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With the help of a life insurance policy, you can protect yourself and your family against a number of risks, unforeseen events, and emergencies in life. It is the sum assured or the total coverage of the life insurance policy that helps your family through difficult times but ensures financial support for their sustenance. This is when an insurance claim settlement ratio becomes important!

With a Tata AIA Life Insurance policy, you can enjoy the security of having your claim settled on time and, thus, protect your family from a host of financial risks and emergencies in your absence!


 

What is a Claim Settlement Ratio?

As per definition, the insurance claim settlement ratio CSR) is the percentage of claims that an insurance company or insurance provider can fulfil in a financial year out of the total claims they receive. Therefore, Claim Settlement Ratio is an important indicator of an insurer’s credibility since it shows that your insurance claim will be settled in a timely and effective manner.

In life insurance, the life insurance claim settlement ratio is especially important because it is an assurance that your family will not have to undergo any financial hardships in times of need. Hence, the higher the claim settlement ratio, the more credible will the insurance provider be. A good life insurance policy and insurance provider can be identified by their ability to settle the claims in full within a specific regulatory turn-around-time.

The official website of the Insurance Regulatory and Development Authority of India (IRDAI) entails the CSR of your insurance provider.



Why is a Claim Settlement Ratio Important?
 

When you purchase a life insurance policy from a life insurance policy provider, there are a number of factors you look at, such as the company’s offerings, the reviews by other customers and so on. However, the life insurance claim settlement ratio is the primary factor that should be researched and looked into when selecting a company as your life insurance provider.

Here are two important reasons why the claim settlement ratio can help you decide whether you should purchase your policy from the life insurance provider of your choice:

  • 01
    Reliability
    Simply put, a high claim ratio means that the company will be able to provide the sum assured to the nominee in the event if the life assured dies during the policy term. Hence, if a life insurance company has been consistent in presenting the highest claim ratio as a result of its successful settlements, it means the company and their life insurance policies can be relied on.
     
  • 02
    Financial Security
    The sum assured from your life insurance policy that your family will receive in case of your untimely demise will provide financial security to them. However, the sum assured cannot be utilised unless the claim has been settled and to ensure that your insurance provider can be trusted to settle the claim, the life insurance claim settlement ratio is important and needs to be considered.
     


How is a Claim Settlement Ratio Calculated?
 

The calculation of the claim settlement ratio of your insurance provider is quite simple, and the figure can be arrived at with the help of the following formula:
 


Claim Settlement Ratio (CSR) = (Total number of approved claims / Total number of received claims) x 100
 


The figure that is arrived at is always represented as a percentage. Hence, when a life insurance provider has an insurance claim settlement ratio of 90%, in simple terms, it means that the company has settled 90 claims out of the 100 claims they had received. A high percentage, such as the Tata AIA Life Insurance claim settlement ratio of 98.53%* in the FY 2021-22, is an indication of the company’s reliability.

A reputed life insurance provider will not only honour the claims filed by their customers and fulfil the settlement in the given regulatory Turn-Around-Time (TAT) but also ensure a smooth and convenient process for the customer to be able to file the claim swiftly. Insurance companies can also choose to make public the amount they have successfully paid out in claims and the number of policies for which they have effectively settled the claims.

Your Claim is our Priority

Know more about how easy it is to submit a claim with Tata AIA Life Insurance.

Step 01

Register you claim online and upload your documents

Step 02

Documents are verified and claim is processed

Step 03

Claim amount is disbursed
  • Easy Claim Initiative provides convenient claim service at your doorstep
    Doorstep claim services

    With our easy claim initiative, you can call our helpline to schedule an appointment for claim service at your doorstep. Our agent will visit your residence and help in completing the documentation and quickly initiate the claim process.

  • Express Claims - 4 hour claim settlement service
    4 hour claim settlement

    With our Express claim service, the beneficiary can submit the necessary documents with our agent who will initiate the claim process and ensure that the claim amount is received within 4 hours~.

Types of Life Insurance Claims
 

Maturity claims and death claims are the two types of claims that you can file under a life insurance policy.

