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With the help of a life insurance policy, you can protect yourself and your family against several risks, unforeseen events, and emergencies in life. It is the sum assured or the total coverage of the life insurance policy that helps your family through difficult times and ensures financial support for their sustenance. This is when an insurance claim settlement ratio becomes important!
As per definition, the insurance claim settlement ratio (CSR) is the percentage of claims that an insurance company or insurance provider has settled in a financial year out of the total claims they received. Therefore, the Claim Settlement Ratio is an important indicator of an insurer’s credibility since it shows the likelihood of your claim being settled in a timely and effective manner.
The official website of the Insurance Regulatory and Development Authority of India (IRDAI) provides the claims settlement ratio of insurance providers. With a Tata AIA Life Insurance policy, you can enjoy the security of having your claim settled on time and, thus, protect your family from a host of financial risks and emergencies!
The insurance claim settlement ratio tends to show how reliable a company is when claims are made. A higher ratio may mean that you can expect your claim to be settled on time.
Tata AIA Life Insurance aims to provide a stable record of CSR, with Individual Death Claim Settlement Ratios showing great consistency in each of the past four years with 98.02% in FY 2020-21, 98.53% in FY 2021-22, 99.01% in FY 2022-23 and 99.13% in FY 2023-24 99.41% in FY24-25 This gives assurance to policyholders and their families of getting dependable financial security in a tough time.
Non-Linked, Non-Participating, Pure Risk, Individual Life Insurance Product (UIN:110N176V06)
Non-Linked, Non-Participating, Individual Life Insurance Savings Plan (UIN: 110N158V14)
Solution Composition
In this policy, the investment risk in investment portfolio is borne by the policyholder.
This advertisement is designed for combination of benefits of following individual and separate products named (1) Tata AIA Smart Sampoorna Raksha Supreme - Unit Linked, Non-Participating Individual Life Insurance Plan (UIN: 110L179V02) and (2) Tata AIA Vitality Protect Advance - A Non-Linked, Non- Participating Individual Health Product (UIN: 110N178V01). These products are also available for sale individually without the combination offered/ suggested. This benefit illustration is the arithmetic combination and chronological listing of combined benefits of individual products. The customer is advised to refer the detailed sales brochure of respective individual products mentioned herein before concluding sale.
The linked insurance product do not offer any liquidity during the first five years of the contract. The policy holder will not be able to surrender/withdraw the monies invested in linked insurance products completely or partially till the end of the fifth year.
We have consistently improved our Claim Settlement Ratio over the years and these consistent figures highlight our unwavering commitment to settling claims promptly and efficiently.
When you purchase a life insurance policy from a life insurance provider, there are several factors you look at, such as the company’s offerings, the reviews by other customers and so on. However, the life insurance claim settlement ratio is the primary factor that should be researched and looked into when selecting a company as your life insurance provider.
Here are two important reasons why the claim settlement ratio can help you decide whether you should purchase your policy from the life insurance provider of your choice:
The calculation of the claim settlement ratio of your insurance provider is quite simple, and the figure can be arrived at with the help of the following formula:
Claim Settlement Ratio (CSR) = (Total number of approved claims / Total number of received claims) x 100
The arrived figure is always represented as a percentage. Hence, when a life insurance provider has an insurance claim settlement ratio of 90%, in simple terms, it means that the company has settled 90 claims out of the 100 claims they had received. A high percentage, such as the Tata AIA Life Insurance individual death claim settlement ratio of 99.41%1 in the FY 2024-25, is an indication of the company’s reliability.
A reputed life insurance provider not only honours claims within the regulatory Turn-Around-Time (TAT) but also ensures a smooth and convenient process. This makes it easier for customers to file their claims promptly . Insurance companies can also choose to disclose the total amount paid in claims and the number of policies successfully settled.
When a life insurance provider has a claim settlement ratio of 90% or above, it is generally considered to be a good claim settlement ratio. This is because 90% is an indication that the insurance provider has settled 90 of the 100 claims they have received during a financial year.
