ABSTRACT
An insurance company is a company which pools the risk of its client to make reasonable or inexpensive payments for their insured. Insurance is more like a contract. it is represented by a policy or a premium which dealt with any individual or an entity is entitled to compensation or repayment for their losses by the insurance company. Repayment of loss will depend upon how much loss occurs. If we look at the history of the insurance company, it started in India from Manu Smriti (Manu). There are many contexts of an insurance company. Like life insurance, vehicle insurance, automobile insurance, and marine insurance, etc. In this paper, it will be dealing with the whole concept of filling a complaint against an insurance company. It also dealt with in what circumstances a person is entitled to file complaints about his loss.
INTRODUCTION
The world we board is filled with uncertainties and risks. Individuals, families, properties, assets, and businesses are exposed to different levels of risks. These include the chance of losses of life, health, assets, property, etc. While it’s not always possible to forestall unwanted events from occurring, the financial world has developed products that protect individuals and businesses against such losses by compensating them with financial resources. An insurance company means a corporation that has insurance and sells insurance to the general public or any entity. The insurance company is susceptible to pay compensation or to create financial payments to its insurer in lieu of the loss suffers by the one who takes insurance from the insurance company. Insurance may be a financial product that’s sold by the insurance company as a safeguard to someone and it’s any reasonable property against the chance of loss occurs. The risk of loss includes damage, burglary, theft, flooding, or any reasonable accident.[2] Insurance policies don’t seem to be just for the aim of a person’s life but insurance would be bought for several other aspects also like for all times, health, agriculture, vehicle, home, automobile, business, and retirement, etc. Any person, entity company, a firm should buy or buy a policy from an insurance company in any aspect of policy. There are many insurance companies in India and everyone over the globe that provide a policy to the people. There are many insurance companies in India and all over the world that provide insurance policy to the people. All those companies are incorporated under IRDR. There are a few points that need to be clear before going in detail about how to do the complaint would be registered and where. These points are premium, policy limit, and deductible.[3]
Premium
A premium means surcharges or insurance amount. It is a sum of the amount to be paid for the contract of insurance. It is also called an installment or additional charge. The premium of a policy is its price which is paid as a monthly cost. The premium is determined by the insurer on the basis of the profile of risk on the subject of the insurance.
Policy Limit
The maximum amount which is paid by an insurer under a policy for covered loss is said to be a policy limit. In case of life insurance, the maximum amount will be paid by the insurer is considered as face value, and the same amount will be paid to the beneficiary upon the death of the insured.
Deductible
The specific amount to be paid by the policyholder before the insurer pays a claim is said to be a deductible. It can apply pre-policy and pre-claim that depends upon the insurer and the type of policy.
A firm understanding of those concepts goes a protracted way in helping you select the policy that most accurately fits your needs. These three points are very important to look at and understand before taking a policy for self and family. These are considered as the core component of the insurance policy.[4]
There are times after you might get unsatisfied with the services provided by your insurer. During this example, you’ll approach the IRDAI for an answer. The insurance regulator may be approached in numerous ways to escalate a problem. IRDA has laid down a Turn Around Time (TAT) for the assorted services rendered by insurance providers to the insured. The maximum turnaround has been set for keeps insurance companies similarly as general insurance companies, supported the kind of service or grievance redressal provided by the corporate.
The maximum TAT (Turn Around Time) on complaints/ requests/ grievances associated with a number of the services offered by insurance companies are given below.
| Service Rendered | Maximum Turn Around Time |
| Processing the proposal, issue of policy or cancellation of a policy | 15 days |
| Obtaining a copy of the policy proposal | 30 days |
| Service requests for errors or refund or NCB (No Claim Bonus) related service requests | 10 days |
| Related to Annuity, Surrender value | 10 days |
| Survival Benefit, Maturity Claim or penal interest not paid | 15 days |
| Raising claim requirements after registering a claim | 15 days |
| Death Claim settlement without investigation requirement | 30 days |
| Death Claim repudiation or settlement with investigation requirement | 6 months |
| Acknowledging a grievance | 3 days |
| Resolving a grievance | 15 days |
If a person feels that there was a delay or disregard on the part of the insurance company in the dispensation of a proposal, servicing a policy or processing claims then, in that case, the person may file a complaint against that insurance company.[5]
That person has to send a written complaint with the document which supports that complaint, to the insurer’s grievance redressal officer, and get information for the same. For this step, all the required information is available on the website of the insurer or the Insurance Regulatory and Development Authority (IRDA).[6] If the insurance company does not address the complaint within the specific time period or if that person does not satisfy with the response of the insurance company, then, in that case, a complaint lodged with IDRA. A person can also use the Integrated Grievance Management System of IDRA t registered a complaint. If a person still not satisfied with these, can approach the Insurance Ombudsman or can file a civil complaint against that insurance company or the insurer before a civil court.
References:
[1]Student of Law, Galgotias University, Greater Noida, UP
[2]https://www.abi.org.uk
[3] https://www.igrad.com
[4] https://www.investopedia.com
[5] https://www.moneyadviceservice.org.uk
[6] https://m-economictimes-com.cdn.ampproject.org
This article is authored by Nikita Kumari, Fourth-Year, B.A. LL.B. (Hons.) student at Galgotias University.
Also Read – How To Make Complaint Against Police?