  • Death Claims

    Under a life insurance policy, a death benefit is paid out to your family members, or the nominee/nominees named in the policy if you pass away during the policy term. Your nominee will be required to produce a set of documents requested by the company as proof of your death, such as the death certificate, doctor’s certificate and so on. The death benefit ensures that your family can sustain themselves financially in your absence.

  • Maturity Claims

    A lot of life insurance policies such as savings plans, retirement plans, ULIPs and endowment plans come with maturity benefits which are paid out as per the policy once the policy is matured. Hence, when you want to file a maturity claim, you can receive the maturity amount or benefits you’re your life insurance company by submitting a set of documents required by the insurance company once the policy matures.

Why Choose our Best-Selling Term Insurance Plan – Tata AIA Sampoorna Raksha Supreme?

A Non-Linked Non-Participating Individual Life Insurance Plan (UIN:110N160V03)
 

TATA AIA

Sampoorna Raksha Supreme
 
Key Features:

  • A comprehensive plan that gives your premiums back**

  • Increase life cover at important milestones

  • Get financial protection till 100 years of your age%.

  • Save Income Tax# up to 46,800++

  • Enhance your protection with optional riders^

 

Factors That May Influence Your Claim Settlement

  • Concealing Information

    Many people tend to hide information to receive their claims without providing proof. However, this can raise suspicion and lead to an investigation. By the end of the investigation the claim can be rejected if the policyholder's fraud is revealed and will negatively influence the insurance company's Claim Settlement Ratio.

  • Ignorance By the Policyholder

    Spend some time understanding the terms and conditions of the insurance policy properly. If you are unable to receive your claim settlement because you could not understand any of the policy exclusions, it leads to claim rejection.

  • Not Disclosing Facts

    If you, the policyholder, hold back or hide important information that could affect the claim process in any way, it will be considered as a case of fraud. Since such an instance prevents your insurance company from settling your claim.

  • Error In Updating Nominee

    In case of your untimely death, your insurer will help your nominee receive the death benefits through the due process. However, if you have been unable to update the correct nominee details or mention any changes, the insurer will not be able to help your nominee.

What is a Good Claim Settlement Ratio?
 

When a life insurance provider has a claim settlement ratio of 90% or above, it is generally considered to be a good claim settlement ratio. This is because 90% is an indication that the insurance provider has settled 90 of the 100 claims they have received during a financial year.

The life insurance claim settlement ratio changes each year, depending on how many claims the insurer was able to settle. When buying a life insurance policy, this annual percentage, as well as the past records, are important since it tells whether the life insurance provider has been consistent in honouring the maximum number of claims possible for each year. To understand what a good claim settlement ratio is, take a look at the points below:

  • A high claim settlement ratio is a clear indicator that your insurer will accept and settle your claim when you need to have the claim settled on time.
  • Though it is the solvency ratio that indicates a company’s financial capacity, the claim settlement ratio also identifies the insurer’s financial health.
  • A good life insurance claim settlement ratio gives policy buyers a sense of security as the insurance company comes across as reliable and capable of paying out claims.

     

Documents Required for Life Insurance Claims

These are the documents that you will need to produce while filing a maturity claim:

These are the documents that you will need to produce while filing a death claim:

Reasons for Life Insurance Claim Rejection

Having your life insurance claim rejected is not a desirable outcome. After all, if you have a life insurance policy, the death claim or the maturity claim are meant to serve an important purpose. While the maturity claim can be primarily used to fulfil your financial goals, the death benefit plays a crucial role in supporting your family in the event of your death. To ensure that your claim does not get rejected, know more about the reasons for life insurance claim rejection:

  • Incorrect Information

    Any document you submit to the insurance company should always contain the right information, even if it is as minor as the spelling of your name. All the spellings, dates and other details should be as per the records on your official documents and identity proofs. Even details of your lifestyle and health records should be honestly revealed. Even all of the information about your nominee will have to be correct so that they do not face any hassles while filing the claim.

  • Unpaid Premiums

    When you buy a life insurance policy, your timely premium payments ensure that you are able to receive life insurance coverage for yourself and your family. In case you miss out on any of the premiums, there are provisions such as the grace period and policy revival to help you activate your policy and continue the life insurance cover. However, it is always better to ensure that your premiums are always paid on time since your untimely demise, coupled with the unpaid premiums, can affect the coverage benefits, if not claim rejection. 

