CLAIMS

CLAIMS FAQs

Our three-step claims process is designed with a clear objective to settle all valid claims with minimal trouble to our customers and in the least possible time.

Foresee the future and prepare your loved ones today.

Your first prudent decision to secure your life and that of your loved ones was of buying a Life Insurance Policy from ALIC. Now, ensure that your virtuous decision serves your ultimate purpose. Please keep the following in mind at all times:

  • Ensure your beneficiary/beneficiaries are updated in our records. This would ensure prompt claim settlement in the unfortunate event of death of the Life Assured.
  • Pay premiums regularly. This would ensure that your Policy is in force. A lapsed policy means no death benefits are payable to the nominee.
  • Keep a record of all your insurance policies and make a file of it. Maintain a record of the Advisor/Branch with their addresses and contact details. Ideally share this information with your loved ones.
  • Educate the loved ones on the process to lodge a claim. It is the responsibility of the beneficiary to inform us about the claim.
  • Inform your beneficiary or immediate family members about the policy you have taken.
  • Verify that the data on the policy certificate is correct. In case of any discrepancies, please contact us immediately.
  • Keep your policy pack safely. Note your policy number and quote it in every communication to the company.
  • Remember that NO agent is authorised to admit any liabilities on behalf of the company, or to alter the list of the documents or any claims requirements called for the Company.
  • No charges are payable to anyone for lodging or settlement of a claim.

 

 

FAQ FAQFAQ Claims

Who is entitled to receive the Death Claim benefit?

The claim monies can be received by any of the following:

  • Nominee* or Appointee (in case the nominee is a minor)
  • The proposer, in case you are not the Life Assured
  • Assignee, in case policy has been assigned
  • Legal Heirs, in case of open title case or rival claimant case
  • Life Assured, in case of living benefit claims such as, claims under disability, critical illness and health claims

* Nominee is the person you appoint at the time of purchasing the policy for receiving the benefits of your insurance policy in your absence. ^Life Assured is the person for whom the life/health insurance policy has been issued.

What happens if there is no nomination in the policy or when Life assured & nominee dies in the same event?

Such claim is considered as Open Title claim. In such an eventuality a Succession Certificate or Probate of will is to be submitted by the Claimant. A Succession Certificate is issued on application by a competent court on the question of the right to the property of the deceased. The Succession Certificate should specifically provide for disbursement of policy monies. If, however, the deceased has left a will, a probate of the will is required along with the copy of the will. If we have accepted the claim but are waiting for the issued certificate of proof, we hold the money till the proof is submitted and pay interest as directed by the Insurance Regulatory and Development Authority of India.

What if there are two or more nominees, how will the Policy Monies be paid?

The claim will be paid to nominees according to the percentage declared in the proposal. A joint discharge will have to be given. Alternatively, all the nominees can give a joint discharge and NOC (No Objection certificate) for payment of claim benefits in favor of one nominee, in which case the claim proceeds would be made in the name of the designated nominee.

If the nominee dies during the tenure of the Policy, What is the next step the Life Assured should do?

The Life Assured should nominate another person in place of the deceased Nominee under section 39 of the Insurance Act.

Are terrorist attacks covered by our policies?

Please note that all Death Benefit Claims under Base Plan caused on account of Terrorist Attacks are covered by our policies. However, Accidental death benefit rider excludes war, terrorism, invasion, act of foreign enemy, hostilities, civil war etc. and hence benefit under ADDD will not be payable if the insured event is a result of terrorist attacks.The above condition is specified under the Terms and Condition of Accident death benefit rider.

What is the time frame within which the claim has to be reported after the date of event?

All Claims including death claims should be intimated as soon as possible, to help us process it faster.If there has been any delay in reporting the claim, the reason for the same should be justified in writing by the claimant.

How do I intimate/report my claim?

a. Submit duly completed claim forms and other documents at the nearest Aegon Life Branch Office.

b. Submit duly completed claim forms and other documents at our Head Office.

c. Call us at our Toll Free Customer Care number- 1800 209 9090 for any further information or visit our website

Please click on this link to connect to our CLAIMS PROCESS PAGE for a detailed claim process, claim forms and branch locator. Your claim will be formally registered only after receiving a written claim intimation along with all the required documents at our branch/Claims Cell

What are the documents required to submit a claim?

Ans- Below are different type of forms available on website:

a. Death Claim To get a list of the documents required while reporting a Death Claim, please CLICK HERE

b.Accidental Disability/ Dismemberment claim

c.To get a list of the documents required while reporting an Accidental Disability/ Dismemberment claim, please CLICK HERE

Critical Illness Rider claim

To get a list of the documents required while reporting a Critical Illness Rider claim, please CLICK HERE

How can I check/know the status of my claim?

