Make an Insurance Claim

Make an Insurance Claim

Bereavement is difficult to deal with and we at HDFC Life understand this completely and do all we can to help your family financially in this moment of distress. We strive to ease the process by enabling faster settlement of your claims.

Please drop us a mail at claims@hdfclife.com for any assistance or query relating to reporting a claim (Death Claims/Critical Illness Claims) or healthassure@hdfclife.com for Health Insurance Claims and we will help you with the details required to process the claim.

For NRI related claims where claimant is residing abroad, please refer to the FAQ’s.

Quick Claims Processing for Disasters & Natural Calamities:

  1. Nominee to approach the Bank wherein the Member was having the ‘Savings Bank Account’ through which he / she was covered under PMJJBY; along with the death certificate of the member.

  2. Nominee to collect Claim Form, and Discharge receipt, from the Bank or any other designated source like insurance company branches, hospitals, PHCs, BCs, insurance agents etc., including from designated websites. The insurance companies concerned shall ensure wide availability of forms at all such locations. Supply of the form shall not be denied to any person requesting the same.

  3. Nominee to submit duly completed Claim Form, Discharge Receipt, death certificate along with photocopy of the cancelled cheque of the nominee’s bank account (if available) or the bank account details to the Bank wherein the Member was having the ‘Savings Bank Account’ through which he / she was covered under PMJJBY.

Claim Evaluation Process

To enable you arrange the documents faster, we have here a tentative list of documents that need to be submitted with the claims form.

Life Insurance Claim Documentation

Natural Death

  1. Death claim form (includes NEFT)
  2. Death certificate issued by Govt. / Relevant Authority
  3. Original Policy Document
  4. Claimant’s Identity & Residence Proof
  5. Medical records at the time of death & past illnesses

 

Un-natural Death (Accidental death / Murder / Suicide)

  1. Death claim form (includes NEFT)
  2. Death certificate issued by Govt. / Relevant Authority
  3. Original Policy Document
  4. Claimant’s Identity & Residence Proof
  5. FIR, Police Inquest Report & Panchanama
  6. Post Mortem Report

 

Additional documentation may be requested on case-to-case basis

Disaster / Natural Calamities

  1. Death claim form (includes NEFT)
  2. Death certificate issued by Govt. / Relevant Authority
  3. Original Policy Document
  4. Claimant’s Identity & Residence Proof

 

Critical Illness Claim

  1. Critical Illness claim form
  2. Medical records (current & past) viz. hospital records, reports of diagnostic tests done.
  3. Original Policy Document
  4. Claimant’s Identity & Residence Proof

 

Additional documentation / forms may be requested on case-to-case basis

 

How To make a claim through HDFC Life Video

 

Reimbursement Claim Process

Cashless Claim Process

The claims must be submitted along with following documents in original:

  1. Claim form duly filled and signed by You/Life Insured
  2. Hospitalization discharge card/summary
  3. Hospital invoice(s)(summary and the itemized invoices) and corresponding payment receipts
  4. Surgical summary (in case the Life Insured has undergone a surgery)
  5. All supporting diagnostic reports and prescriptions
  6. All Pharmacy receipts and corresponding prescriptions
  7. Ambulance invoice if applicable

 

Self attested copies of following documents:

  1. Health card Or Policy document and
  2. ID proof

Please note that above is an indicative list of required documents and we reserve the right to call for additional documents or raise further requirements.

30-Days Waiting Period

Pre-Existing Conditions

Permanent Exclusions, no payment for-

  1. Treatment received outside India
  2. Non Allopathic and Experimental Treatment
  3. Self Inflicted injuries or attempted suicide
  4. Substance misuse and de-addiction
  5. Cosmetic treatments
  6. Sleep and Obesity
  7. Dental Treatment (except due to accident)
  8. Routine Eye and Ear Ailments
  9. HIV/AIDS

View complete list of Exclusions (UIN:101N087V02)
View complete list of Exclusions (UIN:101N087V01 - Closed for sale)

  1. Full disclosures with respect to information requested in the proposal form.
  2. Timely payment of premia on the due date.
  3. Submission of NEFT details along with cheque copy to enable direct credit into your account.
  4. Submission of the complete claims documentation & information requested at our nearest branch.

