Claim Settlement Ratio
Max Life Claims Paid Ratio so far
2020
2021
2022
2023
Claims Paid Percentage
2024
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What is Claim Settlement Ratio?
Claims can be denied, especially when there are some red flags in the policy draft that might go against certain policy requirements. Therefore, when it comes to life insurance, you need to be sure that you fill out the necessary paperwork correctly and choose an insurer that has a proven track record of settling the major portion of the claims received on an annual basis.
Claim Settlement Ratio can serve as a reliable metric to determine if a certain policy and insurer is the right choice for you.
The primary purpose of a life insurance plan, especially term insurance, is to provide financial support to your family, in case something happens to you. When you purchase a term plan or any other insurance product with a high claim settlement ratio:- You can be assured that the entire experience of claim filing to disbursal will be simple, convenient, and transparent.
- In case of an unexpected mishap, your loved ones will have the assurance of a quick disbursal of the life insurance benefits.
How is Claim Settlement Ratio Calculated?
First, you need to understand that the Claim Settlement Ratio is calculated for all the insurance products offered by the insurance company put together, rather than any specific product.
To calculate the claim settlement ratio, use the following equation: Claim Settlement Ratio (CSR) = (Total number of claims settled in a year / Total number of claims in a year) x 100. Consider the following example to understand the calculation of the Claim Settlement Ratio:
Let us say that a life insurance company receives 1,000 claims in a year, out of which it settles 996 claims by paying the insurance benefit (or sum assured) while rejects the remaining 7 claims.
The Claim Settlement Ratio for the company would be (996/1000) % or 99.6%
Claim Paid Ratio = (Total Claims Paid / Total Claims Received)
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What is a good Claim Settlement Ratio?
Overall, the higher the percentage of settled claims, the better the chances that your life insurance policy claim will be accepted and settled by the insurance company. Another reflection of a high CSR is on the insurance company’s finances. With settlement percentages up and above the 95% mark, a prospective life insurance buyer can be sure that the insurers are secure as they are willing to pay the insurance claim amount to most of their customers.
For FY 2023-24, the claim settlement ratio of Max Life Insurance is 99.65%^. However, it is essential that you do not rely on this value as the only factor while determining your insurer.
You must consider other factors such as online reviews of the insurance company, the experiences of your near ones, and the features and benefits of the insurance plan before making a choice.
Why is Claim Settlement Ratio Important?
Buying a life insurance policy is a long-term endeavour. Not only do you have to pay a significant amount of premiums over a specific payment tenure to avail of the policy benefits but you also have to be sure that your insurance policy documentation is well-rounded so that it doesn’t get rejected.
Thus, you need to compare and purchase a life insurance plan from an insurer with a high claim settlement ratio. Claim Settlement Ratio is a reliable metric that can help you determine if a certain insurance company is trustworthy or not and that your family would not have to move from pillar to post in getting the insurance benefit after your untimely demise.
How Long does it Take to Get Claim Payout?
How swiftly your beneficiaries receive the claim benefit is impacted by how quickly they file a claim and fill out the correct forms. Assuming the information is accurate, an insurance company will pay the claim amount in as little as one to two weeks.
The ideal conditions include:
- The life insurance policy is in effect for three years or more
- The insurance policy has all premiums paid and
- The cause of death is not suspicious
Deferrals in filing a claim or getting the right documents together could stretch the payment date. In any case, the life insurance company should pay out a death claim within 120 days.
Reasons Why Our Claims Settlement Process is Unique?
At Max Life Insurance, our claim settlement process is personalised because of the following factors:
Speed:
Insta claim in 1 day- Claim settlements under InstaClaim™ are subject to the following conditions:
- The claim amount on eligible policies is up to Rs. 50 lakh
- The policy has been in force for a minimum of three years
- All the mandatory# documents shall be submitted before 3 pm at any Max Life Insurance office from Monday to Friday
- Nominee Title is clear
- The claim does not warrant field verification
Trust:
Ease:
Dedicated officers:
Support:
How are the Claims Processed?
At Max Life Insurance, we understand the importance of staying protected against life's uncertainties. We believe it is our responsibility to provide the best insurance coverage possible in your hour of need.
Our team of expert claim assessors are guided by the principle of being the 'Fairest, Fastest, and Friendliest' in terms of claims processing. Our life insurance claim settlement processes, thus, include the following three simple steps:
- Claim Registration & Document Submission
- Claim Evaluation
- Claim Decision & Settlement
For FY 2023-24, Max Life Insurance had a claim settlement ratio of 99.65%^.
Furthermore, we assign a dedicated Claims Relationship Officer (or CRO), to guide your beneficiaries/ claimants at different steps of the claims process.
What Documents are Mandatory for Claims Settlement?
Mandatory Documents to support your claim are:
- Original policy document
- Original/ attested copy of death certificate issued by the local municipal authority
- Death claim application form (Form A)
- NEFT mandate form attested by bank authorities along with a canceled cheque of bank account passbook
- Nominee's photo identity proof such as copy of Passport, PAN card, Voter identity card, Aadhar (UID) card, etc.
