Insurance claim processes often leave many policyholders disappointed. However, the process can be smooth if the policyholder puts effort to completely understand the details and remove all doubts before purchasing a policy. In an email interaction with FE Online, Deepak Bhuvneshwari Uniyal, co-founder and CEO, Insurance Samadhan, explains everything policyholders should know and how his organisation helps them. Excerpts:
What are the most common reasons for which insurance companies deny claim to policyholders?
In Life Insurance-Non-disclosure of any pre-existing health issues, non-disclosure of the existing policies, non-disclosure of lifestyle habits like consuming alcohol/ smoking, Incorrect declaration of occupation
In General Insurance- Non-disclosure of pre-existing health issues, no active line of treatment, Hospital not Required
What to do immediately if an insurance company denies a claim?
You can write to the company’s grievance cell stating the reasons why the claim should be paid. The same can be escalated to IRDAI portal and Ombudsman
What are the key points to keep in mind while buying an insurance plan?
Product should be bought based on the need
Brochure should be studied
Fill the proposal form and answer all questions correctly
Why insurance misselling is so rampant?
It’s a very complex product so people normally don’t get into details of the policy terms and conditions. Most of the sellers too do not have the compete understanding of the product. Most of the insurance is bought purely on mutual trust
What should insurance buyers do to keep themselves away from falling prey to misselling?
Don’t get lured by offers which are unbelievable like high returns, bonus, Loan, Gold coin, Tower Installation etc. If in doubt call the customer service of the insurance company and check.
Buy Insurance policy preferably through a known source or online after studying the brochure
Fill the proposal form a declare all information
Listen to the verification call by the insurer and answer all questions correctly.
How Insurance Samadhan helps policyholders?
Insurance Samadhan will guide you through the resolution Journey. We filter the genuine complaints and then bucket them in subtype. Our system then picks the points and regulations which shall help represent the case in the best possible way to the company.
We help customer represent the case at the company level, IRDAI, Ombudsman in the correct way. Our system helps generate prefilled forms and documentation required to represent the complaint at all level.
Our experts are available to help you understand the points and answer all your questions with respect to your complaints