  • Lapsed Policy

    Along the same lines of not paying your premiums on time, you can risk your family’s financial security if you allow the policy to lapse. While you can revive the policy, subject to the policy terms and conditions, a slight delay and sudden emergency can cause quite a lot of problems when your nominee tries to file the claim. If the policy has not been revived at all, then a lapsed policy cannot be eligible for any benefits. To ensure that this does not happen, it is preferred if you do not allow your policy to lapse at all.

  • Medical Details

    Misrepresented, missing, and incorrect medical details on your medical records can be a major reason for your claims to be rejected. While hiding your smoking habits can mean lower premiums, it almost always turns out to be a major cause of claim rejection. If you have medical conditions, either past or existing, of any severity, ensure that your insurance company is aware of the same when you purchase the policy or whenever it is diagnosed. This can help your insurance company and policy support you in any possible way to ensure that your claim does not get rejected and that you may receive the benefits as stated. 

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Claim Settlement Ratio FAQs

How to calculate the claim settlement ratio?

The life insurance claim settlement ratio is calculated as the percentage of claims successfully honoured by an insurance company. It is the number of claims that have been settled by the insurer out of all the claims received by them in a single year.

Hence, if the claim settlement ratio of a company is 98%, it means that the company has settled 98 out of 100 claims for that year. The claim settlement ratio can change every year depending on the company’s efficiency at claim settlement.

When is an insurance provider said to have a good insurance claim settlement ratio?

A claim settlement ratio of 90% or above is said to be a good claim settlement ratio for an insurance provider. However, each year, the claim settlement ratio can change, depending on how many claims the insurance company has been able to honour. And so, if you are looking for a reliable insurance company, you can look for a consistent track record of successful claim settlements in the last few years.

How to apply for an insurance claim with Tata AIA Life Insurance?

To file a claim, you can choose any of the following channels to reach out to us.
 

  • Email us at: customercare@tataaia.com

  • Call our helpline number - 1860-266-9966 (local charges apply)

  • Walk into any of the Tata AIA Life Insurance Company branch offices

  • Write directly to us at:
    The Claims Department,
    Tata AIA Life Insurance Company Limited
    B- Wing, 9th Floor,
    I-Think Techno Campus,
    Behind TCS, Pokhran Road No.2,
    Close to Eastern Express Highway,
    Thane (West) 400 607.
    IRDA Regn. No. 110

What are the reasons for claims being rejected?

Your insurance claim can be rejected if you do not disclose all the information required for the insurance company to settle your claim. Likewise, misrepresentation or misstatement of facts also leads to claim rejection. This means that you have provided incorrect information on the proposal form or held back some crucial information from the insurance company regarding your health, risks, etc.

When should I file a death claim?

A death claim should be filed soon after the death of the policyholder during the policy term. Ensure that all the documents needed for the claim settlement, such as the death certificate, the policy document, etc., are procured on time so that the claim can be filed correctly.

What are the common mistakes people make while filing a claim?

Leaving the claim form incomplete and not providing all the details on the insurance proposal form are two of the most common mistakes people make while filing a claim and when purchasing an insurance policy. Unfortunately, both these mistakes can lead to claim rejection.

What are the documents needed for filing a claim with Tata AIA Life Insurance?

Please click here to know the list of documents needed for the claim intimation and settlement process.

Can I file a claim online with Tata AIA Life Insurance?

Yes, Tata AIA Life Insurance enables you to file an online claim through our official website. Alternatively, you can also locate any of our office branches and pay us a visit to file your claim.

Why is the claim settlement ratio important?

The life insurance claim settlement ratio is important because it is an essential indicator that your claims can be settled by your insurance provider in a timely and effective manner when needed. This ratio shows how many claims have been honoured by the insurance company in a given year as against the number of claims filed or received.

What are the two types of claims that one can file?

You can file a death claim and a maturity claim, depending on the situation and the type of claim that needs to be filed. For example, if the policyholder meets their untimely demise during the policy term, then the nominee can file a death claim. But if the policyholder survives the policy term, they can file a maturity claim on the maturity of the policy, if any.

