Know your rights as an insurance buyer

Know your rights as an insurance buyer

Other rights

 "There are various other issues about which the insured should be vigilant, such as: the timeframe for processing and settlement of claims; the financial limits of a surveyor (there are cases when a surveyor is appointed for claims which are higher than his eligibility limit); that piecemeal information cannot be sought; that a second surveyor cannot be appointed by the insurance company; various circulars regarding standardised definitions, premium, etc," adds consumer activist Jehangir Gai.

 If you are buying a health policy with a term of two years or more, you are entitled to a 15-day 'free-look' period, during which the policy can be cancelled (and the premium refunded) if it doesn't satisfy your expectations. In addition, the insurer cannot delay the decision on approving or rejecting your application for a cover beyond 15 days of submission. Court verdicts constitute another area you need to keep an eye on.

Redress your grievances

 If the insurer fails to serve you to your satisfaction despite meticulous compliance, you can flag off the issue to the company. You are entitled to receive a written acknowledgement from the insurer within three working days of the receipt of a complaint.

 If it is not addressed during this period, the company is supposed to resolve the grievance within two weeks of its receipt and send a final letter of resolution. Your next stop should be Irda - through the online platform (www.igms.irda.gov.in) or the Insurance Ombudsman offices.

 "The final recourse is to approach the consumer forum or a court of law. If a representation is made to Irda, the insured should be vigilant and not wait endlessly for action or communication from Irda, as the time lost there can result in the complaint getting time-barred," sums up Jehangir Gai.

 Finally, if you are not satisfied with your insurer's services, you can always propose to "port", or switch your policy to another health insurer while retaining all the continuity benefits.

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