What is an Insurance Claim?
Purchasing life insurance is a smart step towards protecting yourself, your family, and your wealth. When an unexpected event occurs, you can rely on your insurance to cover your needs or help you recover. To receive compensation, you’ll need to file an insurance claim, which InLife or Insular Life has made easier for policy holders.
Nevertheless, understanding the basics of an insurance claim can help ensure smooth and efficient insurance claims processing for all policyholders. In this article, we’ll discuss what an insurance claim is, the different types of claims, the process for filing one, as well as the requirements to submit.
What is an Insurance Claim?
An insurance claim is a formal request made by a policyholder to insurance company requesting compensation for loss or an event covered by the insurance policy.
A policyholder can file an insurance claim when an insured event occurs, such as an accident, illness, or damage to property. The policyholder must notify the insurer of the event, which then triggers the insurance company to assess the claim and, if it is valid, to provide compensation in the form of payout, repair, or replacement of a damaged item.
What are the Types of Claims in Insurance?
Insurance claims are categorized based on the type of insurance and the nature of the insured event. Here are the most common types of insurance claims:
Disability Claim
A disability claim is filed when a policyholder becomes partially or totally disabled as a result of an injury or illness. Disability insurance provides financial support by replacing a part of the policyholder’s income while unable to work.
A disability claim requires proof of the disability – medical records and doctor’s statement – and proof of income. These will help the insurance company determine the insured eligibility and amount of benefit. Disability benefits can provide financial stability during the insured’s recovery period, showing how life insurance protects your finances.
Hospitalization Claim
Individuals who hold health insurance can file a hospitalization claim when they’re hospitalized due to an illness or injury. Hospitalization benefits cover medical expenses like medication, hospital stays, surgeries, and other health-related costs.
Policyholders must provide hospital bills, discharge summaries, and other medical documents, which will then be assessed by the insurance company.
Once the insurance company has certified the claim’s validity based on the policy coverage, the benefits may be sent directly to the hospital as a cashless claim or to the policyholder as a reimbursement claim.
Dread Disease or Critical Illness
Getting diagnosed with a critical illness is a heavy burden mentally, physically, and financially. Critical illness or dreaded disease insurance claims cover severe illnesses like cancer, heart attack, stroke, and so on. These help the insured manage medical expenses and lifestyle changes required by their illness, offering financial relief during a challenging time.
For critical illness claims, the policyholder or their representatives must submit medical records, pathological reports, and physician’s statements to prove the validity of the claim. The insurance company will then verify the diagnosis and the policy terms before disbursing the benefit.
Death Claim
A death claim is filed when the insured person passes away. The insured person’s beneficiaries or next of kin file this type of claim to receive the death benefit specified in the life insurance policy.
To process a death claim, the beneficiaries must provide a death certificate, policy details, and proof of the insured’s identity. The insurance company verifies the information and disburses the death benefit.
The death benefit may be used to help cover expenses like funeral costs, outstanding debts, and the beneficiaries’ future financial needs.
The Insurance Claims Process
InLife has made the process of claiming benefits easier and faster through our InLife Claims Portal. Through this portal, policyholders no longer need to visit a branch to file a claim. They can do everything online.
Here are the steps for processing insurance claims:
1. Notify InLife
The first step in the claims process is to notify InLife about the insured event. This can be done in our Claims Portal, which you can also access through the InLife mobile app.
It’s important to notify InLife as early as possible or within the prescribed period of filing. Delays in notification can complicate the claim process.
2. Submit the Requirements
After notifying us, start gathering the necessary documentation. The requirements vary depending on the type of insurance claim you’re filing. Proper documentation ensures that your claim is processed without unnecessary delays.
Typically, for disability, hospitalization, or critical illness claims, the policyholder or their beneficiaries will be required to submit medical records, physician’s statements, statements of account, receipts, and other proof on top of various forms. For death claims, the death certificate and birth certificate are required. Other documents may be required for specific situations.
You may check the complete list of insurance claim requirements here.
3. Get a Reference Number
Once you submit your requirements, this will be logged into our system for processing. You will receive a reference number that you can use to check the status of your claim.
You’ll also receive updates on your claim via email or SMS.
4. Assessment
After receiving your claim, InLife will assess it to verify its validity and eligibility vis-à-vis the policy terms and conditions. Our team will carefully review all the documents you submitted. This process may take seven to fifteen days from submission.
During this period, an InLife representative may also contact you if additional information or documents are required.
5. Results and Payout
InLife decides to approve or deny the claim based on the assessment. You will receive an email from our claims representative, or you can check the results of your claim in the InLife Claims Portal.
If approved, you’ll receive your claims proceeds through bank fund transfer to your nominated bank account or check which you can pick up at the nearest InLife office.
Providing a Simpler Insurance Claims Process
As a policyholder, it’s important to have a clear understanding of the insurance claims process, so you know what to do when you need to file a claim.
As one of the most trusted providers of insurance in the Philippines, InLife has made the process of filing claims as convenient and seamless as possible with our InLife Claims Portal. Through this portal, you can guarantee timely notification, accurate documentation, and clear communication between us, so you get a smooth and successful claims experience.
Don’t hesitate to reach out to us if you have any questions about filing an insurance claim.
