Insurance Claim Assistance — Hum Aapke Saath Hain
Claim file karna aksar confusing aur stressful hota hai. Binod Kumar Shukla aur team aapko documentation se lekar settlement tak har step mein free guidance dete hain — health, vehicle, fire, ya life insurance, kisi bhi claim mein.
Note: Claim approval, settlement amount, aur timeline insurer ke policy terms aur documentation par depend karta hai. Hum facilitation aur guidance provide karte hain — final decision insurer ka hota hai.
Claim assistance: Binod Kumar Shukla, Insurance Advisor aur LIC of India, National Insurance Company tatha Niva Bupa ke agent (Chief Life Insurance Advisor (CLIA) aur LIC Chairman’s Club member), insurance claims me documents, insurer se coordination, follow-up aur escalation guidance dete hain. Mutual fund ke liye AMFI-registered Mutual Fund Distributor (ARN-50844).
Kis-Kis Claim Mein Help Milti Hai?
Health / Mediclaim
Cashless ya reimbursement claim — pre-authorization, documents, aur follow-up mein guidance.
Vehicle Claim
Accident, theft, ya damage — survey, repair estimate, aur settlement process mein madad.
Fire / Property
Fire ya property damage claim — loss assessment aur documentation support.
Life / Term Claim
Death claim ya maturity — nominee ko documentation aur process mein guidance.
Commercial Vehicle
Truck, bus, fleet claims — survey aur settlement coordination.
Document Help
Konse documents chahiye, kaise jama karein — step-by-step checklist.
Apne Claim Ke Liye Detailed Guide Padhein
LIC Claim Guide
Death, maturity, survival benefit aur pension claim: documents, steps aur nominee ke rules.
Health Insurance Claim Guide
Cashless aur reimbursement, IRDAI timelines, claim kam ya reject hone ke karan.
Car & Two-Wheeler Claim Guide
Accident, theft, third-party aur total loss claim, aur aam disputes.
Fire & Burglary Claim Guide
Shop, office aur factory ke liye: stock claim, average clause, loss of profit.
Marine & Transit Claim Guide
Damaged ya short goods ka claim: notice, documents aur survey.
Claim Reject Ya Delay Hua?
Complaint aur escalation guide: insurer, Bima Bharosa, Ombudsman, aur ready complaint letter.
Engineering, PA, Liability, Fidelity & Travel Claims
Machinery breakdown, personal accident, workmen compensation, liability, fidelity aur travel insurance claims.
Claim Kyun Atakta Hai: 6 Aam Wajah
Policy active nahi thi
Premium time par na bharne se policy lapse ho sakti hai, aur lapsed policy par claim nahi milta. Renewal ki date note karke rakhein.
Jaankari chhupi ya galat di
Policy lete waqt health, habit, income ya vehicle ki jaankari galat dene se claim reject ho sakta hai. Life insurance me 3 saal ke baad insurer aam taur par misstatement ke aadhar par policy challenge nahi kar sakta, fraud ko chhodkar.
Waiting period ya exclusion
Health me pre-existing diseases aur kuch bimariyon ka waiting period hota hai. Room rent cap, co-payment aur sub-limits se bhi payout kam ho sakta hai.
Deadline miss ho gayi
Claim ki intimation aur documents jama karne ki time limit policy me likhi hoti hai.
Documents adhoore
Bills, reports ya forms adhoore hone par insurer queries bhejta hai, jisse time lagta hai.
Form galat ya adhoora
Blank form par sign na karein, aur har detail check karke bharein.
Claim Process — Step by Step
Intimation
Claim ki jankari turant insurer ko den (call/app/email). Time limit ka dhyaan rakhein.
Documents
Zaroori documents jama karein — policy, ID, bills, FIR (agar zaroori), medical reports.
Survey / Verification
Insurer surveyor ya TPA verification karta hai. Hum coordination mein madad karte hain.
Settlement
Approval ke baad amount settle hota hai. Follow-up mein guidance milti hai.
Claim Type Ke Hisaab Se Documents Checklist
| Claim | Aam taur par ye documents chahiye |
|---|---|
| Health (cashless) | Policy ya health card number, ID proof, doctor ki admission advice, hospital ka pre-authorisation form |
| Health (reimbursement) | Claim form, discharge summary, original bills aur receipts, investigation reports, prescriptions ke saath pharmacy bills, KYC, cancelled cheque |
| Vehicle | Policy, RC, driving licence, claim form, repair estimate ya invoice, photos; FIR (theft, badi accident ya third-party injury ya damage me) |
| Fire / Property | Policy, fire brigade report, FIR (jahan zaroori ho), stock ya asset records, purchase bills, photos, repair ya replacement estimate; business ke liye accounts |
| Life / Term | Claim form, death certificate, policy document, nominee ka ID aur bank details, medical records; accidental ya unnatural death me FIR aur postmortem report |
| Commercial vehicle | Policy, RC, permit, fitness certificate, driver ka licence, FIR, survey report, repair estimate |
Exact list insurer aur claim ke hisaab se alag ho sakti hai. Hum aapke case ki list pehle hi confirm karne me madad karte hain.