The life insurance claim settlement ratio changes each year, depending on how many claims the insurer was able to settle. When buying a life insurance policy, this annual percentage, as well as the past records, are important since it tells whether the life insurance provider has been consistent in honouring the maximum number of claims possible for each year. To understand what a good claim settlement ratio is, take a look at the points below:
A high claim settlement ratio is a clear indicator that your insurer will accept and settle your claim when you need to have the claim settled on time. Though it is the solvency ratio that indicates a company’s financial capacity, the claim settlement ratio also identifies the insurer’s financial health. A good life insurance claim settlement ratio gives policy buyers a sense of security as the insurance company comes across as reliable and capable of paying out claims.
Many people tend to hide information to receive their claims without providing proof. However, this can raise suspicion and lead to an investigation. By the end of the investigation the claim can be rejected if the policyholder's fraud is revealed and will negatively influence the insurance company's Claim Settlement Ratio.
Spend some time understanding the terms and conditions of the insurance policy properly. If you are unable to receive your claim settlement because you could not understand any of the policy exclusions, it leads to claim rejection.
If you, the policyholder, hold back or hide important information that could affect the claim process in any way, it will be considered as a case of fraud. Since such an instance prevents your insurance company from settling your claim.
In case of your untimely death, your insurer will help your nominee receive the death benefits through the due process. However, if you have been unable to update the correct nominee details or mention any changes, the insurer will not be able to help your nominee.
A consistent Claim Settlement Ratio (CSR) is important because it shows the reliability and stability of an insurance company to honour claims over time. If a CSR is high or stable year after year, it indicates that the insurer has a history of paying out claims quickly and fairly for its policyholders. This can be beneficial for those looking for financial security for their families. A consistent and high term insurance claim settlement ratio may also indicate that the insurer has an efficient claims processing system and transparent policies.
Choosing the insurer affects your Claim Settlement Ratio. Insurers with a higher CSR are more reliable and process claims quickly. If you choose an insurer with a lower CSR, you might face delays or higher claim rejections. It’s important to look at the CSR, customer service, and how easy it is to make a claim when selecting an insurer. A higher CSR generally means a smoother experience during claims.
Life insurance covers you and your family when you pay your premiums on time. When you miss a premium payment, there are provisions such as the grace period and policy revival to help you continue the life insurance coverage. In the case of unpaid premiums, it can affect the coverage benefits and even result in the claim being denied.
Letting your policy lapse puts your family's financial security at risk. Although you can revive the policy, subject to the policy terms and conditions, a slight delay or sudden emergency can cause quite a lot of problems when your nominee files the claim. A lapsed policy can't get any benefits if it hasn't been revived.
If your medical records are misrepresented or missing, your claims may be rejected. Hiding your smoking habits may result in lower premiums, but it always leads to claim rejection. Any medical condition should be disclosed to your insurance company when you purchase the policy.
Maturity claims and death claims are the two types of claims that you can file under a life insurance policy.
Under a life insurance policy, a death benefit is paid out to your family members, or the nominee/nominees named in the policy if you pass away during the policy term. Your nominee will be required to produce a set of documents requested by the company as proof of your death, such as the death certificate, doctor’s certificate and so on. The death benefit ensures that your family can sustain themselves financially in your absence.
A lot of life insurance policies, such as savings plans, retirement plans, ULIPs and endowment plans, come with maturity benefits which are paid out according to the policy once it matures. When a life insurance policy reaches its maturity date and the policyholder is alive, the insurer pays the maturity benefit as per the policy terms.
Claim form
Death certificate
Photo identification proof of the nominee
Current address proof of the nomine
Cancelled Cheque of the nominee
First Information Report
(in case of a claim due to an accident)
Post Mortem Report (if conducted)
Discharge summary / Death summary
(in case of hospitalisation)
For NRI customers
FATCACRS self-certification forms—Individual
FATCACRS self-certification forms—Non-Individual
Note: Tata AIA may ask for other documents, which are required on a case-by-case basis.
Mandatory documents
Claim form
Final Hospital Bill
Cancelled Cheque (Insured)
Photo identification proof of the Insured
All the related clinical reports about the claim event
ID/Address proofs
Accidental Hospitalization
MLC / FIR
First Immediate Consultation notes post-accident.
