House Holders Package Insurance Claim Process
Scope of Cover and Documents required for Claims
Section I - Fire & Allied Perils
- Coverage for building.
- Covers contents of the dwelling belonging to the propose and his/her family members permanently residing with him/her.
- It is necessary to obtain the Private Reference and/or Former Employer’s Report forms in addition to completed Employer and Employees application form, as appropriate.
- Fire, Lightening, Explosion of gas in domestic appliances Bursting and overflowing of water tanks, apparatus or pipes.
- Damage caused by Aircraft.
- Riot, Strike, Malicious or Terrorist Act.
- Earthquake, Fire and/or Shock, subsidence and Landslide (including Rockslide) damage
- Flood, Inundation, Storm, Tempest, Typhoon, Hurricane, Tomado or Cyclone.
- Impact damage
Section II - Burglary & House breaking including larceny and theft.
- Covers contents of the dwelling against loss due to burglary, house breaking, larceny or theft.
Section III - All Risks (jewelers & Valuables)
- Covers loss or damage to your jewelers and valuables by accident or misfortune whilst kept, worn or carried anywhere in India subject to the value declared in the schedule.
Section IV- Plate Glass Insurance
- Fixed Plate Glass in the premises.
Section V - Breakdown of Domestic appliances
- Covers domestic appliances against unforeseen and sudden physical damage due to mechanical or electrical breakdown.
Section VI - T.V. Set including VCP/VCR (ALL RISKS)
- Covers loss or damage to T.V.Set including VCP/VCR by fire and allied perils, burglary, house breaking or theft, breakage due to accidental external means, mechanical or electrical breakdown. Any legal liability arising out of bodily injury or accidental death of any person other than insured`s family members or employee as also damage to property not belonging to or in the custody of insured , caused by use of the T.V. Set is also covered up to a limit of Rs.25,000/-.
Section VII - Pedal Cycles (All Risks)
Covers loss or damage to pedal cycles by:
- Fixed Plate Glass in the premises.
- Fire & allied perils
- Burglary, housebreaking, theft
- Accidental external means
- Third party personal injury or Third party property damage for Rs.10,000/-
Section VIII - Baggage Insurance
- Covers loss or damage to insured`s accompanied baggage by accident or misfortune whilst the insured is traveling on tour or holiday anywhere in India.
Section IX - Personal Accident
- Covers Death or bodily injury by accidental, violent, external and visible means to the insured person named in the schedule and subject to limits specified therein.
Section X - Public Liability
- Covers Insured`s legal liability for bodily injury or loss of or damage to property of third party limited to amount specified in the schedule and workmen`s compensation liability to domestic servants engaged in insured`s premises.
Documents required for Claims:
- You need to submit a completed and signed claims form along with a letter stating that you are the owner of the items.
- You also need to submit some other reports and forms that are considered as evidence of the event happening, the nature of the event and the extent of loss:
For Fire Claims:
- Fire brigade report in case of fire.
- Seismological report in case of earthquake.
- Meteorological department`s report in case of flood.
- Estimate of the repairs for Fire/Flood/cyclone/earthquake damage/impact damage.
- In case of Impact Damage, Strike/Riot or Civil Commotion the First Information report from Police is necessary.
- Rental agreement if residing in a rented house.
For Burglary Claims:
- To obtain a First Information report from Police authorities.
- To notify the Insurance Company and complete the claim form.
- Take Photographs of the area broken to enter the house if it is forcible entry.
- List out the articles that have been lost and their approximate value.
- To Follow up with the Police Authorities and obtain the non traceable certificate.
Documents required for Loss of jewelers and valuables:
- Immediate intimation to Police authorities and obtain the FIR.
- Intimation to Insurance Company at the earliest.
- Value of article lost should be duly mentioned in the FIR.
- In case of loss due to forcible entry into house or breakage of Lockers take photographs of the damage.
- Submit a list of items to the Insurance Company that are lost so that they will be able to cross check with the list submitted at the time of taking the policy. Kindly note as and when a new item is purchased the same should be notified to Insurance Company and the requisite premium should have been paid. Even in cases where particular jewelers aare exchanged for a new one the same should have been notified to the Insurance Company.
- Obtain the non traceable certificate from the police authorities.
- Submit the letter of Subrogation to the Insurance Company on legal paper as per the direction of the Insurance Company.
Documents Required for Plate Glass Insurance:
- Completed Claim Form.
