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Group Claims - Critical Illness Claim

Group Claims - Critical Illness Claim

Group Claims - Critical Illness Claim

For Critical Illness claims, 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 the criteria as laid down for claiming the rider benefits are satisfied.

The following documents need to be submitted:

Documents to be Submitted*
Critical Illness Claim
  Employer– Employee Credit Policies Micro Insurance (Social Sector)*
Mandatory Documents      
Duly-filled, stamped and signed Rider Claim Intimation Form
Certificate of Insurance  
Life insured's photo ID proof
Medical records (consultation notes, treatment records, admission notes, hospital indoor case papers, discharge summary, investigation reports, etc )
Supporting Documents      
Life Insured's bank account details along with copy of bank passbook / statement
Critical Illness questionnaire/ medical questionnaire /physician statement

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  • 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.
  • Kotak Life Insurance reserves the right to require the medical examination of the life insured and confirmation of the diagnosis of an insured’s Critical Illness Condition by a specified medical practitioner.
  • The Claim for Critical Illness Rider benefit has to be lodged by the life insured within 30 days from the date of diagnosis.
  • The Critical Illness Benefit (CIB) Rider is terminated automatically on admittance of the 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.

Additional Information:
  • 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.
*Not applicable for Social Sector

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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