Critical illness
Report confirming the diagnosis of critical illness as per listed illnesses (Definition fulfilling document)
Attending Physician’s statement as applicable
Disability & Dismemberment
MLC/FIR
Attending Physician’s statement confirming the permanent disability of the insured as applicable
Terminal Illness
Life expectancy certificate from two (2) independent Medical Practitioners specialising in the treatment of such illness, mentioning the irreversible terminal medical condition suffered by the insured and that is expected to result in the death of the insured within 6 months of diagnosis.
Certificate / Report specifying the terminal stage with all hospitalisation records & diagnostic reports.
Mandatory documents
Claim forms
Copies of hospital bills for the confinement & copies of all related clinical reports about the claim event
Attested true copy of Indoor Case Papers of the hospital
Discharge summary of present and past hospitalisations
Photo identity of life assured with age and address proof
Bank details of the claimant
Medical examination certificate
All related clinical reports pertaining to the claim event
Laboratory test reports
X-Ray / CT Scan / MRI reports & plates
Ultrasonography report
Histopathology report
Clinical / hospital reports
Angiography reports & plates
Certificate of Diagnosis
All follow-up consultation notes in relation to the hospitalized condition
All police reports / First Information Report & Final Investigation Report
Proof of accident - Panchnama / Inquest report
Newspaper cutting / photographs of the accident, if available.
Mandatory documents
Claim Forms
For Disability:
(Part I: Claimant's statement)
(Part II: Physician's statement)
For Dismemberment:
(Part I: Application form for dismemberment (life assured's statement))
(Part II: Dismemberment claim form (attending physician's report))
Attested true copy of indoor case papers of the hospital
Discharge summary of present and past hospitalizations
Photo identity of life assured with age and address proof (list of acceptable ID and address proofs of claimant)
Bank details of the claimant – Cancelled cheque (with printed name and account number) / bank passbook and NEFT form
All related medical examination reports
A disability certificate by the attending physician/institute for the disabled
Rehabilitation certificate, if applicable
Employer's written confirmation / statement — for disability claim
Clinical photographs showing the injured areas, if available
Valid records/proof showing death of the insured member due to floods, cyclones, or other natural calamities.
Claimant’s Statement (to be filled by nominee) with bank details of the nominee.
Photo ID, Address proof of the nominee and Relationship proof of the nominee with the insured.
Mandatory documents
Claim form
Death certificate
Photo identification proof of claimant
Current address proof of claimant
Cancelled Cheque of claimant
(ensure name and account number is printed on cancelled cheque with copy of bank passbook / bank statement).
First Information Report
(in case of claim due to accident)
Post Mortem Report
(if conducted)
Discharge summary / Death summary
(in case of hospitalisation)
For NRIs Customers
Note: We may ask for other documents, which is required on a case-by-case basis.
With our easy claim initiative, you can call our helpline to schedule an appointment for claim service at your doorstep. Our agent will visit your residence and help in completing the documentation and quickly initiate the claim process.
With our Express claim service, the beneficiary can submit the necessary documents with our agent who will initiate the claim process and ensure that the claim amount is received within 4 hours2. | 2T&C apply.
Having your life insurance claim rejected is not a desirable outcome. After all, if you have a life insurance policy, the death claim is meant to serve an important purpose. While the maturity claim can be primarily used to fulfil your financial goals, the death benefit plays a crucial role in supporting your family in the event of your death. To ensure that your claim does not get rejected, know more about the reasons for life insurance claim rejection:
Any document you submit to the insurance company should always contain the right information, even if it is as minor as the spelling of your name. All the spellings, dates and other details should be as per the records on your official documents and identity proofs. Even details of your lifestyle and health records should be honestly revealed. All of the information about your nominee should be correct so that they do not face any hassles while filing the claim.
When you buy a life insurance policy, your timely premium payments ensure that you can receive life insurance coverage for yourself and your family. In case you miss out on any of the premiums, there are provisions such as the grace period and policy revival to help you activate your policy and continue the life insurance coverage. However, it is always better to ensure that your premiums are always paid on time, since your untimely demise, coupled with the unpaid premiums, can affect the coverage benefits, if not claim rejection.
