PNB MetLife - Frequently Asked Questions (FAQ) Claims
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Claims FAQ

What are the IRDAI guidelines pertaining to claim processing?

It’s always important to make a note of important claim related information and be fully aware of all the guidelines. As per IRDAI (Insurance Regulatory Development Authority), the insurance company is required to settle a claim within 30 days of receipt of all requirements for non-investigated cases. However, if the claim warrants further verification, the company should complete its procedures within 6 months from the receipt of the written intimation of the claim. In case of non-compliance of the same relevant penal interest has to be paid. Further the rate and period of interest are decided as per IRDAI guidelines.

We’re happy to help and an intimation of a claim can happen in a host of easy ways.
  • Through Financial Advisor/Sales Manager
  • Through the Branch Office
  • Through Claims Department at the Head Office
  • In case of BABP channel, the claim intimation can be received by the channel partner/Bank – who in turn should communicate with the PNB MetLife Branch/Claims Team at HO
  • Through Regional Service Team (For Group claims)
  • Through Online claim Submission via website

Intimation of a claim can be received through any of the modes mentioned below:
  • Written
  • Letter
  • Email
  • Fax

Information is always critical and helpful. The company considers the sum at risk, cause, circumstances of the claim and duration of the policy. For example, in an accidental death, specific proofs such as post mortem reports and police reports are required. For death due to illness, PNB MetLife calls for hospital records, test reports, etc.

Death Claim
  • Death Certificate (In original or copy notarized)
  • Original Policy Document or Indemnity Bond in case the Original Policy Bond is lost
  • Claimant’s Statement
  • Family Physician Statement
  • Last Attending Physician Statement
  • Photo ID proof and Address Proof of the nominee as per AML Requirements (Refer Annexure for the list of accepted documents)
  • Cancelled cheque leaf or bank pass book of the beneficiary under the policies
 
In exceptional cases, the following documents would be called for:
  • Cremation/ Burial Certificate
  • Obituary Announcements (Copies attested by a PNB MetLife official)
 
Accidental Death Benefit Claim
  • Death Certificate (In original or copy notarized) Original Policy Document or Indemnity Bond in case the Original Policy Bond is lost
  • Claimant’s Statement
  • Family Physician Statement (Non-mandatory)
  • Last Attending Physician’s Statement (Non-mandatory)
  • Photo ID proof and Address Proof of the nominee (Refer Annexure for the list of accepted documents)
  • Attested copy of FIR (If, death due to an accident or unnatural cause. Attestation to be done by the SHO of the concerned Police Station) or Attested copy of the Police Inquest Report (If death due to accident or unnatural cause. Attestation to be done by the SHO of the concerned Police Station) or Panchanama (Attestation to be done by the SHO of the concerned Police Station)
  • Attested Copy of the Post Mortem Report (If, death is due to accident or unnatural cause. Attestation to be done by the SHO of the concerned Police Station)
  • Cancelled cheque leaf or bank pass book of the beneficiary under the policies
 
In exceptional cases, the following documents would be called for:
  • Cremation/ Burial Certificate
  • Obituary Announcements (Copies attested by a PNB MetLife official)
  • Viscera or Chemical Analysis report
  • News Paper Cutting

Critical illness claim
  • Claimant Statement
  • Attending Physician Statement
  • Discharge summary from the hospital
  • Original/Attested copy of all treatment & diagnosis reports. Or
  • Attested copies of other hospital records (Admission sheet, Discharge Summary, bead head ticket etc.) duly attested by the Issuing authority or a notarized copy
  • Original Policy Document
  • Cancelled cheque leaf or bank pass book of the life assured
Please Note: A Critical Illness Rider can be claimed only once the Survival period is completed.
 
Waiver of Premium
  • Claimant’s statement (in specified format)
  • Attending Physician’s statement (in specified format)
  • Original Policy Document
  • Original/attested copy of all treatment & diagnosis reports
  • Attested copies of other hospital records (Admission sheet, Discharge Summary, bead head ticket etc.)
  • Disability certificate issued by the Civil Surgeon / competent specialist. (06 months after the date of injury)
  • Certificate of current status of health
  • First Information Report (FIR) (Copy attested by the SHO of the concerned police station)
  • Cancelled cheque leaf or bank pass book of the beneficiary under the policies
 
MetLife Health Care Claim
  • Hospital Cash Benefit claim form – In original
  • Hospital Certificate – In Original
  • Hospital Admission notes - In Original
  • Hospital discharge summary - In Original
  • Final Cash paid hospital bills - In Original
  • Originals to be verified at branch. To be returned after verification.
  • Cancelled cheque leaf or bank pass book of the life assured

  • The nominee or appointee (in case of minor nominee) last recorded under the policy in case of policy on own life.
  • The proposer in case the policy is not on own life.
  • Assignee in case the policy was assigned.
  • Life Assured himself in case of policy on own life for living benefit claims (Critical Illness rider, Total Permanent Disability, Health Care claims).
  • Trustee under MWP policies/HUF policies.

Once all the required documents are received by PNB MetLife, we will process your claim within 30 days of receipt of last document for all cases where further investigation is not required and upto 6 months from date of intimation for cases where further investigation is required.

Attestation is required on certain documents. Kindly contact your closest PNB MetLife branch for more details.

For life cover, the only exclusion applicable is suicide in the first year. Rider benefits like CI/Accident etc. have various other exclusions applicable as mentioned in the terms and conditions of the policy. Please refer to your policy terms & conditions to know exact details.
 
Is there any particular format for legal heirship/ succession certificate?
There is no particular format for these documents. Legal heirship certificate is a document issued by Tahsildar officer and succession certificate is issued by court. As these are government authorities, no particular format is prescribed to be used.
 
What is the process of death claim, if death occurs abroad?
Documents required are similar to requirements for death happening in India. The death certificate needs to be attested by the Indian Embassy of that country.