Sunday, 24 July 2016

Ways to Force Insurance Company to Pay Your Claim


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Insurance is clearly a legal contract between insured and insurer and it works on utmost good faith; which means both parties (Insurer and Policyholder) are supposed to disclose all the facts clearly. In insurance contract, insurer has a legal obligation to honor the claim.
Usually, no insurer rejects a claim request unreasonably because of stringent guidelines of IRDAI; however, if you think that your claim deserves to be honor but your insurer is not doing so. Then you can force him to pay your insurance claim by approaching authorities setup by the government. You can also take this matter to civil courts but before that, you should approach the authorities that are especially established to handle insurance related disputes.
Insurance policies are subject to certain exclusions; therefore, must read what does your insurance policy cover and doesn’t cover before approaching grievance redressal agencies.

When you can approach grievance redressal agencies:

  • You can knock the doors of a redressal agency if your claim has been denied unreasonably or you are not satisfied by your claim settlement.
  • If your insurance company is delaying in claim settlement.
  • If insurer is not complying with the terms mentioned in the policy documents etc.

Authorities that you can approach if insurer denies to honor a claim

  1. The Grievance Redressal Officer of concerned insurance company (Mandatory)
  2. Integrated Grievance Management System (Optional)
  3. Insurance Ombudsman
  4. Consumer Court or Civil Court (Click here to read detailed post explaining procedure to file a complaint against the insurer)
Note: It is mandatory to approach The Grievance Redressal Officer of concerned insurer before approaching other authorities.
You do not need a lawyer or an expert to lodge a complaint against your insurer. However, if you think that you cannot represent your case then there are some private firms, who help policyholders to get their claim settled but keep in mind that you’re not going to get any compensation for that from your insurer.
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