HDFC Life Insurance
HDFC Life Insurance Claim Settlement Process

HDFC Life Insurance Claim Settlement

HDFC Life Insurance Company promises to offer its consumers a quicker, simpler, and an efficient claim settlement experience, which can also be proved by its excellent claim settlement ratio (98.01%). The company also offers multiple facilities (such as tracking claim status, contacting the insurer, branch locator, etc.) to heighten the quality of claim experience of the consumers. So, today we are going to talk in detail about the claim procedures of different claim types under this insurer. Have a look at the below mentions.

Claim Process of HDFC Life Insurance Policies

No matter which policy you own, HDFC Life has listed out a detailed claim process for all. Let’s check them out.

Death Claim

Follow the below steps to avail of a smooth claim process:

  • As soon as the incident happens, intimate the insurer either via email ID, WhatsApp or by visiting the official branch of the company.
  • For the online process, verify the policy details. And for an offline procedure, download the claim form, and submit the duly filled and signed claim form.
  • In the case of the online process, submit the life assured details. And, for offline, collect all the required relevant supporting claim documents.
  • After that, submit the nominee details if you are availing of the online process. In case of an offline death claim, you just need to submit the documents to the insurer.
  • You are done here. The claim management team of the company will verify and evaluate the documents against your policy wordings.
  • If any further documents are required, you will be notified about the same.
  • Once the company receives all the required documents and no discrepancy is found, your claim amount will be settled within the stipulated time.

Documents Required:

For natural death:

  1. Death certificate issued by Government or relative authority.
  2. Death claim form (Includes NEFT)
  3. Original policy document (In case of DEMAT, original policy documents are not required)
  4. Claimant’s resident proof.
  5. Claimant’s photo ID proof and/or pan card
  6. Claimant’s photograph
  7. Medical records at the time of death and past illness.
  8. Personalized canceled cheque or bank passbook.
  9. Employer’s certificate form, if employed.

For unnatural death:

  1. All the documents are mentioned in the “Natural Death” section.
  2. FIR, police inquest report, and panchnama
  3. Post mortem report

For disaster and natural calamity:

  1. All the documents are mentioned in the ‘Natural Death’ section.

Critical illness Claim

Here are the steps:

  • You need to intimate the insurer as soon as the incident happens following any of the methods mentioned above.
  • After that, you need to download the claim form by visiting the official website of the company.
  • Collect all the required supporting claim documents, and preserve those for future reference.
  • Send the duly filled and signed claim form along with the necessary documents to the insurer.
  • The claim management team will verify the documents, and if any further documents are required, the same will be communicated.
  • Once the insurer receives all the documents, they will process the claim. If the claim is found fair and sound, the claim amount will be settled.

Documents Required:

  • Duly filled and signed critical illness claim form
  • Medical records (current and past) such as hospital records, records of diagnostic tests done, etc.
  • Original policy document (In case of DEMAT, original policy documents are not required)
  • Claimant’s resident proof.
  • Claimant’s identity proof
  • Personalized canceled cheque or bank passbook.

Health Claim

Health Assure and Surgicare Claim Process

Reimbursement procedure:

Get a note of the following steps:

  1. For planned hospitalization, intimate the TPA of the company at least 72 hours prior to the hospitalization. For emergency hospitalization, inform the insurer within 24 hours of the hospitalization through any of the touch points available.
  1. In this case, you can choose the hospital of your choice. It does not have to be a network hospital of the company.
  1. Avail of the treatments, and pay the bills at the time of discharge. Collect all the documents for future reference.
  1. Within 15 days from the date of discharge, you need to submit the duly filled and signed claim form to the available touch point, along with all the required documents.
  1. If any additional documents are required, the company will inform you of the same.
  1. After that, the claim management team will verify the documents against the policy wording and terms and conditions.
  1. If no discrepancy is found, your claim will be settled accordingly.

Cashless Procedure:

Follow the below steps:

  1. For planned hospitalization coordinate with the network, the hospital to forward [re-authorization request to TPA at least 72 hours prior to the hospitalization. For emergency hospitalization, within 24 hours of the hospitalization approach, any of the touch points to share the patient’s health card details.
  1. The TPA will coordinate with the company and will authorize the cashless services as per the terms and conditions of the company.
  1. If necessary HDFC Life will ask for more relevant documents and NEFT details.
  1. On discharge, the hospital will submit the required documents to the TPA.
  1. Any amount over and above the amount pre-authorized will be paid at the time of discharge.

Cancer or Cardiac Claim Process:

Follow the steps below.

  • On diagnosis or treatment of cancer or cardiac condition, do submit all the required documents to any of the touch points of HDFC Life.
  • The company may ask for additional documents if required.
  • Once the insurer receives all the documents, they will verify those and process the claim procedure according to that.

Click 2 Protect Health Claim Process:

  • Cashless procedure:

For a seamless claim process, follow the below steps.