You can know the status of your Claim by calling our Customer Care Helpline at the Toll Free number- 1800 209 9090 or by writing to us at customer.care@aegonlife.com

How much time does the company take to decide on a claim

At Aegon Life Insurance, we endeavor to decide the Claim within 7 working days after all the records, documents and necessary forms are submitted by the Claimant and documentation is complete, subject to all other terms and conditions being met.In case, the Claim warrants further verification, the time taken to decide upon a claim would be slightly extended. Detailed timelines are as given below:

Turn Around Time as mandated by Insurance Regulation and Development Authority of India (IRDAI)Death ClaimsHealth Claims
Raising Claim RequirementsWithin 15 days of receipt of claimWithin 15 days of receipt of claim
Settlement or Rejection or Repudiation of claims wherein Investigation is not requiredWithin 30 days from the date of receipt of last necessary documentWithin 30 days from the date of receipt of last necessary document
Settlement or Rejection or Repudiation of claims wherein Investigation is requiredInvestigation should be completed not later than 90 days from the date of receipt of claim intimation and the claim shall be settled within 30 days thereafterInvestigation should be completed not later than 30 days from the date of receipt of last necessary document and the claim shall be settled within 45 days from the date of receipt of last necessary document
How will I receive the claim amount?

We honour most of our claim payments through direct Bank transfer. Electronic Clearing Service:

  • You need to submit the ECS instructions along with a cancelled cheque with name of claimant printed on it.
  • The claim amount will be transferred directly to your bank account

*Electronic Clearance System or ECS is the mode to transfer your money electronically from one bank account to another. Cheque Payments:

  • A cheque is drawn in name of claimant.
  • It is sent to you at the address mentioned in the claim form
How will a claim be treated if policy is in Lapse status

If the Policy is lapsed as on the date of death of the life assured, no death benefit is payable For death benefit with respect to other plans, please refer to the policy terms & conditions mentioned in your policy document.

When does a claim get rejected?

It is very important to read through the Proposal form and submit true factual details at the proposal stage and provide genuine documents at the time of buying a policy. In order that your claim does not get rejected, please ensure the following:

A.   At the time of buying the policy:

  • Ensure that you read and yourself answer all the questions correctly and accurately to the best of your knowledge
  • Ensure that you have disclosed all material facts to the Company with regard to your health and be truthful about your tobacco and alcohol consumption habits. An affirmative declaration does not mean that your proposal will be rejected.
  • In case of any doubt as to whether a fact is material or not, the fact should always be disclosed
  • Ensure that all the documents submitted by you (E.g. age, address, income proof etc.) along with the proposal form are genuine.

B.Upon the receipt of your policy document, please perform the following checks:

  • Go through the copy of your signed proposal form enclosed along with the policy document
  • Review and ensure that all the questions have been answered correctly and accurately to the best of your knowledge
  • Double-check details with regards to your nominee. Ensure that your nominee knows the details of your policy such as sum assured, policy term etc. Also keep your policy bond in a safe place and ensure that your nominee knows where the original policy bond is stored.
  • In case you come across any discrepancy, please contact us immediately

C. At the claim Stage:

  • If documents submitted at the Proposal/Claims stage are not genuine, it would also lead to claim repudiation.
  • In the claims findings, if it is established that there had been a material suppression of facts pertaining to the proposal information, which would have impacted the assessment of risk, if disclosed at the proposal stage, then it may lead to repudiation of the claim.

Most of the claims get rejected due to reasons like:

  • Fraud (which is a deliberate and intentional attempt to cheat by submitting false claims. for example, submitting a death claim when the insured person is still alive)
  • Non-disclosure of existing disease medical condition or income and occupation details etc at the time of buying the policy
  • Non-disclosure of lifestyle attributes like tobacco and alcohol consumption at the time of buying the policy
  • Committing suicide within the first year or reinstatement of policy
  • Non-payment of premium within grace period which means your policy is in lapse status

 

How do I communicate my concerns with respect to a claim decision?

We strive to pay all genuine claims and hence a simplified claim process. In case the claimant has a query or concern they can approach the Customer Care department at (Toll Free number--1800 209 9090). In the event of response being dissatisfactory for the claimant, he/she may write to our Grievance Redressal Committee. The claimant may communicate his/her concerns to this committee by sending a written communication to the address mentioned below:

Aegon Life Insurance Company Limited, Building no.- 3, Third floor, Unit no.- 1, Nesco IT Park, Western Express Highway, Goregaon (East), Mumbai -400063, Maharashtra If the claimant is still not satisfied with the redressal, the complainant may approach the Insurance Ombudsman. For more information on the Insurance Ombudsman, please refer your policy document.

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Aegon Life Insurance (ALI) is committed as a responsible life insurer to pay out all genuine claims, while reserving the right to repudiate fraudulent claims

Aegon Life Insurance is committed as a responsible life insurer to pay out all genuine claims, while reserving the right to repudiate fraudulent claims.

We trust to reinforces our commitment to ensure a speedy claim settlement at a time, when you need it the most!

Intimate your claim to us through online, this makes your work easier to submit the information require