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  There can be various reasons why an insurance policy holder may want to file a complaint against an insurance company. Insureds may wish to file a claim related to the purchase process, the claims process or generic service requests such as change of address, contact details, appointment, certified tax savings offer, change of mode payment, etc.

The insured must first contact the insurance company itself to have their claim settled. You can contact the complaints officer (GRO) of your insurance company. You can visit the nearest branch or email the GRO. You can find the GRO email id of all insurance companies

Make sure you submit your complaint in writing with the necessary supporting documents. Remember to bring a written confirmation (acknowledgement ) of your complaint with the date.

As per IRDAI set of rules the Insurance companies will reply with 15 days from the date of submission of complaint.

Given below is the grievance redressal officer email addresses of all Life and Non Life Insurance companies in India.

        Resolving a grievance - 15 days

Acknowledging a grievance - 3 days


   
The Complaints Compensation Unit within the Consumer Affairs Department of the Insurance Regulatory and Development Authority of India handles court cases / claims by policyholders.

भारतीय बीमा नियामक और विकास प्राधिकरण के उपभोक्ता मामलों के विभाग के अंतर्गत शिकायत मुआवजा इकाई पॉलिसीधारकों द्वारा अदालती मामलों/दावों को संभालती है। यह प्रकोष्ठ निवारण के लिए संबंधित बीमा कंपनियों के साथ शिकायतों को उठाता है। पॉलिसीधारक जिनके पास बीमाकर्ताओं के प्रति अदालती मामले हैं, उन्हें पहले संबंधित बीमाकर्ता के शिकायत/शिकायत निवारण कक्ष में जाना होगा। बीमाकर्ताओं के शिकायत निवारण अधिकारियों की मेल आईडी के लिए यहां क्लिक करें। यदि वे अब एक सस्ती समय सीमा के भीतर बीमाकर्ता से प्रतिक्रिया प्राप्त नहीं करते हैं या कंपनी की प्रतिक्रिया से निराश हैं, तो वे आईआरडीएआई के उपभोक्ता मामलों के विभाग के भीतर शिकायत निवारण प्रकोष्ठ से संपर्क करेंगे।

Registration of Complaints with the IRDAI by Policyholders: 1. Can make use of the Integrated Grievance Management System(IGMS) - IRDAI Portal at https://igms.irda.gov.in for registering the complaints themselves and to monitor the status of the complaints. 2. Can send the complaint through Email to complaints@irdai.gov.in. 3. Can call Toll Free No. 155255 or 1800 4254 732. 4. Apart from the above options, if it is felt necessary by the complainant to send the communication in physical form, the same may be sent to IRDAI addressed to: General Manager Insurance Regulatory and Development Authority of India(IRDAI) Consumer Affairs Department – Grievance Redressal Cell. Sy.No.115/1, Financial District, Nanakramguda, Gachibowli, Hyderabad – 500 032.

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Motor Insurance Claim Rejected ? 

Source Giphy.com

 Just few days back in motor accident the bike owner lost his life. He was driving Royal Enfield Bullet 350 CC. The Insurance company rejected his claim. The reason that under the insurance policy the vehicle enging cubic capicity was 150 cc. hence the insurance company is not liable to pay the claim as the said vehicle was 350 cc. This agent was forced to reduce the premium as the owner demanded discount in policy and wanted to pay low premium.

Anyhow with intention towards lowering the premium the agent was forced to find a way to reduce the CC of the proposed vehicle where the premium would be low.

After few months of the Insurance policy period the Policyholder met with an accident, where he died on the spot. The insurance claim was rejected as the vehicle was 350 CC and not 150. This maybe the case of Misselling by Agent. 

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Reasons for rejections:

Grounds for refusal Insurance claims for vehicles, whether cars or two-wheelers, are only accepted if the damage is accidental, due to natural disasters, theft or accidental fire.

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Other common reason for claim rejection

Ignorance of Policy and Additional Coverage: A common reason for claim denial and grouse is that certain specific damages are not covered by the policy and for these, separate additional coverage must be purchased. “For eg, engine damage or loss of depreciation is not covered in the base policy and separate engine protections and additional coverage without depreciation are required.

Car or Bike sent for repairs. immediately after accident.

Most common mistake that immediately after accident the vehicle is repaired on your own. Actually one should inform the Insurance company immediately. As it makes difficult for an insurance company to access the loss/damage.

Disclosures.

At the time of buying vehicle insurance or renewing the policy all the material facts to be disclosed such as pre-existing damages or claims in previous year. So if one forgets or misrepresents the previous claim notification for current insurance policy, then also at the time of claim it gets regected due to misrepresentation clause under the policy.

Insurable Interest.

Driving without valid driving licence.

Drink and drive.

Delayed claim intimation.

If you refer to informing the insurer of the accident, it is possible that your request will be refused. The deadline is short, usually 24-48 hours, and you must make sure to notify the insurer within this period.

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चार महीनों में 1,16,00,000 कमाकर अपने सपनों की कार खरीदी- निवेश केवल 5000 रुपये 

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You must know the exclusions.

A basic insurance policy covers only the accidental damage of the body and the engine.

In addition, damage due to the insured or third parties and not due to an uncertain event is not covered. “For example, engine damage from hydrostatic loss during monsoons is common. Here, the damage does not occur due to flooding or rain, but because someone turned on the car in a flooded area. This is not covered by som insurance co's.

Things like engine oil or lubricants are not covered by the base policy, nor are plastic parts or tires. Any damage caused to the vehicle during normal use, such as worn tires or tubes and mechinical, electrical breakdown is not covered.

Important:

If the loss or damage is too small for example in car insurance if you have loss of Rs.2000 due to accidental damage, then first confirm the excess under the policy then only proceed for the claim procedure. As the excess coud be from anywhere from Rs.1500 and upwards. And if you claim then you will receive only Rs.500 further in the next due renewal you will lose the No Claim bonus, in turn will have to pay higher premium.

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