Claim Intimation Process
Definition
Claim intimation is the formal act of notifying the insurance company about a loss or event that may give rise to a claim under the policy. It is the first and most critical step in the claims process, and must be done within the time limits specified in the policy to preserve the right to claim.
Explanation in Simple Language
Claim intimation triggers the entire claims workflow. Once the insurer receives intimation, they register the claim, assign a claim number, and begin their assessment process. Delayed intimation is one of the top reasons insurers reject or reduce claims.
The intimation can be made through multiple channels: insurer's toll-free number, email, mobile app, branch visit, or through the POSP/agent. For motor accident claims, intimation should ideally be within 24 hours. For health claims, it is typically within 24-48 hours of hospitalization. Fire and property claims should be intimated immediately after the incident.
Key details required during intimation include: policy number, date and time of loss, nature of loss, location of incident, estimated loss amount, and contact details. The insurer will issue a claim reference number which must be used in all future correspondence.
Real-Life Indian Example
Mr. Rajesh Verma from Lucknow met with a car accident on NH-24 at 11 PM. He immediately called his insurer's 24x7 helpline, provided his policy number and accident details, and received a claim reference number. The insurer arranged a tow truck within 2 hours. Because of prompt intimation, his claim of Rs 1,85,000 was settled smoothly within 3 weeks.
Claim Scenario
Mrs. Sunita Devi's shop in Varanasi caught fire on a Saturday evening. She was in panic and only informed her insurer on Wednesday, 4 days later. The insurer accepted the claim but noted the delayed intimation. The surveyor found that some damaged stock had already been cleared, making loss assessment difficult. The claim of Rs 12 Lakhs was reduced to Rs 8.5 Lakhs partly because delayed intimation prevented proper evidence preservation.
Learning for POSP / Advisor
1. Always educate your clients about intimation timelines at the time of policy sale itself.
2. Save the insurer's claim helpline number in the client's phone during policy delivery.
3. Assist your client in filing the intimation — do not leave them to figure it out alone.
4. Document everything: take photos of the damage, note the date, time, and circumstances.
5. Follow up with the insurer to confirm the claim is registered and get the claim reference number.
6. Remind clients: "First call police/hospital, second call insurance company."
7. For motor claims, guide clients on whether to use cashless network garage or reimbursement.
Summary Notes
1. Claim intimation is the formal notification to the insurer about a loss event — it is step one in claims.
2. Timelines: Motor — 24 hours; Health — 24-48 hours (planned: 48-72 hours advance); Property — immediately.
3. Key details needed: policy number, date/time/place, nature of loss, estimated amount, contact details.
4. Delayed intimation is a top reason for claim rejection or reduction.
5. Intimation can be done via helpline, app, email, branch, or through the agent/POSP.
6. The insurer issues a claim reference number after intimation — keep it safe.
7. POSP should assist clients with intimation and follow up until claim is registered.
• IRDAI mandates insurers to settle or reject claims within 30 days of receiving the last necessary document. If investigation is required, the decision must be communicated within 45 days. Interest at 2% above bank rate is payable for delayed settlements beyond these timelines (as per IRDAI Protection of Policyholders' Interests Regulations, 2017).