Group Term Life
A lump sum to the family of an employee who dies while in service, under a policy the employer holds for the whole group.
Also calledGTL · Group Term Assurance · Employee Deposit Linked Insurance
First thing, todayTell the insurer within the notice period in the policy and start collecting the death certificate and the service record at once.
- Tell the insurer now, not after the assessment.
- Pre-authorisation, or intimation before a planned admission, and within the hours the policy allows after an emergency one.
- Every document within the time the insurer asks for it.
When you would claim
- Death of an employee in service, from any cause where covered
- Death during a period of leave, where the cover continues
- An accidental death benefit where the policy carries the rider
- A claim under the statutory EDLI scheme alongside the policy
What insurers most often rely on
- The employee not on the member register on the date of death, usually because additions were sent late
- A sum assured based on a salary that was not the one declared
- Non-disclosure on a member added outside the free cover limit
- Death inside a waiting period the policy sets for that member
- Nomination out of date, which delays rather than defeats the claim
A ground is not a verdict. Most of these are questions about what was written on a proposal form years ago, and after three years the insurer is very largely out of time to ask them.
The documents
nothing here is urgent, and all of it is exact10 items, and none of them is in a hurry. What a life claim turns on is that each one is exact and consistent with the last: one date of birth, one spelling of a name, one address.
- Claim form signed by the employer and by the nominee
- Death certificate issued by the municipal authority
- The member register, showing the employee was covered on that date
- Appointment letter, salary record and the date of joining
- Nomination on record, and proof of the nominee's identity
- Post-mortem and FIR where the death was accidental or unnatural
- Medical records where the death followed an illness
- Details of any other insurance covering the same life
- Cancelled cheque and bank details of the nominee, for the NEFT payment
- The sum assured claimed for that member, with the cover schedule in force on the date of death
Next
What the first day looks like
There is no playbook for this and there will not be one, because the first day is short. Tell the insurer or the TPA inside the hours the policy allows, keep every original the hospital gives you, and do not let a discharge happen before the pre-authorisation query has been answered in writing.
The sum assured is the sum assured
Nothing is averaged, nothing is depreciated and nothing is assessed. What is paid is the sum assured plus whatever bonus or rider attaches to it. What a life claim turns on instead is disclosure, and the three years after which the policy can no longer be questioned on it.
Filed under: People and employee benefits · Illness, hospital and life
Claims that sit next to this one
the same life, on another policyLife Insurance Death Claim
the same claim, on a personal policy
Group Health
the same group, for hospitalisation
Group Personal Accident
the same group, for accident
Claim on a policy of somebody who has died, and the questions started? Report a loss or call 92514 56334.