What Happens When a Term Insurance Claim is Filed

What Happens When a Term Insurance Claim is Filed

Filing a term insurance claim is something your family does during the most difficult period of their lives. The process should be straightforward, but understanding it in advance - and preparing your nominee - makes a significant difference. Most claim rejections happen due to documentation gaps or non-disclosure issues that could have been prevented.

This walkthrough covers the entire process from the nominee's perspective - what happens, what documents are needed, and what to expect at each stage.

Back to: Health insurance claims guide

The Claim Timeline

Step 1: Claim Intimation (First 7 Days)

Who files:

The nominee named in the policy. If the nominee is a minor, the appointee (guardian) files on their behalf.

How to file:

Information needed:

• Policy number
• Name of the deceased policyholder
• Date of death
• Cause of death
• Nominee's contact details

What the insurer does:

• Registers the claim and assigns a claim number
• Sends the nominee a claim form and document checklist
• May assign an investigator for policies less than 3 years old

Step 2: Document Collection (Days 7–60)

Documents the nominee must submit:

Additional documents that may be requested:

• Last medical records of the deceased
• Treating doctor's certificate mentioning cause of death
• Pharmacy/treatment records for the last 2–3 years
• Lifestyle declarations (alcohol, smoking history)

Tips for document collection:

1. Get multiple copies of the death certificate (at least 5) - you'll need them for bank accounts, property, and other processes too
2. Request hospital records immediately - hospitals archive records quickly and retrieval becomes harder over time
3. Keep a photocopy of everything before submitting originals
4. Submit documents in batches - don't wait until you have everything; start with what you have

Step 3: Investigation (If Applicable)

When does the insurer investigate?

What happens during investigation:

• Insurer appoints an investigator
• Investigator may visit the nominee, hospital, and employer
• Medical records of the deceased are reviewed
• The investigator verifies that information in the application was accurate
• This is not adversarial - it's a standard verification process

How long does investigation take?

• Standard cases: 30–60 days
• Complex cases (accidental, early claims): 60–90 days
• IRDAI mandates settlement within 15 days of intimation, or 45 days where the claim is investigated

Step 4: Claim Decision

If approved:

• Insurer sends an approval letter to the nominee
• Payout is processed within 7 days of approval
• Amount is credited directly to the nominee's bank account
• If payout was chosen as monthly income, the first installment begins within 30 days

If rejected:

• Insurer sends a rejection letter with reasons
• Common rejection reasons:

  1. Non-disclosure of pre-existing conditions (most common)
  2. Suicide within the first year (excluded by policy)
  3. Death due to excluded activity (e.g., adventure sports without rider)
  4. Policy lapsed (premiums not paid)
  5. Fraudulent claim (misrepresentation)

If you disagree with the rejection:

1. Request detailed rejection reasons in writing
2. Submit additional evidence if you have it
3. File a complaint with the insurer's grievance cell
4. Approach IRDAI ombudsman - ombudsman guide
5. Consumer court - if the claim amount is disputed

Step 5: Payout

Payout options (depending on what was chosen at purchase):

Tax on payout:

• Death benefit from term insurance is 100% tax-free under Section 10(10D)
• No TDS is deducted
• The nominee does not need to declare this as income

How to Prepare Your Nominee Today

Don't wait for a claim to happen. Prepare your nominee now:

1. Tell your nominee about the policy - policy number, insurer name, sum assured
2. Share the insurer's claim helpline number
3. Keep the policy document accessible - not locked away where only you have access
4. Store a digital copy - email yourself the policy document; share the email with your nominee
5. Ensure nomination is updated - if you've married or had children since buying the policy, update the nominee
6. Disclose everything honestly - non-disclosure is the #1 reason for claim rejection. Your family pays the price, not you.

Back to: Term Insurance Guide

Questions about term insurance claims? Our advisors help nominees understand the claim process and documentation requirements. Free consultation.

FAQs - Term Insurance Claims

How long does a term insurance claim take?

45–120 days from intimation to payout, depending on whether investigation is required. Straightforward claims (policy 5+ years old, natural death) are processed within 30–45 days.

What is the most common reason for term insurance claim rejection?

Non-disclosure of pre-existing health conditions at the time of purchasing the policy. Always disclose your complete health history honestly.

Can the nominee file a claim online?

Yes, most insurers allow online claim intimation through their website or app. Documents can be submitted digitally or at a branch.

Is the term insurance payout taxable?

No. Death benefits from term insurance are completely tax-free under Section 10(10D) of the Income Tax Act.

What happens if the policyholder dies within the first year?

The insurer will investigate the claim thoroughly. If the death is due to natural causes and all disclosures were honest, the claim should be settled. Suicide within the first year is typically excluded.