Just like unpaid premiums, letting your policy lapse can put your family’s financial security at risk. While you can revive the policy, subject to the policy terms and conditions, a slight delay and sudden emergency can cause quite a lot of problems when your nominee tries to file the claim. If the policy has not been revived at all, then a lapsed policy cannot be eligible for any benefits. To ensure that this does not happen, it is preferred if you do not allow your policy to lapse at all.
Misrepresented, missing, and incorrect medical details on your medical records can be a major reason for your claims to be rejected. While hiding your smoking habits can mean lower premiums, it almost always turns out to be a major cause of claim rejection. If you have medical conditions, either past or existing, of any severity, ensure that your insurance company is aware of the same when you purchase the policy or whenever it is diagnosed. This can help your insurance company and policy support you in any possible way to ensure that your claim does not get rejected and that you may receive the benefits as stated.
Know more about how easy it is to submit a claim with Tata AIA Life Insurance.
Our customers trust us to be there when they need us the most. Here’s what some of them have to say:
Our experts are happy to help you!
The Individual death claim settlement ratio of Tata AIA Life Insurance in FY 24-25 is 99.41%1.
The life insurance claim settlement ratio is important because it is an essential indicator that your claims can be settled by your insurance provider in a timely and effective manner when needed. This ratio shows how many claims have been honoured by the insurance company in a given year as against the number of claims filed or received.
A claim settlement ratio of 90% or above is said to be a good claim settlement ratio for an insurance provider. However, each year, the claim settlement ratio can change, depending on how many claims the insurance company has been able to honour. And so, if you are looking for a reliable insurance company, you can look for a consistent track record of successful claim settlements in the last few years.
Factors such as fair disclosure of information, accurate nominee data, and fraud detection by the insurer affect CSR. Additionally, misstatement or non-disclosure may result in the rejection of claims, reducing CSR. The efficiency of claim processing by the insurer along with the financial strength, may also influence the CSR.
The life insurance claim settlement ratio is calculated as the percentage of claims successfully honoured by an insurance company. It is the number of claims that have been settled by the insurer out of all the claims received by them in a single year.
Hence, if the claim settlement ratio of a company is 98%, it means that the company has settled 98 out of 100 claims for that year. The claim settlement ratio can change every year depending on the company’s efficiency at claim settlement.
You can file a death claim and a maturity claim, depending on the situation and the type of claim that needs to be filed. For example, if the policyholder meets their untimely demise during the policy term, then the nominee can file a death claim. But if the policyholder survives the policy term, they can file a maturity claim on the maturity of the policy, if any.
The insurance claim is paid to the nominee specified in the policy upon the death of the policyholder. Legal heirs can also claim the amount with valid documents if no nominee is specified.
Yes, the insurance companies often expect nominees to inform them about claims as soon as possible after the policyholder's death. This may help to prevent unnecessary delays in the claim settlement process and tends to ensure smoother processing.
A death claim should be filed soon after the death of the policyholder during the policy term. Ensure that all the documents needed for the claim settlement, such as the death certificate, the policy document, etc., are submitted on time so that the claim can be filed correctly.
To file a claim, you can choose any of the following channels to reach out to us.
Email us at: customercare@tataaia.com
Call our helpline number - 1860-266-9966 (local charges apply)
Walk into any of the Tata AIA Life Insurance Company branch offices
Write directly to us at:
The Claims Department,
Tata AIA Life Insurance Company Limited
B- Wing, 9th Floor,
I-Think Techno Campus,
Behind TCS, Pokhran Road No.2,
Close to Eastern Express Highway,
Thane (West) 400 607.
IRDA Regn. No. 110
Please click here to know the list of documents needed for the claim intimation and settlement process.
Your insurance claim can be rejected if you do not disclose all the information required for the insurance company to settle your claim. Likewise, misrepresentation or misstatement of facts also leads to claim rejection. This means that you have provided incorrect information on the proposal form or held back some crucial information from the insurance company regarding your health, risks, etc.
