For many employees, group personal accident (GPA) insurance offers a crucial safety net that provides financial protection against unforeseen accidents. While having this insurance is important, understanding the different types of claims and their respective processes is equally crucial. Knowing how to file a GPA claim efficiently can make a considerable difference during a difficult time. Let's explore the common claim processes you might encounter.
How to file a death claim?
In the unfortunate event of a covered accidental death, the nominee or legal heir needs to initiate the GPA claim process, which involves the following steps:
- Notify the insurer: Intimate the insurer about the incident without undue delay.
- Claim form submission: The nominee must complete the claim form and submit the same to the insurer.
- Death certificate: It is crucial to provide a copy of the death certificate.
- Police report (FIR): If the death was due to an accident, a copy of the First Information Report (FIR) and post-mortem report is often required.
- Nominee's identity proof: Proof of identity and address of the nominee is essential for verification.
Steps for filing a permanent total disability and permanent partial disability claim?
A group personal accident claim for permanent total or partial disability arises when an accident leads to a lasting impairment. Here is the process to follow in such situations:
- Intimate the insurer: Inform the insurance company about the accident and resulting disability promptly.
- Medical certificates: Submit medical certificates from the treating doctor detailing the injury and its nature.
- Disability certificate: A certificate from a competent medical authority confirming the permanent disability and its percentage.
- Investigation report: The insurer might conduct an investigation to verify the circumstances of the accident.
- Follow-up medical reports: Any follow-up reports from subsequent medical treatments are also required.
How to file a temporary total disability claim?
Temporary total disability claims cover periods when an insured person is entirely unable to work due to an accident but expects to recover fully. This claim focuses on compensating for lost income during the recovery period.
- Initial notification: Inform your insurer about the accident and your inability to work temporarily.
- Medical leave certificate: Provide a medical certificate from your doctor stating the period of your inability to work.
- Employer's certificate: A certificate from your employer confirming your absence from work and details of lost wages.
- Regular medical updates: Submit periodic medical reports demonstrating your continued treatment and recovery progress.
Additional documents required for claim process
While the specific requirements may vary slightly depending on the insurer and the nature of the claim, some additional documents are often requested across all types of group personal accident insurance claims. These are:
- Policy copy: A copy of the group personal accident insurance policy document.
- ID and address proof: Identity and address proof of the insured person and, in death claims, the nominee.
- Cancelled cheque: A cancelled cheque of the claimant for direct fund transfer.
- Witness statement: If available, a statement from a witness to the accident.
- Photographs: Any photographs of the accident site or injuries, if relevant.
Conclusion
Navigating a group personal accident claim can seem complex, but knowing about the particular requirements for different types of claims simplifies the process. By being prepared with the necessary documentation and informing your insurer promptly, you can ensure a smoother and faster settlement. This knowledge empowers you to fully utilise the benefits of your group personal accident insurance when you need it most.
Disclaimer: The information provided in this blog is for educational and informational purposes only. It is advised to verify the currency and relevance of the data and information before taking any major steps. Please read the sales brochure / policy wordings carefully for detailed information about on risk factors, terms, conditions and exclusions. ICICI Lombard is not liable for any inaccuracies or consequences resulting from the use of this outdated information.