paid up to the anniversary due for Survival Benefit. In these cases where amount payable is up to Rs.500,000/-,payments are released without calling for the Discharge Receipt or Policy Document. Survival Benefit under Jeevan Anand policies up to Sum assured Rs. 200000/- is also released without calling for policy bond or discharge form. However, in case of higher amounts these two requirements are insisted upon. Death Claims:The death claim amount is payable in case of policies where premiums are paid up-to-date or where the death occurs within the days of grace. On receipt of intimation of death of the Life Assured the Branch Office calls for the following requirements: b) Certified extract from Death Register c) Documentary proof of age, if age is not admitted d) Evidence of title to the deceased’s estate if the policy is not nominated, assigned or e) Original Policy Document The following additional forms are called for if death occurs within three years from the date of risk or from date of revival/reinstatement. b) Claim Form B1 – if the life assured received treatment in a hospital c) Claim form B2 – to be completed by the Medical Attendant who treated the deceased life assured prior to his last illness. d) Claim Form C – Certificate of Identity and burial or cremation to be completed and signed by a person of known character and responsibility e) Claim form E – Certificate by Employer if the assured was employed person. f) Certified copies of the First Information Report, the Post-mortem report and Police Investigation Report if death was due to accident or unnatural cause. Double Accident Benefit Claims:Double Accident Benefit is provided as an additional benefit to the life insurance cover. For this purpose an extra premium of Rs.1/- per Rs.1000/- S.A is charged. For claiming the benefits under the Accident Benefit the claimant has to produce the proof to the satisfaction of the Corporation that the accident is defined as per the policy conditions. Normally for claiming this benefit documents like FIR, Post-mortem Report are insisted upon. Disability Benefit Claims:Disability benefit claims consist of waiver of future premiums under the policy and extended disability benefit consisting in addition of a monthly benefit payment as per policy conditions. The essential condition for claiming this benefit is that the disability is total and permanent so as to preclude him from earning any wage/compensation or profit as a result of the accident Claims Review Committees:The Corporation settles a large number of Death Claims every year. Only in case of fraudulent suppression of material information is the liability repudiated. This is to ensure that claims are not paid to fraudulent persons at the cost of honest policyholders. The number of Death Claims repudiated is, however, very small. Even in these cases, an opportunity is given to the claimant to make a representation for consideration by the Review Committees of the Zonal office and the Central Office. As a result of such review, depending on the merits of each case, appropriate decisions are taken. The Claims Review Committees of the Central and Zonal Offices have among their Members, a retired High Court/District Court Judge. This has helped providing transparency and confidence in our operations and has resulted in greater satisfaction among claimants, policyholders and public. Insurance Ombudsman
a) any partial or total repudiation of claims by an insurer;
What is the maximum time limit of general insurance?Customers now has the option of declaring any disease contracted up to three months after taking the policy. 3) IRDAI has allowed insurers to increase the maximum age limit filed for insurance policies. Usually, the maximum age limit of health insurance policies filed is up to 65 years.
What is the time limit for insurance claim?And, in case of an emergency, the insurer should be informed 24 hours after hospitalization. However, to avail reimbursement, you can file a claim within 30 days to a maximum of 90 days (depending on the insurer and the policy terms and conditions) of receiving a discharge summary from the hospital," said Goel.
How many days does the insurance company have to share a copy of the proposal form with the policyholder after his her acceptance of the proposal?It is the duty of an insurer to furnish to the insured free of charge, within 30 days of the acceptance of a proposal, a copy of the proposal form.
What is the maximum time given for claim settlement under IRDAI Regulations 2017?Ans: 1) In terms of Regulation 27 (i) an insurer shall settle or reject a claim, within thirty days of the receipt of the last 'necessary' document.
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