10 things you must know about insurance

Insurance related complaints are one of the most commonly reported complaints at Akosha and it was imperative for us to highlight salient points that are often a source of trouble for those who buy insurance. While any average individual cannot be expected to fully comprehend the complexities of insurance products and regulations, here are a couple of points that you must keep in mind when dealing with various insurance products.

1. You can return a life insurance policy within 15 days of receiving the policy documents if you disagree with the terms & conditions and get your premium refunded.

This period is called the free-look period, during which the policy holder is at liberty of returning the policy on any ground and the concerned company shall be liable to refund the amount paid.

2. Beware of the agents who deliberately delay sending crucial documents just to get past the free-look period. Insist on documents immediately and if despite insistence, your agent refuses to send you the documents within this period, seek immediate cancellation before the expiry of the free-look period.

Courtesy: 

3. The claim should be processed without delay. In case of a life insurance claim, any additional documents or information should be asked for by the insured within 15 days of the receipt of the claim and not in a piecemeal manner.

4. A claim of settlement has to be offered within 30 days from the receipt of the report. A delay in settlement is one of the most commonly reported complaints and there is often confusion with respect to the time frame within which the claims must be settled by the insurer.

According to the prevailing regulations, insurer can't delay the claim after the survey and a claim of settlement has to be offered within 30 days from the receipt of the report.

5. You will not be able to claim insurance if the driver's license is invalid or fake. If you own a vehicle and want to ensure a smooth settlement of insurance claims related to the vehicle, make sure the driver you have hired has a genuine and valid license.

6. No insurance agency can reject your mediclaim on the grounds of pre-existing ailment if the ailment was not known to you. Pre-existing ailment is one of the most common grounds for rejection of mediclaims.

Be aware that no insurance agency can reject your mediclaim on the grounds of pre-existing ailment if the ailment was not known to you.

For instance, complications triggered by hitherto unknown kidney stones during the treatment of another ailment will not impact your mediclaim settlement.

7. The insurance ombudsman can be approached if the insurer rejects the complaint or does not respond to within a month. However, the insurance ombudsman should be approached within one year of the insurance company rejecting or not responding to the complaint.

Furthermore, the award passed by the ombudsman is binding on insurance companies but not on the consumer.

8. In case of vehicle theft, you must register an FIR within 24 hours in order to validly claim insurance. Furthermore, in case of vehicle theft, you must inform the insurance company within a maximum of two days in order to claim insurance.

9. In case of an accident, you can claim money from either your insurance company or the other party's insurance company but in the latter case, you will have to prove that the other party was at fault.

If you have not registered your vehicle for commercial use but are still using it for commercial purposes, you cannot claim insurance.

10. A third party is entitled to claim insurance from the insurance company even if the insured is in violation of the insurance policy. In such a case, the insurance company can recover the amount from the insured.