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Do you have online insurance fraud queries?

September 13, 2022 09:39 IST
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Illustration: Uttam

Ever been duped online or offline by people claiming to be insurance agents?

Have you ever received fake insurance policy when you bought it online and didn't know what to do about it?

What precautions must you take to prevent online insurance frauds?

If you questions related to online insurance frauds, then Piyush Ranjan, chief technology officer, Coverfox Insurance Broking (external link) will answer your queries.

Please mail your queries at with the subject line 'Insurance Fraud' and Piyush Tanna will answer all your queries.

The pandemic has accelerated digitisation which has changed the way things operate in the insurance industry.

The concept of purchasing insurance online is the new trend as more and more people are getting accustomed to the digital world. However, there is still this constant fear of getting scammed online especially when every now and then we keep hearing about cybercrimes.

It is imperative for an insurer to ensure their technology, services and data collection is conducted transparently to build trust among the policyholders.

The processes are designed in a manner to avoid fraudulent activities, however, as a consumer there are few questions usually asked and keeping their answers in mind can help you protect yourself and stay informed about online insurance frauds.

How to know if the insurance/broking company is genuine?

The insurance sector is regulated by the Insurance Regulatory Authority of India (IRDAI) to ensure proper functioning of all insurance channels. To check the genuineness of an insurance company or its Web site, you can check if the company is registered with IRDAI.

Licensed brokers also have to list their license number on their Web site and you can view their IRDAI certificate by clicking on the IRDAI license number.

You can validate this license number on the IRDAI Web site as well.

How can I be sure if the claim will be honoured, if I buy the policy online?

IRDAI has set fairly stringent restrictions on who can set up an insurance company, thus ensuring that the insurance company has the capacity to settle their claims, be it general insurance or life insurance.

Whether a policy is sold offline or online, the insurance company has to provide the claim settlement amount given the policyholder is eligible for the claim, after investigation of the case.

Ensure that you also thoroughly read your policy terms before you purchase.

In case you are facing further issues, every insurer is required by IRDAI to establish a grievance redressal mechanism, and the procedure is governed by the Protection of Policyholders' Interests (PPHI) laws, which include specific guidelines and turnaround periods.

If aggrieved claimants are not satisfied with the insurer's resolution of their complaint, they do have the option of contacting the Insurance Ombudsman.

However, it is good to consider the claim settlement ratio of an insurance company when deciding your insurer. Higher claim settlement ratios show credibility and trustworthiness of the insurer.

What to do when you receive a fake policy from someone who claimed to be an insurance agent?

There can be cases where someone calls you and coaxes you to make payments digitally and then sends you a copy of the policy that is not authentic.

In order to avoid such fraud, it is best to make the payment directly from the company's Web site and not through any links or QR codes shared through a personal account. This will help you authenticate your payment through proper channels.

In case an unfortunate incident happens, it is important that you lodge a complaint at your nearest police station explaining the complete incident along with required documents.

What if even after payment is done through cash/online transfer, the policy document is not received?

Digital insurance platforms only accept payment online as it is their business model. Post the payment, the policy document will either be e-mailed to you or will be shared through a preferred mode as decided by you.

However, there are situations when the policy document is not generated instantly and may take up to 72 hours after all due process is complete from your end.

In such cases, an application number, or a payment receipt/cover note is provided instantly.

In case, your policy document does not get delivered even after 72 hours, you can connect with the company and ask for the policy document.

There are cases when payment has not gone through properly, it can be an issue at your bank or payment channel's side. You can resolve it by talking to your bank or raising an issue with the payment partners. Also keeping your insurer or broker informed will help rectify the issue.

If you suspect any fraudulent activity, and that the payment link given to you was fraudulent, immediately report the same to your bank to stop the transaction.

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