Accidental Dismemberment Claim

Employer– Employee
Credit Policies
Micro Insurance (Social Sector)*

Documents to be Submitted* Employer– Employee Credit Policies Micro Insurance (Social Sector)*
Mandatory Documents
Duly-filled, stamped and signed Rider Claim Intimation Form
Certificate of Insurances
Life insured’s photo ID proof
Supporting documents
Life Insured’s bank account details along with copy of bank passbook / statement
Medical records (consultation notes, treatment records, admission notes, hospital indoor case papers, discharge/ death summary, investigation reports, etc)
Medical questionnaire/ physician statement to be completed by the doctor/ hospital treating the life insured
Copy of certified first information report/ inquest/ Panchnama (translation mandatory in the case of vernacular language)
Copy of driving license if the life insured was driving the vehicle at the time of accident
Disability certificate from the relevant government authority

Note

• The life insured is required to undergo the relevant medical tests conducted by medical physicians specified by Kotak Life Insurance.
  
• Kotak Life Insurance must be provided with the relevant details within 30 days of the accident.
  
• The Accidental Dismemberment Rider is terminated automatically when the total payments of 100% of the benefit sum assured are admitted.
  
• The Accidental Dismemberment Rider is subject to the conditions and the exclusions as laid down in the “Annexure Accidental Dismemberment” 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

Disclaimers

These are basic guidelines to expedite 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.