Before you learn about your rights on general Insurance, you need to first understand what exactly general insurance is and how important it is to claim your rights on it. General insurance is a kind of risk management, used primarily to tide over any sudden loss, risk of a contingent and individuals or institutions are faced with different types of risks.
There are two categories of insurance plans, namely life and general (non-life) insurance. Compensation for life insurance benefits goes to the survivors of the decedent’s family or nominee. The second category includes non-life policies like the motor insurance, health insurance, home insurance and travel insurance. All losses of belongings in the respective category will be covered by the insurance company.
The two main benefits of opting for a general insurance policy are that it covers a major loss or the total loss of the belongings covered. The insured gets peace of mind during unexpected happenings where the asset covered are damaged or totally destroyed.
In 2017, the Insurance Regulatory and Development Authority of India (IRDA) amended the Protection of Policyholders’ Interests Regulations to make certain that the policy holder’s interests are protected effectively.
Accordingly, a new set of rules stated the time-frame specified for the insurer to process the claim for the insured, and the process involved.
Let us look at the claim process for general insurance policy holders.
- A surveyor has to be appointed within 72 hours of claim evaluation
- The survey has to be initiated by the surveyor within 72 hours of appointment
- Any requirement for additional documents or any clarifications to be made should contact the company within 7 days on or before receiving the document
- The surveyor has to furnish an interim report to the company by 15 days from the date of the first visit
- The company has to send a communication reminding the claimant to submit complete documentation as it is mandatory to submit these documents
- The surveyor sends the first survey report to the within 30 days
- The insurer can accept or reject all the claims within 30 days of receipt of the final survey
- In the circumstance where the admitted amount is less than the amount claimed, the insurer must inform the claimant in writing with reference from the specific terms and conditions mentioned in the policy
- When the insurer does not settle the claim within 30 days, he is liable to pay the interest, which is usually 2% and above the bank rate, usually from the date of receipt of specific documents till the date of actual payment.
Committee for Grievance Redressal
- The policyholders’ complaints against insurer companies are registered as per the mechanism introduced by IRDAI
- The GRO or Grievance Redressal Officer of the insurer company can be approached to resolve any issues within 15 working days. If the subscriber is not satisfied with the actions taken, he can go to IRDAI for further references
- Get help from the Grievance Redressal Officer of the consumer affairs department of IRDAI
- If solutions offered are still not satisfying, the complaint can escalate further to the insurance Ombudsman. IRDAI will always resolve the issue with the support of the insurance company
- Consumer courts and consumer forums are approached for disputes in enquiry or adjudication is necessary
Few things you should know about general insurance and your rights:
- Purchasing general insurance online is very simple once you have done your homework. A thorough research on which insurance will benefit you can give you a good start
- When a policy is lost, it is your duty to report it to the general insurance Follow the process of getting a duplicate policy by fulfilling formalities. The duplicate policy has the same rights as the original one
- At the time of claim, it is your duty and the right of the insurance company to provide all essential documents for submission. The insured has to ensure that the insurance company reimburses the claims which he/she is liable for, against third parties
- You have the right to cancel a general policy when you don’t accept the terms and conditions put up by the company
- The insurance company has the right to take the defence over any claim and the insurer has the right while conducting any procedure
The insurer has the discretion of making payment on a cashless transaction, which needs pre-authorization in case of health insurance. The insured needs to know the status of the policy and whether the claim form details submitted by him will suffice. The general insurance company has to give comprehensive support to the claimant while closing the policy.
Similarly, the claim process for health insurance, travel insurance and motor insurance may differ, depending on the tenure and purpose of the policy. Documents to be submitted are checked for authenticity, and all original bills are accounted for.
Awareness and empowerment of consumers is imperative. In other words, general insurance policy holders have the right to information. Furthermore, imparting and supporting policyholders is advocated by IRDAI. So, stay informed to stay aware, and make the right decisions when it comes to buying general insurance products.