  1. Register your claim either via phone call, email ID, mobile app, website or by visiting the official branch. After that, you will receive a unique Claim Control Number (CCN).
  1. The NSP (Network Service Provider), or the hospital, will collect all the necessary documents from the insured person and will submit these along with the hospitalization recommendations to Health Claim Services (HCS) of HDFC ERGO.
  1. The HCS will verify the documents, and if everything is alright, the claim will be approved.
  1. At the time of discharge, you may have to pay the differential amount to NSP.
  1. Once the insured is discharged, NSP will send all the documents to the HCS team for releasing the final payment to NSP.
  • Reimbursement procedure:

Have a look at the following steps:

  1. Once you are discharged from the hospital, submit or upload all the relevant documents along with the duly signed and filled claim form against the registered claim ID.
  1. HCS team of the company will verify the documents and will release the payment as per the terms and conditions.

Required Documents: 

For Health Assure Plan:

  1. Claim form
  2. Discharge summary, death summary, or transfer summary.
  3. Hospital final bill, and break-up along with the payment receipts.
  4. Doctor consultation notes
  5. Pharmacy prescriptions, and bills
  6. Diagnostics investigation reports and bills.
  7. KYC, NEFT details, and the PAN card details.
  8. Indoor hospitalization case paper copy attested by the hospital authorities.
  9. In case of an accident, Medico Legal Certificate (MLC), or FIR.
  10. In case of death, nominee details.
  11. Any other documents, if required.

For other health plans:

  1. Claim form
  1. All the medical and diagnostic bills, and receipts.
  1. KYC, NEFT details, address proof, and identity proof.
  1. For cancer care, the self declaration on the chronology of health events and medical evaluations. And, also attending the treating doctor’s statement stating the TNM classification or the stage of cancer.
  1. For cardiac care, the attending doctor’s statement stating the history of heart conditions of the patient, and siblings along with the age at which they suffered from heart conditions, and also his certificate stating the Life Assured survives for a period of 30 days from the date of occurrence or recurrence of the covered condition.

Group Claim

For details, look at the below steps:

  • The claimant needs to submit the information related to the claim to the MPH.
  • The MPH verifies and sends all the documents to HDFC Life.
  • After that, the company does the inward scrutiny and uploads it on Life Next.
  • If any document is pending, it is communicated to MPH or the sales as per SI.
  • Once the insurer receives all the documents, it approves your claim, and the payment is made to the nominee, beneficiary, or MPH via NEF, and the settlement letter is sent to the nominee.
  • If the claim gets rejected, the same is communicated to the nominee or the beneficiary stating the reason for it.

Required documents:

For natural death:

  1. Claim form
  2. Member information or enrolment form (only for lender – borrower). Not applicable for GTI claims.
  3. Death certificate
  4. Doctor’s certificate
  5. Nominee NEFT details
  6. Current and past medical records

For accidental death:

  1. All the documents are mentioned under the section of Natural Death.
  2. Police records (FIR, panchnama, etc.)
  3. Post-mortem report from the hospital

NRI Claim

Here are the steps:

  • For the intimation of the claim, the claim documents can be submitted to the Dubai Representative Office of HDFC Life if you are staying in Dubai. Else, you can email the documents to service@hdfclife.com with the subject line NRI Claim.
  • The physical documents should be sent to the following address:

HDFC Standard Life Insurance Company Limited

5th Floor, ILFS Building, Plot No: C-22, G-Block,

Bandra – Kurla Complex, Bandra (E)

Mumbai – 400051

  • Submit all the relevant documents, along with the duly signed and filled claim form.
  • The documents will be verified by the company, and if no discrepancy is found, the claim amount will be settled in Indian rupees (INR) only.

Rural Claim

Claims Due To Maturity:

Follow the below steps and stay worry-free.

  • HDFC Life will send an advance intimation to the life insured 30 days prior to the date of maturity.
  • The company will also send a blank discharge form.
  • The insured person has to submit the duly filled and signed discharge form pr voucher, along with the required documents at the nearest HDFC Life official branch.
  • In case, the policy is assigned to Society, a consent letter, endorsement copy, along with the policy document has to be submitted.
  • After receiving all the required documents, the insurer will cross check them, and release the pay outs as per the terms and conditions.

Required documents:

  • Original policy document
  • Advance maturity benefit payout discharge voucher sent with the intimation letter
  • Copy of the proposal form
  • NEFT mandate form along with a copy of the canceled cheque leaf
  • Identity and address proof. This should match the company records

Claims Due To Death:

The procedure and the required documents, in this case, will be similar to the claim process and required documents that are mentioned previously in the “Death” section.

NOTE: Nominee declaration is required for rural health claims in case the policy was sourced in the financial years 2011-2012 and 2012-2013.

Whom Should I Contact If Claim-Related Query Is Not Resolved By HDFC Life’s TPA?

In this case, you can contact the insurer following any of the below methods.

  • You can write to the company using their email ID service@hdfclife.com stating your problem.
  • You can call the insurer at 18602679999 (local charges apply).
  • You can use the link Grievance Redressal that is available on their official website.
  • You can also contact the company at the below address.

Grievance Redressal Officer

HDFC Life Insurance Company Limited,

12th Floor, Lodha Excelus,

Apollo Mills Compound, N. M. Joshi Road,

Mahalaxmi, Maharashtra, Mumbai – 400011.

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