Insurance Claim: Insurance companies have rejected your claim, so know where you can complain, know the full method

Insurance Claim: Insurance companies have rejected your claim, so know where you can complain, know the full method


New Delhi. During the Corona epidemic, there has been a huge jump in the cases of insurance claim. In many cases of insurance claims, even after a long time, the claim money has not been received by the victims. In such a situation, customers have the right to complain to the insurance company. Customers can complain about the insurance company to the Insurance Ombudsman.

There are a total of 17 Insurance Ombudsmen at different places in the country. Customers can complain to the insurance company with the Insurance Ombudsman of the place where they are staying. The customer can make this complaint himself or through his legal heirs or nominee.

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Complain to the insurance company first
Before complaining to the Insurance Ombudsman, customers should place their complaint with the insurance company. Customers can first place their complaint in front of the Grievance Redressal Officer i.e. GRO of the insurance company. Customers can mail their complaint to the GRO or register their complaint by visiting the nearest branch of the insurance company.

You can also approach the insurance regulator
Customers can also register their complaints using the online portal IGMS of Insurance Regulatory Authority of India (IRDAI). The insurance company has 15 days to resolve your complaint. If your complaint is not resolved within this period or you are not satisfied with the resolution, then you can place your complaint before IRDA. You can lodge a complaint by e-mailing IRDA at [email protected] Customers can also complain on IRDA’s toll free number 155255 or 1800 4254 732. If you are also not satisfied with the resolution of IRDA, then at the next level, you can complain to the Insurance Ombudsman about the insurance company.

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Step by step complaint in Insurance Ombudsman
– The insured can make his complaint to the Insurance Ombudsman by writing or typing on a plain paper through registered post and email.
In this, the name of the insured, signature, policy number of the insurance, insurance claim number, how much the claim is worth, will have to be mentioned.
Full address with pin code, phone number, email id, name of the insurance company and the address of the office from where the policy is taken should be given.
A copy of the hospital bill, doctor’s prescription, investigation report, rejection letter given by the insurance company should be attached with the complaint.
In the complaint letter, it must be written that the reasons for the claim rejection given by the insurance company are wrong and why your claim is correct.

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Can’t complain in this situation
Complaints to the Insurance Ombudsman can be made in person by letter or by post. If the case of any claim is pending in the consumer court, then in that case a complaint cannot be made to the Insurance Ombudsman. No fee is charged for complaints in the Insurance Ombudsman. Complaints to the Insurance Ombudsman can be made by the insured or by the heir of the insured.

Tags: health insurance, Insurance, Insurance Company


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