Cashless Ya Reimbursement: Kaun Sa Kab?
Cashless
Network hospital me. Hospital insurer ya TPA se pre-authorisation leta hai. Planned admission me policy me jo notice period likha ho uska dhyaan rakhein; emergency me admission ke turant baad insurer ko batayein. IRDAI ke Master Circular (May 2024) ke anusar insurer ko cashless authorisation request par 1 ghante me, aur discharge par final authorisation 3 ghante me decision dena hota hai.
Reimbursement
Non-network hospital me, ya cashless na milne par. Pehle aap bhugtan karte hain, phir documents jama karte hain. Original bills, discharge summary, reports aur claim form sambhal kar rakhein, aur policy ki deadline dekhein.
- Discharge se pehle final bill line-by-line check karein.
- Non-payable items (jaise consumables) ka alag hisaab maangein.
- Room rent ki limit se bill kitna prabhavit hoga, ye admission ke waqt hi poochh lein.
Nominee Ke Liye: Death Claim Kaise Karein
- Insurer ko jaldi se jaldi likhit ya online batayein, policy number ke saath.
- Claim form, death certificate, policy document, nominee ka ID aur bank details, aur zaroori medical records jama karein. Accidental ya unnatural death me FIR aur postmortem report bhi lagti hai.
- Policy ke pehle 3 saal me hui death me insurer aam taur par zyada jaanch karta hai, isliye jaankari sahi aur poori rakhein.
- IRDAI ke Master Circular (2024) ke anusar jis death claim me jaanch ki zaroorat nahi, wo aam taur par 15 din me settle hona chahiye; jaanch ho to 45 din tak. Exact terms insurer aur policy par depend karte hain.
Zyada detail ke liye hamari term insurance guide ka claim section padhein.
Claim Reject Ho Gaya? Ye Rasta Apnayein
- Reason likhit me maangein. Rejection ka exact karan aur policy ki kaun si clause ka hawala diya gaya hai.
- Insurer ke Grievance Redressal Officer ko likhit shikayat bhejein. Copy aur proof of delivery rakhein.
- Jawab na mile ya santusht na hon, to IRDAI ke Bima Bharosa portal par complaint register karein.
- Insurance Ombudsman (Bima Lokpal). Insurer ko pehle likhit shikayat dene ke baad, aam taur par insurer ke final jawab ke 1 saal ke andar. Claim value ki limit lagti hai, aur wahi case court ya consumer forum me pending nahi hona chahiye. Ye process free hai.
Hum documents aur follow-up me guidance dete hain. Final decision insurer, Bima Lokpal ya court ka hota hai.
Aksar Puche Jane Wale Sawaal
Ye claim type, documentation completeness, aur insurer par depend karta hai. Cashless health claims jaldi hote hain, reimbursement aur survey-based claims mein time lagta hai. Exact timeline insurer batata hai.
Rejection ka reason samjhein — aksar documentation ya non-disclosure ki wajah se hota hai. Insurer ke grievance cell ya Insurance Ombudsman mein appeal kar sakte hain. Binod sir guidance denge.
Binod sir apne clients ko claim guidance free dete hain. Lekin koi bhi claim ka final outcome insurer ke decision par depend karta hai.
IRDAI ke Master Circular (May 2024) ke anusar insurer ko cashless authorisation request par 1 ghante me decision dena hota hai, aur discharge par final authorisation 3 ghante me. Agar hospital ya insurer deri kare to hum follow-up me madad karte hain.
Jitna jaldi ho sake. Planned hospitalisation me admission se pehle (policy me jo notice period ho), emergency me admission ke turant baad. Vehicle theft ya badi accident me turant, aur FIR jahan zaroori ho. Exact time policy me likha hota hai.
IRDAI ke Master Circular (2024) ke anusar jis claim me jaanch ki zaroorat nahi wo aam taur par 15 din me, aur jaanch ho to 45 din tak settle hona chahiye. Exact terms insurer par depend karte hain.
Insurer ko likhit shikayat dene ke baad, jab insurer reject kare, santusht jawab na de, ya 30 din me jawab na de. Aam taur par insurer ke final jawab ke 1 saal ke andar. Claim value ki limit lagti hai, aur case court ya consumer forum me pending nahi hona chahiye.