Traditional Insurance Process

Claimants submit policy-specific documentation such as death certificates, specialist diagnosis reports, employer statements, and bank records, depending on claim type.

• Life insurance often includes death certificate and beneficiary identity checks.
• Critical illness relies on specialist diagnosis and prognosis evidence.
• Income protection requires employment and earnings verification.

Insurers validate policy status, exclusions, prior disclosures, and whether illness or disability definitions are satisfied under policy wording.

• Medical underwriting checks for pre-existing conditions.
• Financial checks compare income claims with tax and banking records.
• Occupation checks may evaluate ability to perform alternative work.

• Policy lapse due to unpaid premiums.
• Non-disclosure or alleged misrepresentation.
• Condition severity not meeting policy criteria.
• Suicide clause exclusions in early policy periods.

After rejection, claimants typically move through internal review, ombudsman or regulator complaint channels, and litigation if needed.