1. Has your insurance claims been rejected? Here is what you need to do

Has your insurance claims been rejected? Here is what you need to do

You are the nominee in a life insurance policy whose policyholder has died. You lodge your claims with the insurance company only to be notified that your claims has been rejected.

By: | New Delhi | Updated: October 13, 2016 2:07 PM
There are various forums which can be approached by you in such a situation to try and get your claims honoured. (Source: Reuters)

There are various forums which can be approached by you in such a situation to try and get your claims honoured. (Source: Reuters)

You are the nominee in a life insurance policy whose policyholder has died. You lodge your claims with the insurance company only to be notified that your claims has been rejected. You had banked on the claim money to meet your financial needs and now you do not know what to do.

Last week we told you about the major reasons for which insurance claims are rejected and the steps to take to ensure that the insurance company does not have any ground for denying your nominee of the claims money in your absence. Here we tell you the steps that you need to take in case you still end up in a situation where the claim is rejected.

There are various forums which can be approached by you in such a situation to try and get your claims honoured. This includes the company’s grievance redressal unit, the insurance ombudsman or the insurance regulator, the Insurance Regulatory and Development Authority of India (IRDAI), itself.

However, the first step to take is to arm yourself with the ground on which the insurer has rejected the claims. “You must approach the insurer to find out the reasons for which your claim was rejected,” Tarun Mathur, Head of Life Insurance, Policybazaar.com, told FeMoney.

Mathur says this should be followed by a lodging a complaint with the insurance company and if that does not yeild results you can approach the Ombudsman. “You may choose to raise a complaint with the insurer along with adequate documentation in case you are not satisfied with the reason. You may consider approaching the insurance ombudsman for addressing your grievance if you do not receive a response from the insurer or your nominee is unhappy with the response,” Mathur said.

Mahavir Chopra, Director – Health, Life and Strategic Initiatives, Coverfox.com, suggests lodging a written complains and insisting on an acknowledgement at every step. “The nominee can approach the grievance cell of the insurance company and make a complaint in writing with copies of relevant documents. Ensure you have an acknowledgement of the lodged complaint. In the case of unsatisfactory response, or no response within 15 days, you can approach the grievance cell at IRDAI,” Chopra said.

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