Please fill the form to initiate a Death Claim request. Claim will be registered after submission of documents at branch.
Fields marked with "*" are mandatory to be filled.

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Claim Track Record for FY 2013-14

At HDFC Life, we ensure a hassle-free and uniquely sensitive claim experience. We are always doing our utmost to enable faster settlement of claims and our Claims Settlement Ratio reflects our assurance. We have settled 94.01% under Individual death claims and 100% under Group Claims* of the claims received by us, the claim amount being worth 245.89 Crores.

Please visit the IRDAI website www.irda.gov.in for further details.

*as per IRDAI annual report 2013-14 [for Individual & Group Death claims]

1. What are the documents required to process a death claim?

The documents required to process the claim are based on the cause of death are:

Sr. Document Name Natural Un-Natural Natural Disasters
i. Claims Form * with bank account proof
ii. Death certificate issued by the Government
iii. Claimant’s Residence & Identity Proof
iv. Original Policy Document
v. Police records attested by police authorities
vi. Post Mortem attested by hospital authorities
vii. Medical records for diagnosis and treatments
viii. Doctor’s / Hospital’s certificate (Form)*
ix. Employer’s certificate (Form)* if employed

✔ : Required Documents
✖ : Documents Not Required

Note

  • Unnatural cause would mean Accidental / Murder / Suicide.
  • Any document submitted in photocopy needs to be Originally Seen and Verified by HDFC Life employee.
  • * All the required forms are available on our website in “Download Form” tab under the following link - http://www.hdfclife.com/customer-service/claims
  • Documents (i – iv) are only required where claims are submitted under following products - Pension Plans, Single Premium Whole of Life, Savings Assurance Plan, Immediate Annuity Plan.
  • Original Policy document will not be required for Group Claims.
  • HDFC Life may call for documents apart from the above (case specific).

2. What are the documents required for Critical Illness Claim?

  • Critical Illness claim form with bank account proof
  • Medical records viz. reports of diagnostic tests, hospital and treatment records for illness diagnosed
  • Original Policy Document
  • Claimant’s Identity & Residence Proof

3. Which account proofs can be submitted?

Original cancelled personalized cheque or original bank statement with pre-printed Account Number, IFSC code and the customer’s name on the same or copy of the bank passbook.

4. What needs to be done if the Policy documents are not available with the Nominee?

  • An Indemnity Bond should be submitted in lieu of Policy document which is lost. The indemnity needs to be executed on the stamp paper and duly notarized. The value of the stamp paper would be as applicable in the state.
  • The template for indemnity bond is available on our website in “Download Form” tab under the following link - http://www.hdfclife.com/customer-service/claims

1. To whom will the death claim amount be paid?

The claim amount is payable to the Policyholder / nominee / beneficiary / appointee / assignee under the Policy. Every Policy document clearly states the names against these roles.
Rule for payments Payee
In UL-Young Star / Children’s Plan Beneficiary
Proposed Policyholder is different from the Life Assured Proposed Policyholder
Policy is Assigned Assignee
None of the above Nominee (for death claims) / Life Assured (for living benefit claims)
Nominee is a minor Appointee

Note:

  • In case the life assured has changed the nomination / appointee. The death claim amount is payable to the latest nominee / appointee registered with the Company
  • In case the Policy is re-assigned, then the death claim amount is payable to the latest nominee / appointee registered with the Company
  • In case there are no nominations under the Policy the death benefits would be paid to the heirs of the deceased Life Assured. HDFC Life would seek Succession Certificate; if the successor is minor, then Guardianship Certificate

2. How can I intimate a claim to HDFC Life?

A claim can be submitted by:

3. What is the time frame within which the claim has to be reported to the Company?

A claim must be reported as soon as possible to enable the company to process the claim.