- Current Address proof of the claimant. (Any one of the following: Aadhar Card, Valid Passport or Driver's License, Voters ID are considered as proofs)
- Signed copy of PAN card / Form 60 of the claimant
- Employer certificate with complete leave records - Form E
- ITR for last 3 years/GST certificate in case of Self-employed
- Other life/health insurance details with claim history details
- Bank statement of last 2 years of the Life Assured
- Body transfer certificate / Embassy documents/Post Mortem report whichever applicable in case of death in foreign country
- Complete Passport copy in case of death in foreign country
- Medical booklet/CGHS card details in case of Defence and Central Govt personnel
- Attending physician's statement (Form 'C')
- Medical records (admission notes, discharge/death summary, test reports, etc.) of current and /or any previous admissions
Additional documents required based on the cause of death are:
Medical/Natural death:
- Attending physician's statement (Form 'C')
- Medical records (admission notes, discharge/death summary, test reports, etc.)
- Medical booklet / CGHS card details in case of Defence and Central Govt personnel
Accidental/Unnatural death:
- Copy of the First Information Report (FIR) or Panchanama/Police complaint
- Copy of Post Mortem report (PMR)/Autopsy and Viscera report
- Copy of the Final Police Investigation report (FPIR)/Charge sheet
- News Paper Article, if any
- Driving License
What is the Claim Settlement Ratio of Max Life Insurance in the past 6 years?
Claim settlement ratio or individual death claim ratio of a life insurance company is first published as part of the company’s annual audited financials. Subsequently, IRDAI collects the individual claim settlement ratio data of life insurers operating in India to create a comprehensive list that is published as part the IRDAI Annual Report. Both of these data sources are freely available to the public through the respective websites.
Below table illustrates the claim settlement ratio of Max Life Insurance over the past 6 years as reported in the IRDAI Annual Report of the applicable financial years:
| Year | Individual Death Claims Paid Ratio |
|---|---|
| FY 2023-24 | 99.65% |
| FY 2022-23 | 99.51% |
| FY 2021-22 | 99.34% |
| FY 2020-21 | 99.35% |
| FY 2019-20 | 99.22% |
| FY 2018-19 | 98.74% |
| Source: IRDAI Annual Report FY 18-19, FY 19-20, FY 20-21, FY 21-22, FY 22-23. and FY 23-24 | |
Max Life’s InstaclaimTM Promise - 24 Hours is All We Take
The grief of losing your dear one in the hands of destiny is beyond words. As your trusted life insurer, Max Life Insurance offers InstaclaimTM Service to settle your claims within one day, so you can deal with your responsibilities in the absence of your loved one.
We, at Max Life, recognise that claim is the ultimate moment of truth for our business. Therefore, we intend to make your claim settlement experience convenient and quick with the InstaClaimTM initiative.
Through the InstaClaimTM initiative, Max Life endeavours to pay eligible death claims up to Rs. 50 lakh in only 24 hours. Additionally, a dedicated Claim Settlement Officer facilitates a convenient, quick, and simple settlement process.
The 24 hours claim settlement is available for the following:
- Eligible policies that have completed three continuous years
- The claim does not warrant field verification
- All mandatory documents are submitted before 3 pm at any Max Life Insurance office from Monday to Friday
- Nominee Title is clear
- Claim amount on all eligible policies is up to Rs. 50 lakh
Furthermore, if you don't receive the payment within the time frame, you'll be entitled to additional payments in the form of ‘interest’ on the total amount of your death benefit. T&C apply
With the InstaClaimTM initiative, Max Life further aims to enhance customer experience by paying death claims within just 24 hours in eligible cases.
Moreover, in a country with a low protection quotient (as per the IPQ survey), Max Life’s claim settlement ratio of 99.65 percent gives a sense of security that their families will be financially safe during an eventuality, thus encouraging them to opt for life insurance products.
Selecting the Adequate Sum Assured for Term Insurance
Along with checking the claim settlement ratio it’s important that you identify the adequate sum assured required to financially protect your loved ones. To make it easy for you, we have provided some of the sum assured options available below:
Disclaimer: %*Standard daily premium for 24-year old healthy male, non-smoker, 25 years policy term, 25 year premium payment term (exclusive of GST) for Max Life Smart Total Elite Protection Term Plan (UIN: 104N125V06). ARN: C/SA/011024
Stay Safe, Stay Protected
As a policyholder or buyer, you can take a cue from the claim settlement ratio. However, the IRDAI advises that the claim settlement ratio should not be the only parameter that you consider when buying a life insurance policy. Instead, you need to ask whichever insurance company you have decided to purchase life insurance from, to provide all the material information about their policy undertaking and claim settlement process.
On the other hand, you must make sure that you are sincere and transparent while filling out the application form so that your family does not have any problems submitting a claim to the insurer in your absence.
Claims Settlement Ratio FAQs
ARN NO: PCP/CSR/071124
Claims Process Simplified in just Three Steps
Step One
Claim Registration & Document Submission
Step Two
Claim Evaluation
Step Three
Claim Decision & Settlement
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