Who can claim insurance? – cruxofinsurance.com

Who Can Claim Insurance? A Simple Guide for Everyone

Insurance can seem like a complicated world of big words and long contracts. You pay money every month or every year, hoping you never need to use it. But when something bad happens, the big question is: who can actually ask for the money? Who can make an “insurance claim”?

In the simplest terms, an insurance claim is a formal request you make to the insurance company to pay for a loss that is covered by your policy. But the person who can make this request is not always the same. It depends on the type of insurance and the situation.

Let’s break it down into simple pieces.

The Golden Rule: You Must Have an “Insurable Interest”

This is the most important idea in insurance. It sounds fancy, but it just means that you must be in a position to suffer a financial loss if something bad happens. You cannot claim insurance for something that doesn’t hurt you financially.

Think of it this way:

You CAN claim for your own car if it gets damaged. You suffer a loss because you have to pay for repairs.
You CANNOT claim for your neighbour’s car if it gets damaged. You don’t own it, so you don’t suffer a direct financial loss.

This rule stops people from gambling on bad things happening to other people’s property or lives. So, for any insurance claim, the first thing checked is whether the person claiming has a real, financial interest in what is being insured.

Now, let’s look at the different types of insurance and see who can claim in each case.

1. Motor Insurance (Car, Bike, Truck)

This is one of the most common types of insurance.

The Policyholder: This is the main person who can claim. If you own the car and the insurance policy is in your name, you are the one who will file the claim if your car is in an accident, stolen, or damaged by fire or flood.
Any Authorised Driver: What if someone else were driving your car with your permission? In most cases, the insurance will still cover the damage. The policyholder usually makes the claim, but the event is covered even if they weren’t driving at the time.
Third-Party Victims: This is a special case. Let’s say you are driving and you accidentally hit another car or a person. The owner of that other car or the injured person is the “third party.” They have the right to claim money from your insurance company for their losses or injuries. They are claiming against the policy you hold.

2. Health Insurance

This insurance pays for your medical bills when you are sick or injured.

The Policyholder: If you have a health insurance policy for yourself, you can make a claim for your own hospital bills.
Dependents (Family Members): Most health policies are family plans. This means you can also include your spouse (husband or wife), your children, and sometimes your parents. If your child gets sick and is hospitalised, you, as the policyholder, can make a claim for their medical expenses. They are covered under your policy.
The Hospital: Sometimes, if you have a “cashless” facility, the hospital directly sends the bill to the insurance company. In this case, the hospital is dealing with the company, but they are doing it on your behalf because you are the insured person.

3. Life Insurance

This is different from other types. A life insurance claim is not for the person who bought the policy. It is for their family after the policyholder passes away.

The Nominee or Beneficiary: When you buy a life insurance policy, you are asked to choose a “nominee.” This is the person who will receive the money after you die. This person is usually a spouse, child, or parent—someone who depends on your income. So, if the policyholder dies, the nominee is the one who files the claim with the insurance company to receive the sum of money.

4. Home Insurance (or Property Insurance)

This covers your house and the things inside it against fire, theft, or natural disasters.

The Homeowner: If you own the house and have the insurance, you are the one who will claim if your house is damaged.
The Bank (in some cases): If you have taken a loan from a bank to buy the house, the bank has a big financial interest in your property. They want to make sure that if the house is destroyed, the loan can be repaid. So, the bank is often listed on the policy. In case of a major loss, the insurance company might pay the bank first to settle the loan, and give the remaining money to you.

5. Travel Insurance

This covers problems that can happen while you are travelling.

The Person Named on the Policy: If you bought a travel insurance policy for your trip, you can claim for lost baggage, trip cancellation, or medical emergencies during your travel.
Family Members on the Same Policy: Many travel policies cover the entire family travelling together. So, a parent can claim for a child’s medical emergency abroad under the family travel insurance plan.

What if I’m not the owner?

This is a common question. Generally, if you are not the owner of the insured item and you are not named on the policy, you cannot make a claim.

Example: You are driving your friend’s car, and you have an accident. You cannot claim on your friend’s car insurance. Your friend, as the policyholder, must be the one to file the claim. Your own personal car insurance does not cover you when you drive someone else’s car.

The Process of Claiming is Also Important

Just being the right person isn’t always enough. To successfully claim insurance, you must also:

Inform the Company Quickly: You must tell the insurance company about the loss as soon as possible. There is usually a time limit.
Fill Out Forms: You will need to fill out a claim form with all the details of what happened.
Provide Proof: This is very important. You need to show evidence of the loss. For a car accident, this could be photos and a police report. For a health claim, it’s the hospital bills and medical reports. For a life insurance claim, it’s the death certificate.
Cooperate with the Surveyor: For big claims, the insurance company will send a “surveyor” or “adjuster” to check the damage and confirm your story. You must help them with their inspection.

Conclusion

So, who can claim insurance? The answer is always tied to a financial connection.

It is the person who will suffer a money loss (the policyholder or the owner).
It is the person who is named to benefit (the nominee in life insurance).
It is the person who is legally entitled (the third-party victim in car insurance).

Understanding this simple idea helps clear up the confusion. Insurance is a promise of help during a difficult time, and knowing who can ask for that help is the first step to making it work for you and your family. Always read your policy document carefully to know exactly who is covered and what the rules are.