Is there any time limit for filing insurance claims?

There are many instances when insurance holders may not be able to immediately file for claims. But is there any time limit for filing such claims? The answer to this is ‘No’. However, insurers will check whether the policy was active at the time of the event . Moreover, they also investigate the reasons for filing such delayed claims.

Life insurance: There is no time limit set for nominees to intimate the claim after the death of the policyholder.

Anup Bansal, chief business officer of Scripbox, said, “There is no time limit for a nominee to make a death claim. There is a time limit that a life insurance company has to adhere to when a death claim is made. As per the 2017 regulations of the Insurance Regulatory and Development Authority of India, a death claim under a life insurance policy shall be dealt with—either paid or rejected or repudiated, giving all relevant reasons—in 30 days of the date of receipt of all relevant papers and required clarifications.”

However, if the nominee of the deceased also dies after a certain time, then the insurer can find it difficult to reimburse any other family members even if they are in possession of the policy documents.

Even in such a scenario, the family members can still file a claim.

Sachin Dutta, chief operating officer of Canara HSBC Life Insurance, said, “In case where both the policyholder and nominee are no more, there is still a provision to file the death claim. In such a case, legal heirs of the policyholder need to provide relevant supporting documents. Besides, the claim will be paid if the deceased policyholder has left a will/testament and an executor is mentioned therein for executing it.”

Health insurance: There is a time limit set for the policyholder to intimate about the claim post hospitalization. For different kinds of health insurance claims such as cashless or reimbursement, there are different time limits. Naval Goel, founder and CEO of PolicyX.com, said policyholders must adhere to the timelines to avail of health benefits.

“In the case of availing of the cashless facility, one has to inform the insurer about the planned hospitalization 48 or 72 hours in advance (depending on the insurer). And, in case of an emergency, the insurer should be informed 24 hours after hospitalization. However, to avail reimbursement, you can file a claim within 30 days to a maximum of 90 days (depending on the insurer and the policy terms and conditions) of receiving a discharge summary from the hospital,” said Goel.

Amit Chhabra, head of health insurance, Policybazaar.com, said, “Filing a reimbursement claim beyond 90 days can lead to claim rejection. Typically, the insurer investigates the reasons for the delay and the claim can be rejected if it is not authentic.”

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