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How To Claim Personal Accident Insurance plan?

Updated On Mar 02, 2021

Personal Accident Insurance Cover provides financial protection for unfortunate events and losses arising due to accidents and income loss because of accidents. Any kind of unfortunate events caused due to road, rail, air accidents, collision, fire explosion, and others, all these kinds of accidents are covered under this insurance.

An insurance company also gives compensation if due to the accident the policyholder suffers from any kind of disability which may prevent them from working. These disabilities may include both permanent and temporary disabilities. In case of income loss due to an accident, the insurance company also gives you monthly income to help you carry on with life.

Steps to Claim Personal Accident Insurance Plan

In order to file a personal accident insurance health insurance plan at the time of emergencies, one must be aware of the procedure to file a claim. Below mentioned are steps involved in personal accident health insurance claims.

Step 1: Inform the Insurer

The first thing you would need to do at the time of an accident or within 24 hours of hospitalisation is to inform the insurer about the accident and the medical emergency. You can do it either by contacting customer care services or through the website of the insurance company.

Step 2: Provide Policy Documents

After informing the insurer, the insurer will then ask for all the policy-related documents. Such as policy card, policy purchase receipts, premium receipts etc. for verification purposes.

These documents include all the information about your policy and the status of your policy.

Step 3: Provide Duly Filled in the Claim form

Then, the company will provide you with a policy claim form, or if not received by the company itself you can ask the company directly for such form. You would need to fill the form with required and correct details and it would need the signature of the policyholder or their nominee. After duly filling the form, you may submit it to the insurer or TPA.

Step 4: Submit other required documents as per the case

After submitting the form and policy documents the insurer will ask you to submit other verification documents such as Id proof, address proofs etc. You would need to submit a copy of such documents to the company.

Step 5: Scrutiny by Insurer

After receiving all the documents and information regarding the policy and treatment required the insurance company will then conduct scrutiny to understand the authenticity of the claim and the accident. Through this, the insurance company wants to ensure that the treatment you are filing a claim form is required and isn't unnecessary, and also it is purely because of an accident or any event covered under the policy's terms and conditions.

Step 6: Claim Settlement

After inquiry and all the verification, if the company feels satisfied with the authenticity of the claim, they may approve the claim. If rejected the company may ask for other documents for further verification, if still not satisfied, they might right the claim.

Documents Required for Personal Accident Health Insurance Claim Process

In order to get a personal accident health insurance claim on time, it is important to be aware of the documents required to file a claim. They may include:

  • Duly signed Claim form
  • Death Certificate as the case may be
  • Disability Certificate as per the case
  • Doctors Report
  • Medical Certificate
  • Medical Bills
  • Medication Bills
  • Discharge Summary
  • Accident Investigation Report

Disclaimer: This article is issued in the general public interest and meant for general information purposes only. Readers are advised not to rely on the contents of the article as conclusive in nature and should research further or consult an expert in this regard.

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