Insurance Claim: Definition, How to Claim, Tips and Purpose

Insurance claims are the most important thing in an insurance purchase process. A claim means that you redeem the dependents promised by the insurance for the purposes of paying the risk guaranteed by the insurance.
 


For example, if your car is scratched and has all risk car insurance, then you can redeem the sum insured to replace the cost of servicing your car. Curious about how to claim and what tips should be done so that an insurance claim is accepted? Let's see the full discussion here! 

Definition of Claims in General

If interpreted in general terms, a claim is a benefit from the insured to the insurer. Claims can be made if the insured and the insurer agree on an agreement.


Definition of Insurance Claim

When viewed from the point of view of the insurance world, the party who is borne is the customer and the party who bears is the insurance company.

Usually to make an insurance claim, the customer must meet the requirements first. These requirements are usually an identity card, and a policy book.

Simply put, an insurance claim is an official request from a customer to an insurance company with the aim of requesting dependents that have been promised by the insurance company.


What are the Purposes of an Insurance Claim?

If you already understand the meaning of an insurance claim, let's see what the purpose of a claim is. Here's the explanation:


1. Minimize risk

The first function of an insurance claim is to be able to minimize the risk of loss. When a claim is submitted and received, you will receive a deposit to compensate for the losses that you have experienced.


2. Compensation

Furthermore, the money from your claim can also compensate for the losses you have experienced. For example, if your house is on fire and requires large renovation costs, insurance will provide some funds to compensate for losses due to the house fire.


3. Compensation

Especially for life insurance the compensation fund can be very useful for family members who are still alive.

For example, if a family head dies, the source of income will automatically disappear. Well, this is where the compensation fund can help living family members to support their own lives.


How to Claim Insurance?

Considering that there are various types of insurance, here we attach how to claim each type of insurance:


1. How to claim life insurance

Before knowing how to claim life insurance, you must first know the 4 types of life insurance:

  • Term Life Insurance: Provides protection for customers with a certain period of time ranging from 5, 10, to 20 years.
  • Life Insurance for Life: Usually the age limit covered can reach 100 years.
  • Dwiguna Life Insurance: Provides two benefits, namely as insurance and a form of savings
  • Unit Link Life Insurance: Provides benefits in the form of self-protection and investment that can be profitable in the future

Here are the steps for a life insurance claim:


– Contact the insurance company


The first thing you have to do is contact the insurance company. Report that the insured in the insurance has died.


– Prepare supporting documents

Provide a death certificate, a death certificate from the hospital and an ID card.


- Fill in the form provided by the insurance company

Then the insurance company will send you a form for you to fill out. Fill in the complete data so that your claim process runs smoothly.


– The insurance company will verify the documents

Furthermore, if you have provided the form and document requirements, the insurance will carry out a verification process.

If it is complete and in accordance with the rules, then you just have to wait for the dependent money to be given to you.


2. How to Claim Health Insurance

Before you make a health insurance claim, make sure you have read carefully what the benefits are provided by the insurance. If so, then follow these steps:


– Make sure the policy is active and complete the documents

The first step is to make sure you continue to pay the premium in the policy. If you seek treatment at a partner hospital, all you need is an insurance membership card.

However, if you seek treatment at a hospital that is not a partner, then you must save the payment receipt as a claim supporting document.


– Make a claim as soon as possible

Try if you are out of the hospital immediately make a claim. Make a claim before 30 days. Also make sure the disease you are suffering from is a disease covered by insurance.


– Fill in the form and provide a receipt

Then you will be sent a form by the insurance company. Fill in completely and don't forget to attach proof of payment receipt to the insurance company.


- Process checks and disbursement of funds

If the documents you send are complete, it usually doesn't take long for the insurance to disburse your dependents. Usually it only takes 2-3 working days.


How to Claim Car and Motorcycle Insurance


Actually, how to claim car and motorcycle insurance is almost the same. There are 2 types of automotive insurance that you need to know first:


– Asuransi TLO (Total Loss Only)

This type of insurance will only provide dependents when a vehicle is damaged above 75%.

This means that if the damage is only due to a dented body, the insurance will not provide dependents. The amount of premium to be paid is not too expensive


- All Risk Insurance

All types of damage to the car will be covered by all risk insurance. So no matter how small the damage to the vehicle, the insurance will provide coverage.

Steps to claim vehicle insurance


– Prepare photos, and supporting documents

First of all you have to provide a photo of the condition of your vehicle first, then after that you prepare documents such as a driver's license, STNK, policy book, and a certificate from the police if the damage is more than 70%.


– Go to the insurance branch office


Go to the nearest insurance branch office, and fill out the form. If you have brought complete documents, the insurance company will immediately take you to their partner workshop.


How Long is Liquid Insurance Claim?

Every company has a different time. But generally it takes about 14-60 days for your insurance claim to be liquidated.


Possible Causes of Failed Insurance Claims

There are several possible reasons why your insurance claim was not accepted. Here are the possible causes:

  • Insurance policy is not active (late payment)
  • Claims submitted are not included in the insurance benefits
  • Submission of claims exceeds the predetermined time limit (3 x 24 hours) and 60 days for life insurance products
  • Incomplete required documents
  • Police are on standby
  • The claim submitted is a disaster caused by an illegal act
  • The area of ​​occurrence is not included in the coverage of insurance coverage
  • Falsification of incident reports
Tips to get your claim accepted

There are several tips that you can do so that your claim is accepted:
  • Fill in the data in the form correctly and carefully
  • Make sure the policy is active and there are no outstanding fees
  • Know what risks are covered by insurance
  • Submit a claim within 30 days of the incident
  • Complete all required documents
  • The incident was not caused by the influence of drugs and alcohol
  • The incident was not caused by anything that violated the law

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