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What is the process for submitting a life insurance claim?

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How is the process of submitting a life insurance claim?

All life insurance claims and health insurance have the same process, namely preparing a claim submission form, a doctor’s certificate, and supporting documents for a doctor’s diagnosis. After that, all documents are sent to the insurance company for verification. If the data is complete, the insurance company will analyze our claims.

For submitting a death claim, it must be seen from the type of death claim, whether due to an accident, disability, or critical illness. Although the claim submission process is the same, each claim requires different supporting documents for filing a claim. The claim submission process can be done if we have prepared the documents beforehand.

What is the detailed explanation of the completeness of the documents for each cause of claims in life insurance?

a. Claims of death and death due to accident

In submitting a death claim, in general, several supporting documents are required that we need to prepare, such as:

The original policy, photocopy of the identity of the insured, policyholder, and heirs, official death certificate issued by the hospital or doctor, death certificate, death claim form filled out by a doctor, bank account number notification form, power of attorney for medical record contents, original policy book, photocopy of ID card, if due to an accident it is necessary to attach a letter of BAP (Minutes of Investigation) from the police, and other supporting documents if needed.

b. Critical illness claim

If we file a claim for critical illness, in addition to preparing a critical illness claim form, we also need to complete a bank account number notification form, a power of attorney containing medical records, photocopies of ID cards, and doctor’s certificates for critical illnesses that we suffer from. However, it is still possible to require other supporting documents according to the condition of the critical illness proposed, such as copies of examination results and diagnostic support.

c. Defect claims

The forms that must be prepared in a disability claim are a disability claim form filled out by the policyholder, a disability claim form filled out by a doctor, a bank account number notification form, a photocopy of an ID card, and a power of attorney containing the contents of the medical record. If you are disabled due to an accident, you need to attach a BAP (Minutes of Investigation) letter from the police. In addition to these documents, it is still possible to require other supporting documents according to the proposed defect condition.

How long does the diversification and analysis process take for the insurance company’s decision to pay claims?

The verification and analysis process for the insurance company’s decision to pay claims has a different time. Starting from 7 working days to 14 working days, it all depends on the policy of the respective insurance company. However, it should be noted that the claim process can only be carried out after the insurance company has received all the documents required for filing a claim. In certain cases, it is possible to carry out verification/investigation which takes more than 14 days. And even up to 60 days when data is found that needs to be verified further.

In the event of loss or damage:

  1. Report every incident in writing or verbally to ABDA Insurance (to the Integrated Claims office or nearest branch office) within 5 x 24 hours after the loss and or damage occurred.
  2. If the report is verbal, follow it with a written report to ABDA INSURANCE.
  3. Fill out the claim, or through the online facility
  4. Always provide true information and data.
  5. Complete the required claim supporting documents.
  6. Immediately report every incident to the Sector Police (Polsek) at the scene (for partial loss/damage caused by theft or involving a third party). Or to the Regional Police (Polda) at the scene (for total loss/damage).
  7. Protect, maintain, and save the Motor Vehicle. And the insured interest and allow other parties to save the Motor Vehicle and or interest.
  8. Securing Motorized Vehicles and or insured interests that can be saved.
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