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Why Your Insurance Claim Can't Be Rejected That Easily Now
You invest a good amount of your hard-earned money into buying your favourite set of four wheelers – be it a luxury car or the trucks & tractors meant for your business- and you feel a sense of pride every time you see your precious possessions. You also follow each and every procedure related to the documentation while insuring your vehicle (to protect it against any future damage).
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- Why Your Insurance Claim Can't Be Rejected That Easily Now
However, you can never be sure whether your insurance claim is going to be accepted or rejected by your insurance company. Convincing and claiming your insurance successfully isn’t an easy task at all.
As per an old set of rules defined by insurers, claims were meant to be intimated immediately in case any sort of accidental damage or loss occurred to one’s vehicle. And, in case there was any delay caused in intimation it could lead to rejection of the claim as in the meantime the general insurance company could lose an opportunity to confirm facts and figures, which are especially critical in the cases of loss and damage (as in the scenarios of theft or fire accidents).
However, the latest iudgement released by the Supreme Court has brought a wave of relief amongst policy holders. The case was filed by a Hisar-based truck driver, Om Prakash, when he was denied an insurance claim for the theft of his truck from his insurer on the grounds that he was 1 week late in filing the claim. The Supreme Court ruled in the favour of the consumer and stated that the insurance claims cannot be rejected on the basis of delay caused in filing the claim if it has a satisfactory reason associated with it, as it will cause “the loss of confidence of policy-holder in insurance industry”.
The bench of Justices S Abdul Nazeer and R K Agrawal said that rejecting a claim on the basis that there has been a delay caused in filing the claim isn’t a reasonable condition at all (from the consumer’s perspective). If the reason for the delay has been justly explained and the claim has been found fair and genuine after the investigation performed by the investigator, there is no cause to reject the claim. They also stated that the aim of Consumer Protection Act is to protect the interest of consumers rather than harassing them. The bench also directed the insurance company (Reliance General Insurance Company) in this particular court case to pay a sum of Rs. 8.35 lakhs to the consumer.
The court added in its statement that although, it’s understandable that the owner needs to intimate the insurer on an immediate basis for any sort of damage caused to her/his vehicle, it’s very natural that s/he will firstly try to trace the vehicle on her/his own. Hence, such particular conditions shouldn’t hamper the settlement of genuine claims if the delay caused is due to real and unavoidable circumstances. The bench of justices further mentioned that the new rule is for the benefit of consumers and shouldn’t be misused at all.
In the appeal filed by Om Prakash, the consumer, it stated that his truck was stolen on March 23rd 2010, from Bhiwari (Rajasthan); however, as he was busy trying to trace his vehicle, he was not able to file the claim till the next week i.e. on March 31st, 2010. Following his claim, an investigation was held and the responsible corporate claim manager had approved a claim amount of Rs. 7.85 lakhs. However, later he was denied the claim amount based on the grounds that he had violated one of the company’s conditions where it mentioned that it is mandatory for the policyholder to inform the firm on an immediate basis in case of any accidental damage or loss to her/his vehicle.
Conclusion:
The latest statement released will ensure that insurance companies don’t have the complete authority when it comes to writing the rule book and the customers’ interests are taken care of, too. The Supreme Court has rightly observed that rejecting claims purely on technical grounds such as late intimation by the consumer will make her/him lose confidence in insurance sector.
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Disclaimer: The list mentioned is according to the alphabetical order of the insurance companies. Policybazaar does not endorse, rate or recommend any particular insurer or insurance product offered by any insurer. For complete list of insurers in India refer to the Insurance Regulatory and Development Authority of India website www.irdai.gov.in
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*We will respond in the first instance within 30 minutes of the customers contacting us. 30-minute claim support service is for the purpose of giving reasonable assistance to the policyholder in pursuance of the claim. Settlement of claim (including cashless claim) is the responsibility of the insurer as per policy terms and conditions. The 30- minute claim support is subject to our operations not being impacted by a system failure or force majeure event or for reasons beyond our control. For further details, 24x7 Claims Support Helpline can be reached out at 1800-258-5881.
*Product information is authentic and solely based on the information received from the Insurer. Policybazaar is acting only as a facilitator and claims settlement shall be at the sole discretion of the Insurer. Policybazaar does not provide any medical or surgical advice or diagnosis and is not responsible for your interactions / treatment by a medical practitioner/hospital. Please consult a registered medical practitioner for any medical or surgical advice. The Information that you obtain or receive from Policybazaar, and its employees, or otherwise on the Website is for informational purposes only. As per the Insurance guidelines, you are allowed to cancel the policy with-in 30 days from the date of Issuance of policy.This option is available incase of policies with a term of one year or more.
*All the health insurance plans cover hospitalization expenses including COVID-19 treatment cover up to the specified limits. You can also buy specific COVID-19 health insurance policies such as Corona Kavach Policy and Corona Rakshak policy.
**All savings and online discounts are provided by insurers as per IRDAI approved insurance plans. #Tax Benefits are subject to changes in tax laws.
*₹1748/month is the starting price for a 1 crore health insurance for an 18-year-old male, with no pre-existing diseases. Discount on renewal premium is subject to the number of wellness points earned in the health insurance policy. For more details about the plans, please read the sale brochure carefully to get upto 100% discount on renewal premium.
*₹400/month is the starting price for ₹ 5 lakh Health insurance for a 30 year old male & 29 years old female, living in Delhi with no pre-existing diseases
*₹541/month is the starting price for ₹ 10 lakh Health insurance for a 30 year old male & 29 years old female, living in Delhi with no pre-existing diseases
*₹762/month is the starting price for ₹ 1 Crore Health insurance for a 30 year old male & 29 years old female, living in Delhi with no pre-existing diseases
*₹243/month(₹ 8/day) is the starting price for a 5 lakh health insurance for a 20-year-old male, non-smoker, living in Bengaluru with no pre-existing diseases
*₹2020/month is the starting price for ₹ 1 Cr Health insurance for a 50 year old male & 50 years old female, living in Bangalore with no pre-existing diseases rounded off to nearest 10.
*₹390/month (₹13 per day) is starting price for 1 cr. Health insurance for 25 years old male, with pre-existing diseases, residing from tier 1 city rounded off to the nearest 10.
*No medical tests are required unless requested by the insurer’s underwriter. In-case of pre-existing diseases relevant medical proof would be required as per the terms and condition of the policy opted.
*The values taken for effective cost calculation are indicative values and may change as per the selected plan.
*Coverage upto double the amount of Sum Insured is available on certain covers for a minimum plan of Rs. 5 Lakh on the first claim only to an individual of upto 45 years of age with no pre-existing diseases. The benefit is available with or without extra cost depending on the plan chosen.
*Coverage of pre-existing diseases is provided by insurer as per their underwriting policy.
*The scope of coverage may vary from plan to plan.
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