Life vs General Insurance Claims
A life policy pays an agreed sum; a general policy pays the measured loss. Every other difference follows.
A life claim and a general claim look alike on paper: a form, some documents, a payment. Underneath they work on different logic. A life policy pays a fixed sum when a known event happens. A general policy pays the measured value of a loss, and no more.
Almost every difference IC-01 asks about follows from that one point, so learn the logic first and the details will hang off it.
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Life and General Claims Side by Side
What is paid
Life insurance claim
The sum assured plus any bonuses, less loans or unpaid premium
General insurance claim
The assessed loss, up to the sum insured
Basis
Life insurance claim
Benefit (a valued contract): human life has no market value
General insurance claim
Indemnity: put the insured back where they were, no better
Loss assessment
Life insurance claim
None needed for the amount; the event is proved
General insurance claim
A surveyor assesses cause and amount above IRDAI's threshold
Subrogation and contribution
Life insurance claim
Do not apply
General insurance claim
Apply, since they enforce indemnity
Who claims
Life insurance claim
Nominee, assignee or legal heirs (for death claims)
General insurance claim
The insured, or a third party under a liability cover
Current timeline
Life insurance claim
Death claim: 15 days from intimation, or 45 days if investigation is warranted
General insurance claim
Surveyor allocated in 24 hours, report in 15 days, decision within 7 days of the report
| Point | Life insurance claim | General insurance claim |
|---|---|---|
| What is paid | The sum assured plus any bonuses, less loans or unpaid premium | The assessed loss, up to the sum insured |
| Basis | Benefit (a valued contract): human life has no market value | Indemnity: put the insured back where they were, no better |
| Loss assessment | None needed for the amount; the event is proved | A surveyor assesses cause and amount above IRDAI's threshold |
| Subrogation and contribution | Do not apply | Apply, since they enforce indemnity |
| Who claims | Nominee, assignee or legal heirs (for death claims) | The insured, or a third party under a liability cover |
| Current timeline | Death claim: 15 days from intimation, or 45 days if investigation is warranted | Surveyor allocated in 24 hours, report in 15 days, decision within 7 days of the report |
The Kinds of Life Insurance Claim
- check_circleDeath claim: the life assured dies during the term. A claim arising soon after the policy starts or is revived (an early claim) is more likely to be investigated for non-disclosure.
- check_circleMaturity claim: the policy reaches the end of its term with the life assured alive. The insurer usually sends the discharge form before the due date so payment can be made on the day.
- check_circleSurvival benefit: a money-back plan pays a part of the sum assured at set intervals during the term.
- check_circleSurrender: the policyholder ends the policy early and takes the surrender value. Under current rules this is paid within 7 days of the request.
- check_circleRider claims: accidental death, critical illness or disability benefits attached to the base policy.
The Kinds of General Insurance Claim
- check_circlePartial loss: the scooter's damaged panel is repaired, less depreciation and any compulsory deductible.
- check_circleTotal loss: the stolen two-wheeler is never traced. The insurer pays the insured value and takes over rights in the vehicle.
- check_circleLiability claim: a third party sues the insured; the insurer pays what the insured is legally liable for.
- check_circleHealth claim: cashless, where the insurer or TPA settles with a network hospital, or reimbursement, where the insured pays and claims back. IRDAI now requires a cashless decision within one hour and discharge authorisation within three hours.
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Two Rules That Settle Disputes
Section 45 of the Insurance Act, which applies to life policies only: after three years from the date of the policy, commencement of risk, revival or rider (whichever is later), a life policy cannot be called in question on any ground. Section 47: where there are conflicting claims or insufficient proof of who is entitled, the insurer may pay the money into court, and the court's receipt discharges the insurer. Your courseware may describe section 47 as a life insurance rule; since February 2026 the amended Act applies it to any policy of insurance due for payment.
How IC-01 Tests This
Questions give you a short claim and ask which principle or document applies. The commonest trap is applying indemnity thinking to life cover: a candidate reasons that a nominee should get only the family's "actual loss". Life cover pays the agreed sum; there is nothing to measure.
The second trap is timelines. The study course may quote older regulations (for example, a death claim paid within 30 days of the last document, investigations completed within 90 days). The current master circular counts from intimation and is shorter. Know both, and read what the question asks.
FAQs
What is the difference between a life insurance claim and a general insurance claim?expand_more
A life claim pays a fixed sum assured when the insured event is proved. A general claim pays the measured loss, up to the sum insured, after assessment, because general insurance is a contract of indemnity.
How long does a life insurer have to settle a death claim?expand_more
Under IRDAI's 2024 master circular, 15 days from intimation where no investigation is needed, and 45 days where the claim warrants investigation. Late payment carries interest at bank rate plus 2%.
Does subrogation apply to life insurance?expand_more
No. Subrogation and contribution exist to stop the insured profiting from a loss, which only makes sense in contracts of indemnity. A life policy pays its agreed sum regardless of other policies or who caused the death.
What is an early death claim?expand_more
A death claim that arises within a short time of the policy starting or being revived. Insurers look closely at these for undisclosed material facts, within the three-year window that section 45 allows.
Next steps
- Claims processarrow_forward
- Indemnityarrow_forward
- Material Factsarrow_forward
- Sum Assured vs Insuredarrow_forward
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