by
Tanmay Ahuja
| Sep 24, 2024
Updated on 29 Oct 2025
A personal accident insurance plan offers crucial financial protection if you suffer from accidental injuries, disability or death. But when an emergency strikes, many people are unsure how to make a claim and access the benefits they’re entitled to. Understanding the claim process in advance can help you act quickly and avoid delays.
In this guide, we break down the steps to claim personal accident insurance, whether for hospital expenses, disability or loss of life, so you or your loved ones can get timely support when it matters most.
Types of claims under personal accident insurance
Under a personal accident insurance plan, you can make different types of claims depending on the nature of the incident. In case of accidental death, the nominee receives the full insured amount. If the accident results in permanent total disability, such as the loss of both eyes, hands or legs, the full sum is also paid.
For permanent partial disabilities like losing one limb or eye, a portion of the insured amount is given based on severity. Temporary total disability claims provide weekly compensation if injuries temporarily prevent you from working. Some policies also cover medical expenses and ambulance charges related to the accident.
What documents are required for personal accident health insurance claim process?
Certain vital documents are necessary for personal accident or medical insurance plans to ensure the smooth processing of insurance claims. Here's what you should have available.
- Completed claim form
- Photocopy of the insurance policy
- Medical certificates and bills
- Discharge summary (for inpatient claims)
- FIR or police report - if there has been an accident
- Report on cause of death (in cases where the claimant dies)
- Identity proof of the claimant
- Information on bank accounts to facilitate the process of claim settlement
Steps to claim a personal accident insurance plan
Let us start with the steps on how to claim personal accident insurance:
Notify Your Insurance Provider
The first step for claiming a personal accident insurance plan is immediately reporting the occurrence to your insurance company. Many insurers have a time limit for reporting claims, so you must save time. You can usually notify them through:
- A call to their claim's hotline number
- Their website or mobile app, as the case may be
- Email or physical mail (please refer to your policy on this)
Fill Out the Claim Form
After informing your insurer, you will get a claim form. This is where you'll need to provide detailed information about:
- How the accident occurred
- The injuries you sustained
- Any medical treatments you have ever had
Gather Supporting Documents
Your insurer is likely going to request proof before attending to your claim. Here's a quick list of documents you might need:
- Medical records and bills
- Police reports (if applicable)
- Pictures of the bruises or the area of the accident
- Witness statements
Submit Your Claim and Wait for Processing
Once you complete the form and gather all the documents your insurance company may ask for, send the documents to your insurance company. They will analyse your claim and sometimes contact you to request additional information.
Why personal accident claims get rejected?
Personal accident insurance offers financial support for accidental injury, disability or death, but claims can be rejected for several reasons. Common causes include missing or incorrect details in the claim form, a delay in reporting the accident or not informing the insurer within the required time.
Claims may also be denied if the accident falls under exclusions like self-harm, intoxication or adventure sports. Inadequate documentation, such as missing medical records or police reports, can lead to rejection, as can an inactive or lapsed policy. Claims based on pre-existing conditions or those found to be fraudulent are also likely to be rejected.
What to do if a personal accident claim is rejected?
If your personal accident insurance claim is rejected, start by carefully reading the rejection letter to understand the reason. Common issues include incomplete documentation, delays in filing or claims that fall outside policy coverage. Revisit your policy to confirm what is and isn’t covered. Contact the insurer’s customer service for clarification and guidance.
If missing or incorrect documents caused the rejection, gather and resubmit the correct paperwork. You can also file a formal appeal or request reconsideration, attaching all required supporting documents to strengthen your case.
Conclusion
Understanding how to claim personal accident insurance is crucial for effectively utilising your insurance plan, especially when selecting the right health insurance for parents. By following the steps outlined and having the necessary documents, you can ensure smooth claims process and receive the support you need during difficult times. Always remember that insurance companies are there to assist you with all your needs in this process.
If you are still unsure about how to claim your insurance, please fill out the form on this page to receive expert advice tailored to your specific needs.
Disclaimer: The information provided in this blog is for educational and informational purposes only. It may contain outdated data and information regarding the topic featured in the article. It is advised to verify the currency and relevance of the data and information before taking any major steps. ICICI Lombard is not liable for any inaccuracies or consequences resulting from the use of this outdated information.