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Group Personal Accident

Procedure for Group Personal Accident

Intimation & Registration of Claim

  • Insured can intimate the claim on 1800 2700 700 or send email on claimintimation@hdfcergo.com or can intimate the claim to concerned HR of his company
  • On receipt of this intimation, claim will be registered
  • On registration of claim, HDFC ERGO Claims Team will send claim form to Insured along with check list of documents pertaining to respective section under which the claim is reported

Claim Processing

  • If claim documents are incomplete, then Query should be sent to Customer via SMS / Mail / Call / Letter (hard Copy)
  • Upon receipt of all documents, Claim to be processed as per the merits of the Policy

Claim Settlement

  • After receipt of all deficient documents, The claim will be processed and cheque will be prepared and dispatched to the concern.
  • If Claim is rejected than claims team will dispatch Rejection Letter to the Insured/ beneficiary/ concerned point of source / HR of the corporate through courier

Turn Around Time for Claims Settlement

  • Claim will get registered within 24 Hrs from receipt of Intimation through mail / call / documents
  • First deficiency communication to customer within 3 days from the date of receipt of documents
  • Complete documentation - Claim to be settled within 7 working days from the date of receipt of last document OR Complete set of claim documents
  • Generation of cheque – within 2 days from the date of approval

Documents follow up for claims pending for deficient documents

  • Reminder for Submission of document after every 15 days
  • Final Reminder to be sent on 45th day from the date of Intimation
  • After 3 Reminders claim to be closed unless communication received from Insured /beneficiary/POS/HR about Submission of documents

GROUP PERSONAL ACCIDENT – CLAIM PROCESS



GROUP PERSONAL ACCIDENT – CLAIM PROCESS
 

List of documents Required


Accidental Death Permanent Disablement Temporary total Disablement
Originals    
Duly filled claim form Duly filled claim form Duly filled claim form
Photo ID Proof Photo ID Proof HR Letter stating exact leave period
HR Letter HR Letter Doctor Fitness Certificate
Attested Copies    
Salary Slip prior to accident Salary Slip prior to accident Salary Slip prior to accident
Death Certificate issued by Tehsil/Municipal authority All medical papers including investigations reports All medical papers including investigations reports in original
Policy FIR/MLC copy Policy FIR/MLC copy  
Post Mortem Report Disablement Certificate from Authority  
Police Inquest/ Panchnama report Photograph of the Insured showing disablement/affected part  
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