Navigating Insurance Claims After My Husband's Passing: Can I Request a Written Denial Reason?

Hi, my husband died on 23 Mar. I was told by his company that I am the nominee in the insurance. Do I have the right to claim it? Apart from this, they said that I will get the employee welfare trust amount. However, now, after the final report, they say it was denied. Can I ask for a written reason for the denial? Please help as I have a 2-year-old daughter.

You can get the insurance amount from his EPS if your husband was a member of the PF. You will surely receive a pension and a lump-sum amount from the PF. If he had ESIC or any other death insurance, you can also claim the amount. I'm sure the employer will help you with this.

Regards,

First, you should check with the employer whether your husband has incorporated your name as a nominee in Form-2. If yes, then you will definitely receive the PF lump sum amount as well as the pension amount. Please remember, at that time when you approach the employer for the PF amount and pension, take the following documents: legal heir certificate (original), death certificate (original), age proof, address proof, and photographs.

Regards,
Balaji

For hi, my husband died on 23 Mar. I was told by his company that I'm the nominee in the insurance. Do I have the right to claim it? Apart from this, they said that I will get the employee welfare trust amount. However, now after the final report, they say it got denied. Can I ask for the written reason for denial? Please help as I have a 2-year-old daughter.

Further Benefits and Inquiries

Further to the benefit from PF, i.e., EDLI and Pension to you and your children, the employer will pay Gratuity also. Please inquire about this. Whatever the length of service, in case of the death of an employee, the amount will be paid to his nominee.

Regards, NVS Rao

Mr. Subba Rao's solution is correct. Ask your brother or parents to go in person to your husband's employer. In case the employer is not helpful, please approach the local PF authority directly. Express your grievances to them; they will definitely guide you on how to obtain the amount. Before going to the PF authority, ensure you know your husband's PF account number and have a record of all the documents you have submitted to the employer.

Regards,
Balaji

I am sorry to hear about the sad demise of your husband. You are entitled to the following from EPF:

1. EPF accumulation.
2. Pension for you & your child.
3. EDLI: Employee Deposit Linked Insurance.

There are prescribed forms for this. A search on this site will provide you with details of these and the documents required to be submitted along with the forms. You can obtain these forms from any EPF office along with an instruction sheet for filling them out. However, after filling out the forms, they must be routed through your employer. Your employer should definitely assist you in this process.

You will also receive gratuity from the employer.

Dear viewers and respected Ms. Avantika,

It's shocking that the HR department of the company has not been fulfilling its duties, especially in the 21st century, in this modern era.

Information Required for Case Understanding

Please provide the following required information for a full understanding of the case:

- What is the final report you mentioned in your post? Please explain.
- What was the reason for his death?
- What is the name and address of the company?

Legal Claims and Entitlements

You have lost your husband, but you have legal claims over dues and entitlements as listed below:

1. Unpaid salary, leave encashment, gratuity amount, death benevolent fund (only if the company has a scheme).
2. PF accumulation and interest thereon.
3. Pension for you for your lifetime and for your daughter until her marriage.
4. Approximately Rs. 75,000 as a one-time payment from EDLI/Group Term Insurance Scheme.

Benefits under clauses 2 and 3 above are fully admissible, and the PF authorities have to settle within a month's time legally.

For more details on obtaining other requested information, please provide further guidance.

Best wishes,

RDS Yadav

As the final report states, the cause of death was accidental due to a fall from height. However, in the forensic report, it mentions a head injury associated with ethyl intoxication.

I have submitted the postmortem report, FIR copy, medical report, and final FIR. Now, they say it's because of alcohol, so I will not receive the benefit amount. Regarding PF, I am entitled to receive only the pension, not the EDLI amount. Please explain.

Please correct me if I have any doubts:

1. If the final report is a police report, it should be signed by the Superintendent of Police under whose jurisdiction the death occurred.

2. Was your husband on duty when he died, or what was he doing at that time? His duty hours were from ---- to ---- on what date?

3. Please provide the company's name and address. Also, if possible, share the HR manager's name and contact details.

4. Please ask your brother to obtain the accident report filed by the company with the Factory Inspector. If the accident occurred at the factory site, the company should have submitted written information to the Collector, SP, and the Police station. Copies of the letter and accident report can also be located.

Regards,
RDS Yadav