Critical Illness Claim
In case of a Critical Illness Claim, the rider amount will be paid if the life insured is diagnosed to be suffering from any of the illnesses as specified in the Policy Contract and if the criteria for claiming the rider benefits are satisfied.
The following documents need to be submitted:
|Documents to be Submitted*|
|Duly-filled Rider Claim Intimation Form|
|Original policy documents|
|Life Insured's photo, current address proof and photo ID proof|
|Medical records (consultation notes, treatment records, admission notes, hospital indoor case papers, discharge summary, investigation reports, etc )|
|Life Insured's copy of bank passbook / statement with bank account details|
|Critical Illness questionnaire/ medical questionnaire /physician statement|
- Kotak Life Insurance reserves the right to request for a medical examination of the life insured and confirmation of the diagnosis of an insured's Critical Illness Condition by a specified medical practitioner.
- The Critical Illness Benefit claim is to be lodged by the life insured within 30 days from the date of diagnosis.
- The Critical Illness Benefit Rider is terminated automatically on admittance of the Critical Illness Benefit (CIB) claim.
- The Critical Illness Benefit Rider is subject to the conditions and the exclusions as laid down in the "Annexure CIB" within the Policy Contract.
- Under Kotak Capital Multiplier Plan, Critical Illness Benefit amount is not paid – but credited to supplementary account
- In case of a Critical Illness Claim, the rider amount will be settled if the Life Insured is diagnosed as suffering from any of the illnesses specified in the Policy contract and if the criteria for claiming this benefit are duly satisfied.
- All submitted documents must be the original or photocopies attested by a gazetted officer, SEM, magistrate or a person of local standing, e.g. Sarpanch, Talathi, Tahsildar or Police Sub-Inspector.
- All medical reports, documents and certification shall be issued by the attending physician and who is qualified to provide such document/certification according to the laws of India.
- Depending on the facts and circumstances of the claim, Kotak Life Insurance reserves the right to call for and request certain additional documents.
- Kotak Life Insurance reserves the right to conduct an independent investigation/inquiry to prove the authenticity of any claim where it is considered necessary.
These are basic guidelines to assist in the claims procedure. Please refer the Policy Contract for actual claims details.
The documents listed above are basic primary documents to be submitted for each claim. Based on the circumstances and the requirements of the case, Kotak Life Insurance may require further/alternate documents.
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