Leaving the claim form incomplete and not providing all the details on the insurance proposal form are two of the most common mistakes people make while filing a claim. Unfortunately, both of these mistakes can lead to claim rejection.
Yes, Tata AIA Life Insurance enables you to file an online claim through our official website. Alternatively, you can also locate any of our office branches and visit us to file your claim.
Yes, you can track claim status through Tata AIA’s official website using your claim details.
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Disclaimer
Tata AIA Sampoorna Raksha Promise - Non-Linked, Non-Participating, pure risk, Individual Life Insurance Product (UIN:110N176V06)
The complete name of Tata AIA Fortune Guarantee Plus is Tata AIA Life Insurance Fortune Guarantee Plus (UIN: 110N158V14) - Non-Linked, Non-Participating, Individual Life Insurance Savings Plan.
1©2024 Morningstar. All rights reserved. The Morningstar name is a registered trademark of Morningstar, Inc. in India, and other jurisdictions. The information contained here: (1) includes the proprietary information of Morningstar, Inc. and its affiliates, including, without limitation, Morningstar India Private Limited (“Morningstar”); (2) may not be copied, redistributed or used, by any means, in whole or in part, without the prior, written consent of Morningstar; (3) is not warranted to be complete, accurate or timely; and (4) may be drawn from data published on various dates and procured from various sources and (5) shall not be construed as an offer to buy or sell any security or other investment vehicle. Neither Morningstar, Inc. nor any of its affiliates (including, without limitation, Morningstar) nor any of their officers, directors, employees, associates, or agents shall be responsible or liable for any trading decisions, damages or other losses resulting directly or indirectly from the information.
2Applicable to only non-early claims with more than 3 years of policy duration, non-investigation cases, up to Sum Assured of ₹50 Lakh. Applicable for branch walk in. Time limit to submit claim to Tata AIA Life Insurance is 2 pm on working days. Subject to submission of complete documents. Not applicable for ULIP policies and open title claims.
3Individual Death Claim Settlement Ratio is 99.41% for FY 2024-25.
4Illustrated premium of ₹501 is the monthly premium excluding taxes for a 20 yr. old female, Standard Life, Non-Smoker for ₹1 Cr. Sum Assured with Policy Term of 20 yrs. (Regular Pay) under Life Promise Option with first year premium discount of 10% for digital purchase and 8.5% for salaried person. Please refer Benefit Illustration for more details. Premium is subject to applicable taxes, cesses & levies which will be entirely borne/paid by the Policyholder, in addition to the payment of such Premium. Tata AIA Life shall have the right to claim, deduct, adjust, recover the amount of any applicable tax or imposition, levied by any statutory or administrative body, from the benefits payable under the Policy. Kindly refer the sales illustration for the exact premium.
5As per the duly approved product design and terms & conditions of the product. This includes first year digital discount of 10% for Limited Pay/Regular Pay and 8.5% salaried discount. For Single Pay, 1% discount will be available for online purchase and salaried discount each.
6Under Life Promise Plus Option, an amount equal to the 100% of the Total Premiums Paid (excluding loading for modal premiums) shall be payable at the end of the Policy Term, provided the life assured survives till maturity and the policy is not terminated earlier.
7Guaranteed Income shall be total of Guaranteed annual Income plus Income Booster payable in a year. Guaranteed Income as per the chosen Income Frequency shall commence after maturity till the end of the Income Period, irrespective of survival of the life insured(s) during the Income Period.
8Income Tax benefits would be available as per the prevailing income tax laws, subject to fulfillment of conditions stipulated therein. For ULIP policies, maturity income will be taxable if annual aggregate premium exceeds ₹2.5 Lakh in a financial year. For non ULIP insurance policies, maturity income will be taxable if annual aggregate premium exceeds ₹5 Lakh in a financial year. Tax laws are subject to change from time to time. Tata AIA Life Insurance Company Ltd. does not assume responsibility on tax implications mentioned anywhere on this site. Please consult your own tax consultant to know the tax benefits available to you.
9Available under Regular Income with an Inbuilt Critical Illness Benefit option
105-year computed NAV for Multi Cap Fund as of March 2025. Other funds are also available. Benchmark of this fund is S&P BSE 200.
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