General insurance policies are non-life insurance policies that provide coverage for a wide range of risks and liabilities. They include insurance products such as property insurance, motor insurance, health insurance, travel insurance, liability insurance, and other types of coverage that protect individuals, businesses, and assets against potential losses or damages.
Claim payments under general insurance policies are the amounts paid by the insurance company to the policyholder or a third party to cover losses or damages as per the terms of the policy. Claims are estimated in General Insurance Policies based on the:
- Terms decided at the beginning of the policy
- The type of policy
- The type of asset insured
- The Assessors Report
All claim payments under general insurance policies will also account for applicable deductible and co-payment clauses before paying the claim amount.
Things to remember when filing a claim under General Insurance Policies
When filing group insurance claims, there are several important things to remember. Firstly, gather all necessary documentation, such as claim forms, medical records, and supporting evidence. Ensure accuracy and completeness of the information provided. Be aware of claim submission deadlines and adhere to them. Communicate promptly and effectively with the insurance provider, following their specific instructions. Keep copies of all documents submitted. Lastly, follow up on the claim’s progress and maintain open communication until it is resolved satisfactorily.
Promptly filing an insurance claim is crucial as it allows for timely assessment and processing, ensuring a faster resolution. Delays can result in missed deadlines, potential loss of coverage, or difficulties in obtaining necessary evidence. Timeliness is vital in making time-critical decisions, accessing benefits, and recovering from losses efficiently.
The claim settlement ratio of an insurer represents the percentage of claims settled by the insurer out of the total claims received. It can be checked by referring to the insurer’s annual report, website, or by contacting the insurer directly for the relevant information.
The documents required for filing a claim under a group insurance scheme typically include claim forms, medical records, and supporting documentation.
Case on How are Claims Estimation in General Insurance Policies
Building Insurance
Bharti Jain is a reputed builder and is currently involved in a personal construction project of one of his relatives Jatin Ahuja. As per his standard practice, he advised Jatin to insure this building to save himself from expenses of reconstruction if the building damages, due to a natural cause.
While the building was near completion, with only finishing and paintwork pending, a heavy hailstorm struck the city, damaging the building’s structure. The total damage assessed by the insurer was about Rs. 27,000 . paid the amount without any deductions since the building was under construction at the time of loss.
Auto Insurance
Mrs. Sarath has a 1400CC car which got damaged when it collided with another vehicle breaking suddenly on a busy highway. After all, consideration, estimated it as an accident with no fault of the vehicles as there was an animal on the road. Her car is 3 years old, and the insured total repair cost was Rs. 15,000, out of which the insurer reimbursed Rs. 8400 after depreciation. (Compulsory deductible applicable for vehicles less than 1500CC is Rs. 1000).
Marine Insurance
Shubhendu Das Gupta is a garment exporter, usually sending fashion garments across Europe and America. Last month he sent goods worth Rs. 15,00,000 with Rs. 12,000 for insurance and Rs. 18,000 for freight transport to a London port. A fire on the ship damaged or destroyed goods worth Rs. 500,000, caused by a lightning strike in the sea. Since could restore any of these goods, the insurer paid 110% of the proportional CIF value for the damaged and lost consignment; i.e. Rs. 561,000.
