Claims making and payment are the most challenging aspects of life insurance and indeed any area of insurance. Often times, prospective insurance buyers do not take time to do all that are expected of them at the point of buying the life insurance. Life insurance claims occur when an insured person passes away. And if one understands what is involved during the claims process, then he can help prevent any delays in payment. There are a number of factors that can cause delays in a claim being paid and knowing what these factors are can help you make the claims process happen much faster and avoid any delays. Life insurance is purchased to provide financial protection for those left behind and when you purchase this coverage you want the benefits to be available as soon as possible to avoid any financial hardships. Life insurance claims involve a number of steps and during each step any mistakes or omissions can cause a delay, which could be short or take months to redeem, depending on the specific reasons for the delay. The first step is to locate the actual policy, which has information that will be needed. Look at the policy to determine the life insurance company that is on the policy and then contact the insurer. Usually the policy will contain all the relevant information on who to contact regarding a claim. If you can not locate the policy but know the company who offered it then you can call the company and explain the situation.
The next step for life insurance claims is to fill out the claim form. This is usually sent by the life insurance company. This step is very important and the form should be filled out completely and as comprehensive as possible. If you do not know the answer or it does not apply make sure it is clearly written in the answer space. Do not leave any questions blank, because this will delay the claim payment while the company investigates the answer. It is also very helpful to have the policy number, because this will make the life insurance claims process go much faster. If you are not sure of an answer or do not know, you can call your insurance agent, your broker or the life insurance company. They may be able to look up any missing information if it is in the database and providing this on the claim form may prevent any unnecessary delays.  Another important part of the life insurance claims process is the death certificate. After you have filled out the claim form completely, you will need to get a certified copy of the death certificate for each claim being sent in. It may be a good idea to call first and determine where to go to get this certificate. You may be able to get the needed copies from the hospital if one was used, or you may have to go to either the local government that the deceased resided in or the state where the death occurred. A claim without a certified copy of the death certificate may be delayed or even denied. Once you have the required death certificate, send it together with the completed life insurance claims forms to the life insurance company. These tips can help you avoid any delay in the claim payment. However one topical question to ask is when does an insurance claim delay becomes an insurance claim dispute. It is only disreputable insurance companies that apply delay tactics to frustrate claimants. And this is based largely on the premise that by forcing you to wait for settlement of your claim, you will eventually give up. Giving up translates to less or no money for the claim payment and thus more money for the insurance company.  This unholy practice used to be in place in Nigeria when we had over hundred insurance companies with some of them unregistered and unregulated. In furtherance of this endeavor, carriers will utilize a variety of tactics to delay your claim through a process dubbed "claim management". Insurance consumers must arm themselves with sufficient knowledge to identify the difference between legitimate insurance claim investigations and illegitimate claim delays. An insurance company has a right, a duty in fact, to conduct insurance claim investigations.  The key here is that the investigation must be reasonable and timely. Insurance policies require that the insured must cooperate with the carrier in matters concerning a claim.  These conditions are generally included in the petition. Accordingly, it is reasonable for your insurer to ask you for specific documents or items related to your claim. By all means, it is advisable to comply with requests for relevant information and data. Likewise, it is important to cooperate with the insurer’s request, including your recorded statement, proof of lost documents which must be supported with affidavits. If one fails to comply with these reasonable requests, such a person may be putting himself in jeopardy of a lengthy investigation and a probable claim denial. Some of the delay tactics that insurance companies utilize include confirmation of coverage.  Your adjuster may cling to some little issues as "confirm coverage" which is based on the terms of the insurance policy.  Flawed, faulty, or unfair policy interpretation is also one of the more common examples of unfair tactics insurance companies often use to delay claims.  This process is frequently no more than a search for reasons not to pay claims. Requirement for a follow-up recorded statement is another plot.  In a legitimate claim, follow-up statements should not be necessary. While the adjuster has the duty to properly investigate the claim, he also has the obligation to keep you abreast of the status of your insurance claim.  If a claimant is experiencing to the level that he is continuously told that "the claim remains under investigation", then one should assume that a problem of denial was looming. In making claims, investigations are crucial to the final outcome, one of which is referral to the special investigations unit.  Such referrals are legitimately a means to investigate potential insurance fraud.  However illegitimate referrals represent a process designed to avoid payment of insurance claims. One other trick of insurance companies is examination under oath.  This is a formal proceeding taken under oath and is usually convened when the carrier legitimately requires additional detailed information from the policyholder in order to make a coverage decision.  When such is used illegitimately, it is aimed at unfairly targeting claims for denial.  In either event, if you are called for an examination under oath, it means there is a problem with your claim. Having known these, it is instructive to be on the alert while also considering stand by solution to any such delay tactics. One of the ways to frustrate such evil plots is to continue to cooperate, no matter the approach of the insurer to frustrate you. It is better to assume the position that you have cooperated to the fullest extent possible.  This places additional burdens on the insurance company.  This is more so as they cannot argue that their processes were delayed solely because you "failed" to cooperate. It is also important that you call the adjuster frequently, behaving courteously as you do.  In doing so, always be prepared to ask specific questions about the progress of your claim rather than engaging in boring conversation.  Always offer to provide any additional information needed. An insurance company’s failure to properly conclude your legitimate insurance claim suggests the essence of unfair claims handling.  Document all activities in anticipation of unfair settlement offers or an outright denial in case your claim delay has qualified as a claim dispute.