Disclaimer

  • *Individual death claim ratio for FY 2021-22 as per annual financial statements.

  • ~Applicable to only non-early claims more than 3 years of policy duration, non-investigation cases, up to Sum assured of 50 lacs. Applicable for branch walk in. Time limit to submit claim to Tata AIA by 2 pm (working days). Subject to submission of complete documents. Not applicable to ULIP policies and open title claims.

  • The complete name of Tata AIA Sampoorna Raksha Supreme is Tata AIA Life Insurance Sampoorna Raksha Supreme (UIN:110N160V03) - A Non-Linked Non-Participating Individual Life Insurance Plan

  • %Applicable for specific plan options. Please refer brochure for additional details.

  • **Under Life Plus Option, an amount equal to the 105% of the Total Premiums Paid (excluding loading for modal premiums) shall be payable at the end of the Policy Term as Maturity Benefit, provided the life assured survives till maturity and the policy is not terminated earlier.

  • ^Rider is not mandatory and is available for a nominal extra cost. For more details on benefits, premiums, and exclusions under the Rider, please contact Tata AIA Life's Insurance Advisor/ branch.

  • Tata AIA Life Insurance Non-Linked Comprehensive Protection Rider (UIN:110B033V02 or any other later version) - A Non-Linked, Non- Participating Individual Health Rider, Tata AIA Life Insurance Non-Linked Comprehensive Health Rider (UIN: 110B031V02 or any other later version) - A Non-Linked, Non- Participating Individual Health Rider, Tata AIA Vitality Protect (A Non-Linked, Non- Participating Individual Health rider (UIN:110B046V01), Tata AIA Vitality Health (A Non-Linked, Non- Participating Individual Health rider (UIN:110B045V01) are available under this plan

  • Vitality is a trademark licensed to Tata AIA Life by Amplify Health Assets PTE. Limited, a joint venture between Vitality Group International, INC. and AIA Company Limited. The assessment under the wellness program shall not be considered as a medical advice or a substitute to a consultation/treatment by a professional medical practitioner.

  • #Income Tax benefits would be available as per the prevailing income tax laws, subject to fulfillment of conditions stipulated therein. Income Tax laws are subject to change from time to time. Tata AIA Life Insurance Company Ltd. does not assume responsibility on tax implication mentioned anywhere in this document. Please consult your own tax consultant to know the tax benefits available to you.

  • ++Tax benefits of up to ₹46,800 u/s 80C is calculated at highest tax slab rate of 31.20% (including cess excluding surcharge) on life insurance premium paid of ₹1,50,000. Tax benefits under the policy are subject to conditions laid under Section 80C, 80D,10(10D), 115BAC and other applicable provisions of the Income Tax Act,1961. Good and Service tax and Cess if any will be charged extra as per prevailing rates. The Tax-Free income is subject to conditions specified under section 10(10D) and other applicable provisions of the Income Tax Act,1961. Tax laws are subject to amendments made thereto from time to time. Please consult your tax advisor for details, before acting on above.

  • This plan offers pure risk premium option under Life Option and return of premium benefit under Life Plus Option along with other benefits. Please refer sales brochure for complete details.

  • This product is underwritten by Tata AIA Life Insurance Company Ltd. This plan is not a guaranteed issuance plan, and it will be subject to Company’s underwriting and acceptance.

  • Insurance cover is available under this product. For more details on risk factors, terms and conditions please read Sales Brochure carefully before concluding a sale.

  • In case of sub-standard lives, extra premiums will be charged as per our underwriting guidelines.

  • Buying a Life Insurance policy is a long-term commitment. An early termination of the policy usually involves high costs, and the Surrender Value payable may be less than the all the Premiums Paid.

  • This publication is for general circulation only. This document is for information and illustrative purposes only and does not purport to any financial or investment services and do not offer or form part of any offer or recommendation. This document is not and should not be regarded as investment advice or as a recommendation regarding any particular security or course of action.

  • Please know the associated risks and the applicable charges, from your insurance agent or the Intermediary or policy document issued by the insurance company and this document is not and should not be regarded as investment advice or as a recommendation regarding any particular security or course of action.

  • L&C/Advt/2022/Nov/2884