‘Insurance should be bought based on need’
Hyderabad: Some insurance claims get rejected on technical grounds. There could also be cases of wrong products sold or other service-related issues. However, some consumers may find it difficult to get their grievances resolved. Technology platform Insurance Samadhan guides customers to deal with misselling, claim rejection, delay in claim processing, lapsed policies, policy rejection, and service issues. Shilpa Arora, co-founder and chief operating officer of Insurance Samadhan tells Telangana Today about the resolution assistance available
Common problems
Some customers are stuck with wrong insurance. They are sold in the name of loan, bonus on old policies, fixed deposits with higher returns, offer of free health insurance and other allurements. A few health claims get rejected on technical grounds. Some claims relating to fire, property and vehicle insurance are also dealt the same way.
Best practices to be followed
Customers should not get lured by offers. Insurance should be bought based on needs to cover risks pertaining to life, health and general. They should ask for product brochures and read the terms and conditions. They should always fill the proposal form, provide the information correctly and attend the pre-issuance call from the insurer.
Channels available
An insurance product is governed by terms and conditions laid down by the insurance regulatory authority. We help policyholders represent their case at the company level, IRDAI, ombudsman and other forums in a correct way. Customers need to share their policy details and upload the required documents for assessment. Login is provided at the time of registration. The complaints are filtered and our system generates pre-filled forms and documentation required to take up the grievances at various levels. So far, it has helped to get more than 14,500 cases to be solved and the value of these is about Rs 40 crore.
Timeframe
It takes 15-30 days for resolution. If the case is moved to an ombudsman or a consumer court, the resolution may take up to six months or more depending on the availability of dates for hearing the case. One time registration charge is Rs 500. It charges 12 per cent fee from cases successfully resolved due to its intervention.
Trends in Telangana
There are complaints of mispelling with a promise of a loan or a bonus on lapsed policies. We have seen some Covid claims getting rejected or offering partial settlements. Some health claims are also rejected. We are shortly coming up with a multilingual app Polyfix including in Telugu. The app would help them check the quality of their insurance policies, find errors if any and fix them so that they do not face any problems at the time of claims.
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