“Kindly submit the following documents.”
So you do.
“Other documents are required.”
So you do again
Another request
If you are a victim of this, you might be asking,
“Why won’t my insurer accept my documents?”
It could be that they need other documents but sometimes the problem lies with missing, incomplete, contradictory, unclear, and unreadable documents, or documents that were not submitted correctly
Here are the most common issues:
1. Missing Documents
The most basic one is – incomplete claim file
Depending on the claim, the insurer could ask for the following:
- Claim form
- Policy documents
- Bills
- Medical records
- Discharge summary
- Diagnostic reports
- FIR
- Repair estimates
- Receipts
- And other documents. The requirements will vary from claim to claim.
2. Incomplete Claim Form
The claim form may also need resubmission if there are gaps in the information. Before you submit it, double-check:
- Policy number
- Claim number
- Date
- Incident details
- Contact information
- Bank details
- Signature
- Declarations
It will only take a couple of minutes to go over the entire form.
3. Different Dates in Different Documents
It is easy to make a mistake when filling out a form. If the date on your claim form does not match the date on another document, the insurer may ask you to clarify.
Before you submit your claim, compare the critical dates on all the documents. If the dates do not match, double-check everything.
4. Names or Other Information Do Not Match
Make sure the name, the date of birth, address, policy number, claim number, amount, and other information on your documents match. Again, mismatched data on any of these documents could cause you to receive a query. Take a moment to make sure everything is in order.
5. Incomplete Medical Records
If you are making a health or life insurance claim, the relevant papers might consist of:
- Consultation records
- Diagnostic reports
- Prescriptions
- Hospital records
- Discharge summary
- Treatment records
- Bills
- Payment receipts
Do not give the insurers a reason to ask for more by submitting incomplete medical records.
Click to know more about Health Claims related issues
6. Poor-Quality Scans or Photographs
A document may have been successfully uploaded but it is blurred. Avoid submitting:
Blurred photographs
Cropped pages
Missing pages
Dark images
Unreadable text
Double-check the documents to ensure that they are all there and that the text is readable.
7. No Proof That You Submitted the Documents
It is essential to keep a copy of your email, upload confirmation, acknowledgment from the portal, receipt from courier, or submission receipt. It will help you later if you need to explain what documents you submitted (and when).
8. The Same Document Is Requested Again
If you have already submitted a document, do not just send the same one again without explanation.
Instead, let the company know that you have already sent the documents. For example:
“The document you have requested was submitted on [date]. Please find the previous acknowledgment attached for reference.”
9. Documents Are Not Organised
Rather than sending a stream of documents, make it easier for the adjuster by including a quick table of contents with your submission. For example:
- Claim Form
- Policy
- Medical Records
- Bills
- Payment Receipts
- Supporting Documents
- Previous Communication
This will save time for both you and the adjuster.
10. You Don’t Know What Is Actually Pending
If your claim is being repeatedly delayed due to documentation, rather than sending more papers, you instead ask the insurer to provide the documents that are pending from your side.
You could also add:
“Please confirm whether previously submitted documents have been received and considered.”
This way, you keep a paper trail if the insurer asks you for something that you already sent.
What Should You Do If Documentation Is Causing a Claim Delay?
1. Make a document list
Start by making a list of everything you have already submitted to the insurer.
2. Check your acknowledgments
Compare it to the documents that you have received. Make sure everything has been submitted correctly.
3. Ask for the exact pending documents
Request a list of documents that are currently pending from your side. That way, you know exactly what to prepare.
4. Submit missing documents promptly
As soon as you submit anything new, save a copy of the submission as proof.
5. Follow up in writing
Always follow up in writing, so that you have a paper trail for every step of the way.
6. Escalate if the issue remains unresolved
If the above steps do not help, you might consider escalating the issue.
If your grievance is not resolved through the insurers’ process, Bima Bharosa allows policyholders to register and track their grievances.
Bima Bharosa – Check & Track Insurance Grievances
What If You Have Already Submitted Everything?
If you have proof that the documents the insurers have asked for have already been submitted, but the claim is still rejected or delayed, you should not keep sending the documents blindly.
Instead, here is what you should do:
- Policy copy
- Claim form
- Document submission proof
- Insurer’s document requests
- Emails
- Claim status
- Any rejection or delay communication
Once you have this, take some time to understand what exactly has caused the delay.
You can also consult the insurance claim assistance services from ECS if you need help with this.
Final Takeaway
Documentation does not have to be the reason why your insurance claim gets stuck. Make sure that your documents are complete, accurate, readable, and in order. Double-check everything, especially dates and personal information, for typos and inconsistencies. Save a copy of everything you submit as proof that you sent it.
If your claim is in limbo because of a documentation issue, Eternity Claim Solutions can help you to review the documents, understand the issue, and the correct grievance process.
Claim stuck because of documentation? Get help from Eternity Claim Solutions.
