Is there a stipulated time period within which a general insurer is expected to pay the claim? And in case the insurer fails to do so, what kind of action can the insured take?
A general insurance company is liable to make claim payment within 30 days after receiving all the documents, statements and forms from the insured. An insurance company always tries to abide by the stipulated timeline. However, if there is an instance where the insurer is not in compliance with the same, the insured can directly call up the insurance company's call centre and report the grievance. Additionally, the insured can also reach out to the regulator's call centre or lodge the complaint on its website. Such claim payment related queries and delays are closely monitored by the regulator.
I am 33, traveling to the north-east next month for an adventure trip. I have taken a travel cover, but are adventure activities covered under such policies, or is there any other cover I need to buy?
Most insurance companies are cautious about covering adventure-related activities through travel insurance. Even if they do insure, it is done with additional charges of approximately 100 to 200 per cent over the base cost. Also, while this cover is offered by select insurers for overseas travel, very few companies cover adventure activities under domestic travel.
My friend's mother (54), recently underwent a minor eye surgery. Her insurance agent asked her to inform the insurance company herself as this is the duty of the policy proposer. But calls to the insurer went unanswered and there was no reply to mails. Is it not the agent's duty to help clients with claim process?
A claim is the moment of truth for a customer in his/her relationship with an insurance company. Insurance companies invest significantly in making the claim process simple and smooth, so that customers are not disadvantaged. The agent has a moral duty to facilitate and educate the customer about the claim process. The agent could have helped by identifying all the mandatory documents, help filling the claim form, dispatching the document to the insurance company and resolving the queries that might have risen while the claim was being processed.
You can highlight the issues you have faced to the insurance company. If you are not satisfied with the resolution provided by the insurance company, you may contact Insurance Regulatory and Development Authority (Irda) through their Grievance Call Centre at their toll free no 155255. You may also approach the Insurance Ombudsman for the redressal of your grievance.