Why life insurance claims get delayed or rejected, and what you can do

You’ve been through a very bad period, and a loved one has just passed away. It’s during these very traumatic and trying times that you have to get involved with that great bugbear – life insurance. Or the benefit from the recently deceased.

While this insurance may help you to tide over the trying financial and other times that you, the survivors, will undoubtedly face, please keep an eagle eye open that the paperwork is done as per norms, so that times that are already trying do not become more so.

“Having life insurance is only half the job done,” says Anup Seth, Chief Distribution Officer, Edelweiss Life Insurance. The real purpose of the policy is fulfilled only when your loved ones can easily access it and claim the benefit when needed.

“It (claiming the life insurance sum) is often a difficult time for nominees, and truly the moment of truth for life insurers,” says Rajesh Krishnan, Chief Operations and Customer Experience Officer, Bajaj Allianz Life Insurance.

“The most common errors (that LI claimants make) are incomplete claims forms, or giving outdated contact details,” says Rakesh Goyal, Director, Probus.

People also forget to attach required documents, for example, the original policy bond or proof of bank account, leading to follow-ups or a second round of paperwork to obtain documents that are mandatory to submit their claim.

In cases of accidental or unnatural deaths, omission of police records or hospital discharge summaries would lead to further delays in processing.

In some cases, families make mistakes with respect to the cause, date, or both, of the death because they were confused about what occurred, increasing likely unnecessary complications. “Beneficiaries should be careful not to submit photocopies without appropriate attestations as well,” says Goyal.

Even from the point of view of the management of the life insurance policy, too, some mistakes may lead to the rejection or postponement of the policy benefits to the successors.

“Non-payment of premiums or delaying paying premiums, leading to the policy lapsing or reduced benefits,” says Seth.

At the policy purchase stage, concealing information related to health issues/ financial conditions often surfaces during claim investigations, creating grounds for rejection.

Another point is not informing the insurer if the nominee passes away or if other changes to the policy that may occur.

The basics…

As in all asset classes, for insurance, too, certain documentation has to be filled out carefully.

At the time of purchase of the policy, be very careful with the nominee details. Make sure the nominee’s name is written exactly as it appears in their KYC document. Even a small mismatch—such as a different spelling, initials, or date of birth—can cause delays during claim settlement.

Also, contact details. Always update your correct mobile number and email ID. This ensures the insurer can reach you with policy updates and premium reminders so that there is no lapse or gap in the policy, and the claim processing becomes smoother.

When claiming life insurance policy benefits, beneficiaries usually must submit the following documents, such as a duly filled claim form, original policy document, death certificate, and bank account details for payment.

Additionally, if it were a hospital death or an accidental death, the beneficiaries may also have to submit medical records, FIR, or post-mortem reports.

“Most insurers will request an original death certificate from the issuing municipality because it is the primary proof of death. In practice, most insurers will accept a certified or notarized copy as long as the copy has been attested via a statement of a gazetted officer or notary public,” says Goyal.