- Photographs of the plate glass that is damaged.
- Original Invoice value.
- Current invoice bill.
- It should be noted here that every year the Insured has to ensure that the value of the glass adheres to current replacement value. In case the current replacement value is higher than the original insured value then “Average” clause becomes applicable. However no depreciation will be deducted other than Salvage Value if any.
Documents required for breakdown of domestic Appliances:
- Completed claim form.
- Detailed report from the repairer regarding cause of loss.
- Repairers estimate.
- Here the “depreciation clause” becomes applicable @10% per year from date of purchase subject to 50%.
- In case the item is on warranty such details as required must be furnished.
Documents required for damage to TV/DVD/MP3 or other Musical equipment:
- Completed claim form.
- Report from repairer about the cause of loss.
- Repairers estimate.
- In case of flood/cyclone/Hurricane/Earthquake etc then meteorological report /seismological report is required.
- If the value of the article damaged is less than the current market value then ‘Average Clause’ will become applicable.
- For Picture Tubes the rate of depreciation would be 10% per year subject to a maximum of 50%.
- In case of injury to any third party the FIR from Police is required.
- In case the articles are damaged due to Riot Strike or Malicious act then FIR from Police authorities is required.
- In case of burglary claims then FIR from Police authorities and Non Traceable certificate is required.
- Final Bill paid to repairer.
Documents required for Pedal Cycle claims:
In case of damage whilst plying on the road then:
- FIR from the police authorities regarding damage if it involves third party. Otherwise a Self Declaration regarding the reason for the damage is sufficient.
- Repairers estimate for damaged items
- Here also ‘deprecation clause’ is applied for the spare parts.
- In case the market value is higher than the Insured value ‘Average Clause” will become applicable.
- In case of Loss of life or Injury to third party FIR is required.
- In case of Burglary Claims:
- FIR from police authorities is a must. However if it is not possible to obtain an FIR then a General Diary entry from Police authorities is required.
- Letter of subrogation on Legal paper as directed by the Insurance Company.
Documents required for Loss of Baggage:
- Proof of Travel. E.g. Air Ticket/Train Ticket/Bus ticket. In case of loss of baggage by any other means of travel then a self declaration regarding the same. However loss of baggage for travel undertaken within the municipal limits of the Village, town or city wherein Insured is permanently residing is not covered.
- Registered letter of complaint should be lodged on the carrier if travel by Public Transport.
- Detailed list of items carried in the Baggage. However the insured should note that money securities, manuscripts, deeds, Bills of exchange, Promissory notes, stock or share certificates, jewelers, precious stones, watches, travel tickets, Cheques, bank drafts etc are not covered.
- If possible a report of loss from the carriers. Otherwise FIR/General Diary entry from Police is required.
- The compensation will be according to the value mentioned in the Policy schedule only.
Documents required for Personal Accident Claims:
- Completed claim form
- FIR from Police authorities regarding the accident.
- For death claims Postmortem Certificate, Legal Heir certificate and Inquest report.
- For Disability a certificate from the Government Medical Practitioner mentioning the percentage of disability and medical reports for treatment taken and the disability sustained.
- In case of death or disability in the course of employment then a certificate from the employer that the Insured person was in their service at the time of death or disability.
Documents required for Liability:
- In case of third party: FIR from Policy authorities is required. Thereon the Insurance Company will make arrangements to defend the Insured since this is Legal Liability. The Insured should cooperate with the Insurance Company and make himself available as and when required by the court. However this is restricted to Rs.25000/- only as compensation and litigation expenses incurred by the Insured.
- In case of Death or disability of domestic servants: The said domestic servant should be named in the policy schedule. The compensation will be paid according to the Workmen`s Compensation Act and the proceedings should move from the disabled servant or from the legal heirs of the deceased servant. The documents to be submitted to Insurance Company are FIR from Police, Postmortem certificate and Inquest report (for death Claims). Thereupon the Insurance Company will deal with the case.
In the event of Claims being repudiated by the Insurance Company the following options are available as a recourse:
- Make a representation to the Insurance Company/TPA.
- If no reply is received within 15 days on making such representation make a representation to the Grievance Cell of the Insurance Company.
- If No Reply is received or if the reply is not satisfactory then make a representation to the Insurance Ombudsman who has Quasi Judicial powers to hear the case and make adjudication.
- If still not satisfied the next option is to go to court.