Insurance Policies - Discharge your Responsibilities and Assert your Rights
When you buy a policy
Fill the proposal form yourself correctly and truthfully, it is the basis of the insurance contract
Do not leave any column blank, do not sign a blank proposal form
You will be responsible for any information in this document as it bears your signature. Disclose “all material information” about the risk you want to cover
Select the term of the policy as per your needs
Select the amount of premium you can afford to pay
Choose between Single Premium or Regular Premium
Choose your premium paying frequency such as annual, half - yearly, quarterly or monthly
Opt for electronic payment of your premium (ECS) for your convenience, safety and records
Ensure to register nomination under your policy. Fill the nominee’s name correctly
After you submit the proposal form
Once the proposal is submitted, you should hear from the insurance company in 15 days
If not, take up the matter in writing
If any additional documents are asked for, comply immediately
Once the proposal is accepted by the insurance company, the policy bond should reach you within a reasonable amount of time i f not, contact the insurance company about it
When policy bond is received, check it and be sure that the policy is the one that you wanted.
Go through all the policy conditions and be sure that these are the same that were explained to you by the intermediary/ insurance company official at the time of sale
In case of doubts, contact the intermediary/ insurance company official immediately for clarification.
If necessary contact the insurance company directly
Maintaining the policy
Pay your premium regularly on the due dates/ within the grace period
Do not wait for a premium notice. It is only a courtesy. It is your duty to pay the premium to avoid lapsation or other penal ties
Do not wait for your intermediary or anyone to pick up your cheque. Make your own arrangement for paying the premium on time
If there is a change of address, please intimate the insurance company immediately.
After the policy is issued, you can change the nomination by:
Filling a notice of change of nomination and
Sending them to the insurance company for them to register it in their records
If the nominee is a minor, appoint an appointee to receive any claim paid while the nominee is still a minor
Get the appointee to sign in the endorsement showing consent to act as an appointee
If your policy lapses
If you fail to pay the premium in time, your policy may lapse. Contact the insurance company for reviving it.
If you lose your policy
If you lose your policy bond, report it to the insurance company immediately
Get a duplicate policy by complying with the formalities
The duplicate policy confers the same rights as the original policy bond
At the time of a claim
Comply with all the requirements of the insurance company
Whenever required, you should help the insurer in a prosecution or for recovery of claims which the insurer has against third parties You have the right to
Cancel the policy within 15 days from the date of receipt of the policy document. If you disagree to any of the terms or conditions in the policy
Return the policy stating the reasons for objection
You will be entitled to a refund of the premium paid
A proportionate risk premium for the period on cover and the expenses incurred by the insurer on medical examination and stamp duty charges will be deducted If it is a unit linked insurance policy (ULIP) in addition, the insurer can repurchase the units at the price on the cancellation date.
Complaint Redressal in Insurance Sector
Insurance Regulatory Development Authority (IRDA) has mandated all insurance companies to have an effective grievance handling system which needs to be specified in their policy document. Based on the grievance handling system in Insurance sector:
The consumer in case of any complaint is advised to write his complaint by letter/email to the concerned insurance company. All the insurance companies are required to provide contact details of their Grievance Redressal Officer on the policy documents, web - site etc. Click here for contact details of Grievance Redressal Officers, GRO, of all insurance companies. The complaint may be submitted in written form and the acknowledgement obtained. The complaint is required to be redressed within 15 days of the receipt of the complaint.
In case of no response within 15 days or un-satisfactory response, the consumer is advised to escalate the complaint through IRDA grievance Redressal cell through their toll free number 155255 or through email email@example.com or through Integrated Grievance Management System (IGMS) of IRDA deployed at www.igms.irda.gov.in. IRDA normally forwards the complaint to the concerned insurance company. The complaint if being sent by letter or fax, may be sent to Consumer Affairs Department, Insurance Regulatory and Development Authority, 3-5-817/818, United India Towers, 9th floor, Hyderguda, Basheerbagh, Hyderabad – 500 029, Fax no. 040 - 66789768.
The Complaint registration process through IGMS involves the following TWO SIMPLE steps
Step 1 : Register yourself by entering your details
Step 2 : Register your complaint and view its status
In case the consumer still does not get any response within 30 days of the complaint or gets un-satisfactory response, the consumer may approach Insurance Ombudsman as per stipulated jurisdiction. The award of Insurance Ombudsman is to be complied by Insurance Company within 15 days. However, the Insurance Ombudsman cannot take cases where the value of claims exceeds Rs. 20 lakhs. The Ombudsman shall pass an award within three months of receipts of the complaint and the award is binding on the insurance Company. The time limitation for filing a complaint with Insurance Ombudsman is one year from the date of which either the insurer is responded or should have responded after receipt of the complaint.
In case the consumer still feels aggrieved from the awards of Insurance Ombudsman, the consumer can file a case with District Consumer Forum or if the value of claim exceeds Rs. 20 Lakhs, the consumer can file a case with State Consumer Redressal Commission.
General-Life Insurance/ General Insurance
Processing of proposal and Communication of decisions including requirements/issue of Policy/Cancellations
Obtaining copy of the Proposal
Post policy issue service requests concerning mistakes/ Refund of proposal deposit and also Non - Claim related service requests
Acknowledging a Grievance
Resolving a Grievance
Surrender Value/Annuity / Pension processing
Maturity claim / Survival Benefit / Penal interest not paid
Raising claim requirements after lodging the Claim
Death Claim settlement without Investigation requirement
Death Claim settlement / Repudiation with Investigation requirement
Survey report submission
Insurer seeking addendum report
Offer of Settlement/ Rejection of Claim after receiving first/ addendum survey report