How to File a Claim

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When you experience a loss, illness, injury, or other covered event, NICE Insurance is here to help. Filing a claim is the process of requesting payment of benefits under your insurance policy. This article explains when to file a claim, what information you will need, how to submit your claim, and what to expect during the claims process. Understanding these steps in advance helps ensure your claim is processed smoothly and quickly when you need it most.

When to File a Claim

You should file a claim with NICE Insurance whenever you experience an event that may be covered under your policy. Different policy types cover different events:

Policy Type	Events That May Trigger a Claim
NICE Lifetime Protect / NICE Term Shield / NICE Future Savings	Death of insured person, diagnosis of terminal illness, critical illness (if rider included)
NICE Medical Guard	Hospitalisation, surgery, outpatient procedures, advanced medical treatment
NICE Cancer Care	Cancer diagnosis, cancer treatment, cancer-related hospitalisation
NICE Hospital Plus	Hospital admission for any covered cause
NICE Auto Protect	Vehicle accident, theft, vandalism, weather damage, injury from accident
NICE Home Guard	Fire, storm damage, water damage, theft, vandalism
NICE Contents Cover	Damage to or loss of personal belongings from covered perils
NICE Earthquake Protection	Earthquake damage, volcanic eruption damage, tsunami damage

If you are unsure whether an event is covered, file a claim anyway. It is better to submit a claim and have NICE Insurance assess it than to assume something is not covered and miss out on benefits you are entitled to receive.

Claim Filing Deadlines

NICE Insurance policies require claims to be filed within specified time periods. Filing promptly helps ensure evidence is preserved, details are accurately remembered, and your claim can be processed without delay.

Claim Type	Recommended Filing Time	Maximum Filing Period
Life insurance death claim	As soon as possible after death	Within 3 years of death
Health insurance claim	Within 30 days of treatment	Within 3 years of treatment
Auto insurance claim	Within 60 days of incident	Within 3 years of incident
Property insurance claim	Immediately after discovering loss	Within 3 years of incident

While the maximum filing periods allow considerable time, filing earlier is always better. Delayed claims may be more difficult to verify and process. For property and auto claims in particular, early filing allows NICE Insurance to inspect damage before repairs are made or evidence is lost.

Information You Will Need

Before filing your claim, gather the following information and documents. Having everything ready helps you complete the claim submission smoothly and reduces back-and-forth requests for additional information.

For All Claims

Your NICE Insurance policy number
Your personal identification
Your contact information including phone number and email
Bank account details for benefit payment

For Life Insurance Claims

Death certificate (戸籍謄本 showing death or 死亡届)
Doctor's statement regarding cause of death if applicable
Original policy certificate if available
Claimant's identification and proof of relationship to deceased
Claimant's registered seal

For Health Insurance Claims

Medical certificate or diagnosis report from treating physician
Hospital admission and discharge records
Itemised medical bills and receipts
Surgery report if applicable
Proof of treatment dates and procedures

For Cancer Claims (NICE Cancer Care)

Pathology report confirming cancer diagnosis
Oncologist's statement including cancer type, stage, and treatment plan
Treatment records for surgery, radiation, or chemotherapy
Hospital records for cancer-related admissions

For Auto Insurance Claims

Police report (事故証明書) for accidents involving other parties or injuries
Photos of vehicle damage from multiple angles
Photos of accident scene if possible
Other driver's information and insurance details
Repair estimates from authorised repair shops
Medical records if injuries occurred

For Property Insurance Claims

Photos of damage before any repairs or cleanup
List of damaged or lost items with estimated values
Police report for theft or vandalism
Fire department report for fire damage
Receipts or proof of purchase for valuable items
Repair estimates from contractors

How to Submit Your Claim

NICE Insurance offers multiple ways to file your claim, depending on the claim type and your preferences.

Online Claim Submission

For many claim types, you can start the process through your NICE Insurance online account:

Log in to your NICE Insurance online account.
Navigate to the Claims section from your dashboard.
Select the policy you are claiming under.
Choose the type of claim you are filing.
Complete the online claim form with details of the incident or event.
Upload supporting documents and photos as requested.
Review your submission and confirm.
Note your claim reference number for future correspondence.

Online submission is available for most health insurance claims, auto insurance claims, and property insurance claims. Life insurance claims and complex cases may require additional documentation submitted by mail or in person.

