Insurance claim karne ka step-by-step process yahan simple language me samjha gaya hai. Life, health aur vehicle insurance claim kaise karein bina mistake ke – full guide.
💡 Introduction
Insurance lena to easy hota hai, lekin jab claim karne ki baari aati hai tab log confuse ho jaate hain.
Documentation, process aur company ke terms samajhna har kisi ke liye easy nahi hota.
Is article me hum simple language me samjhenge insurance claim karne ka step-by-step process, taaki aap apna claim fast, smooth aur hassle-free approve karwa saken.
🔹 1. Sabse Pehle Policy Details Samjhiye
Claim process start karne se pehle apni policy ko achhe se samajhna zaruri hai.
📘 Check karein:
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Policy number aur type (health/life/vehicle)
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Coverage limit
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Claim type (cashless ya reimbursement)
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Exclusions list
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Claim submission deadline
Ye sab information aapko company ke policy document me mil jaayegi.
👉 Focus Keyword Use: Jab aap insurance claim karne ka step-by-step process follow karte ho, sabse pehla step policy understanding hi hota hai.
🔹 2. Incident Ya Hospitalization Ki Information Company Ko De
Claim tabhi valid hota hai jab company ko timely inform kiya jaaye.
Health Insurance ke liye:
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Planned hospitalization hai to 2–3 din pehle inform karein.
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Emergency case me 24 hours ke andar intimation dena zaruri hai.
Vehicle Insurance ke liye:
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Accident hone ke turant baad insurance company ko call karein.
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FIR ya damage report prepare karwaen.
💡 Tip: Claim helpline number aapko company ke website aur policy document dono me mil jaata hai.
🔹 3. Required Documents Collect Karein
Claim approval ke liye proper documents hona sabse important part hai.
Health Insurance Documents:
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Claim form (filled and signed)
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Hospital bills aur discharge summary
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Doctor’s prescription aur reports
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ID proof aur policy copy
Life Insurance Documents:
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Claim form
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Death certificate
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Policy document original
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Nominee’s ID proof
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Bank account details
Vehicle Insurance Documents:
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Claim form
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RC copy & driving license
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FIR copy
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Repair estimate aur bills
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Photos of accident spot
📂 Har company ke website pe “Required Documents” list mention hoti hai — use cross-check zarur karein.
🔹 4. Claim Form Bhar Kar Submit Karein
Ab jab aapke paas saare documents ready hain, to next step hai claim form fill karna.
👉 Don’t leave any section blank.
👉 Details sahi aur updated honi chahiye.
👉 Attach documents clearly scanned copies ke form me.
Claim form online ya offline dono mode me submit kar sakte hain — ye depend karta hai ki company ka process kya hai.
🔹 5. Claim Verification Process
Jab aapka claim form company ke paas pahuchta hai, to unka claim assessment team verify karti hai sab details.
Verification Steps:
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Document authenticity check
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Hospital ya repair workshop se confirmation
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Policy validity check
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Claim reason evaluation
Ye process health aur motor insurance dono me common hai.
💬 Note: Agar koi document missing hai to company aapse clarification ya additional proof maang sakti hai.
🔹 6. Claim Approval Aur Payment
Verification complete hone ke baad company decision leti hai:
✅ Claim Approved
❌ Claim Rejected
Agar Claim Approved Hai:
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Cashless claim me hospital ya workshop ko direct payment hoti hai.
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Reimbursement claim me amount aapke bank account me transfer hota hai.
Generally, claim approval 7–15 working days ke andar complete ho jaata hai.
🔹 7. Claim Rejection Ki Situation Me Kya Karein
Kabhi-kabhi policy terms ya document issue ke wajah se claim reject bhi ho sakta hai.
Common Reasons:
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Incomplete documents
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Exclusion clause applicable
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Delay in claim intimation
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False information
💡 Solution:
Aapko rejection letter milta hai jisme reason clearly likha hota hai.
Uske baad aap grievance redressal department ya IRDAI complaint portal (https://irdai.gov.in) pe complaint register kar sakte hain.
👉 Focus Keyword: Jab aap insurance claim karne ka step-by-step process sahi se follow karte ho, to rejection ka chance bahut kam ho jaata hai.
🔹 8. Cashless vs Reimbursement Claim – Difference Samjhiye
| Type | Process | Payment |
|---|---|---|
| Cashless | Company directly hospital/workshop ko pay karti hai | Direct to service provider |
| Reimbursement | Pehle aap pay karte ho, baad me company refund karti hai | To policyholder’s bank account |
Agar aap hospital ke network list me admission lete ho to cashless facility milti hai.
🔹 9. Track Your Claim Status
Claim submit karne ke baad regularly apna claim status track karein.
Tracking Methods:
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Company ke website/app pe claim number se check karein
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Customer care pe call karein
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SMS/email notification system activate karein
Ye step ensure karta hai ki process delay na ho.
🔹 10. Final Settlement Aur Record Keeping
Claim settle hone ke baad, hamesha:
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Settlement letter save karein
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Payment receipt aur communication record rakhein
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Next policy renewal ke liye experience note karein
Isse aapko future me same policy ya kisi aur plan ke liye help milegi.
🧩 Real-Life Example
Example:
Mr. Raj ne health insurance policy li thi ₹10 lakh coverage ke saath.
Hospitalization ke time unhone 24 hours ke andar company ko inform kiya, claim form submit kiya aur saare documents attach kiye.
Result – Unka cashless claim sirf 4 din me approve ho gaya.
Ye example dikhata hai ki agar aap insurance claim karne ka step-by-step process sahi se follow karte ho, to claim jaldi milta hai.
💬 Pro Tips
✅ Policy details hamesha updated rakhein
✅ Hospital/garage se proper bills aur reports lein
✅ Deadline ke andar claim file karein
✅ Duplicate ya fake bill kabhi na lagayein
✅ Communication email/SMS me record rakhein
🧾 Conclusion
Ab aapko puri clarity mil gayi hogi insurance claim karne ka step-by-step process ke baare me.
Sahi documents, timely information aur transparent communication ke saath aapka claim smoothly approve ho sakta hai.
“Insurance tabhi kaam aata hai jab claim process sahi tarike se follow kiya jaaye.”
To agli baar jab bhi insurance claim karna ho, ye 10 steps zarur yaad rakhiye.
❓ FAQ – Insurance Claim Karne Ka Step-by-Step Process
Q1. Claim karne ke liye pehle kya karna chahiye?
Ans: Sabse pehle company ko incident/hospitalization ki information deni chahiye — within 24 hours.
Q2. Claim form kahan milta hai?
Ans: Company ki official website pe downloadable form hota hai, ya customer care se mang sakte ho.
Q3. Claim reject hone par kya karein?
Ans: Rejection reason check karein aur grievance redressal department ya IRDAI portal pe appeal karein.
Q4. Cashless aur reimbursement claim me kya farq hai?
Ans: Cashless me company directly payment karti hai, reimbursement me pehle aap pay karte ho aur baad me refund milta hai.
Q5. Claim process me kitna time lagta hai?
Ans: Normally 7–15 working days lagte hain, depend karta hai document verification aur company ke TAT par.
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