4. Is NEFT mandatory for all Life, Group & Rural claims?

  • As per the IRDAI circular no. IRDA/F&A/CIR/GLD/056/02/2014 dated February 13, 2014, all payouts made to customers need to be in the electronic form. Hence, NEFT details of the customers are mandatory to process the claim payouts.
  • NEFT payments would be made only in Indian Saving Bank Accounts or NRO Accounts.
  • Cheque would be issued if payment has to be deposited in NRE Account.

5. What is the maximum processing timeline prescribed by Insurance Regulatory Development Authority of India?

  • A claim under a life Policy shall be paid or be disputed giving all the relevant reasons, within 30 days from the date of receipt of all relevant papers and clarifications required. However, where the circumstances of a claim warrant an investigation in the opinion of the insurance company, it shall initiate and complete such investigation at the earliest.
  • Where in the opinion of the insurance company the circumstances of a claim warrant an investigation, it shall initiate and complete such investigation at the earliest, in any case not later than 6 months from the time of lodging the claim.


Type of claim Claim settlement turnaround time
Claim which does not requires an investigation 30 days from receipt of all relevant papers and clarifications required
Claim which requires an investigation 180 days from the date of lodging the claim

What is the Grievance mechanism available if, I am not satisfied with the Claims decision?

The claim can be represented to HDFC Life within 30 days of receipt of the rejection letter on the following address:

Claims Review Committee
HDFC Standard Life Insurance Company Limited
5th Floor, ILFS Building, Plot No. C-22, G-Block,
Bandra-Kurla Complex, Bandra (E),
Mumbai – 400 051

If you are still not satisfied with the response provided by the Claims Review Committee, you could also approach the Insurance Ombudsman in your region. For address visit our website www.hdfclife.com.

1. How will I know that a claim is registered?

  • HDFC Life will send an acknowledgement letter within 10 days of receiving the documents.
  • In case there are any further requirements the same will be intimated via this letter, e-mail on your registered address and SMS on your registered mobile number.

2. What communications are sent to claimant for cases wherein post death claim, maturity benefit is payable?

The Endorsed Original Policy document is sent back to the claimant, which details the benefit that is paid & will be payable at Maturity & during the term of the Policy.

3. What if the NEFT payment made by HDFC Life is rejected by the Bank?

  • A letter will be sent to the claimant informing them of the NEFT failure.
  • The payment will be processed on receipt of the fresh NEFT mandate along with the account proof.

4. If a claim is rejected, then how will the same be communicated?

HDFC Life will send a detailed rejection letter within 10 days of decision including the reason for the rejection of the claim.

The claims processing, communications and documentation will remain as mentioned in the links. We have provided enablers as mentioned below if the claimant is residing outside India.

1. How can I intimate a claim to HDFC Life?

  • If the claimant resides in Dubai, then claim documents can be submitted at our Dubai Representative Office.
  • Alternatively the claimant can email us the documents at claims@hdfclife.com (with subject line NRI Claim). The physical documents should be sent to the following address:

    Claims Department
    HDFC Standard Life Insurance Company Limited
    5th Floor, ILFS Building, Plot No. C-22, G-Block,
    Bandra-Kurla Complex, Bandra (E),
    Mumbai – 400 051

2. Would the claim be paid in foreign currency?

The claim would be paid in Indian Currency (INR) only.

3. Can I submit an NRE Account for receiving the claims proceeds?

  • If the claimant provides a NRE account number then cheque would be issued and dispatched to the address.
  • A repatriation letter would be issued only if the premium towards the Policy has been paid from a NRE Account. Please submit the proof of premium payment via NRE account to enable us to issue a repatriation letter.