Branch Claim Submission

You can file claims in person at any NICE Insurance branch:

Gather your documents and visit your nearest NICE Insurance branch.
Inform the staff that you wish to file a claim.
A claims representative will guide you through the required forms.
Submit your supporting documents for copying or verification.
Receive confirmation of your claim submission and reference number.
The representative will explain next steps and expected timeline.

Branch submission is recommended for complex claims, when you have questions about the process, or when original documents must be submitted.

Phone Claim Notification

For urgent situations, you can notify NICE Insurance of your claim by contacting customer service:

Contact NICE Insurance customer service.
Inform the representative that you need to file a claim.
Provide your policy number and describe the incident.
The representative will create an initial claim record and explain what documents you will need to submit.
Follow up with document submission within the timeframe provided.

Phone notification is useful for immediate reporting of auto accidents or property damage, but you will still need to submit documentation to complete your claim.

The Claims Process

After you submit your claim, NICE Insurance follows a structured process to evaluate and pay valid claims.

Step 1: Claim Acknowledgment

Within 1 to 3 business days of receiving your claim, NICE Insurance will send acknowledgment confirming receipt. This confirmation includes your claim reference number, the name of your assigned claims handler, and contact information for questions.

Step 2: Documentation Review

Your claims handler reviews all submitted documentation to ensure everything needed is present. If additional information or documents are required, you will be contacted with a specific list of what is needed. Responding promptly to these requests helps avoid delays.

Step 3: Investigation and Assessment

Depending on the claim type and complexity, NICE Insurance may conduct additional investigation:

Medical claims — Review by medical professionals to verify diagnosis and treatment appropriateness
Auto claims — Vehicle inspection, accident reconstruction if needed, liability assessment
Property claims — On-site inspection by adjuster, assessment of damage extent and repair costs
Life claims — Verification of policy status, cause of death review, beneficiary confirmation

Step 4: Decision and Communication

Once assessment is complete, NICE Insurance makes a decision on your claim and communicates the outcome:

Approved claims — You receive notification of the approved amount and payment timeline.
Partially approved claims — Some elements are approved while others may be excluded, with explanation provided.
Denied claims — The reason for denial is explained, and you are informed of your options to appeal or provide additional information.

Step 5: Payment

For approved claims, NICE Insurance processes payment according to the method specified for your policy type:

Claim Type	Typical Payment Timeline	Payment Method
Health insurance	5 to 14 business days after approval	Bank transfer to your account
Life insurance	14 to 30 business days after approval	Bank transfer to beneficiary's account
Auto insurance (repairs)	Direct payment to repair shop or reimbursement	Direct payment or bank transfer
Property insurance	14 to 30 business days after approval	Bank transfer to your account

Tracking Your Claim

You can monitor the status of your claim at any time:

Online account — Log in and navigate to the Claims section to see current status and any pending requirements.
Contact claims handler — Reach out to your assigned claims handler directly using the contact information provided in your acknowledgment letter.
Customer service — Contact NICE Insurance customer service with your claim reference number for status updates.

If Your Claim Is Denied

If NICE Insurance denies your claim, you have options:

Understand the reason — Review the denial explanation carefully. Common reasons include policy exclusions, lapsed coverage, insufficient documentation, or incidents occurring outside the coverage period.
Provide additional information — If the denial was due to insufficient documentation, you may be able to submit additional evidence for reconsideration.
Request formal review — You can request a formal review of the decision by a senior claims officer.
External dispute resolution — If you remain unsatisfied after internal review, external dispute resolution options may be available depending on your policy type.

Tips for Smooth Claims Processing

Following these practices helps ensure your claim is processed efficiently:

File promptly — The sooner you file, the easier it is to gather evidence and remember details.
Document thoroughly — Take photos, keep receipts, and maintain records from the moment an incident occurs.
Be accurate — Provide truthful, complete information. Inaccuracies can delay processing or result in denial.
Respond quickly — When NICE Insurance requests additional information, respond as soon as possible to avoid delays.
Keep copies — Retain copies of everything you submit and all correspondence about your claim.
Ask questions — If anything is unclear, contact your claims handler for clarification rather than guessing.

Next Steps

If you need to file a claim, gather your documentation and submit through your NICE Insurance online account for the fastest processing, or visit your nearest branch if you prefer in-person assistance. If you have questions about whether an event is covered or what documentation you need, please contact customer service before submitting. We are here to help you through the claims process and get you the benefits you are entitled to receive.