Whenever there is any occurrence of any unexpected health hazard, a health insurance plan has turned out to be a genuine privilege mostly. The prime intent behind buying a comprehensive health insurance policy is that it will take care of the medical-related expenses such as the pre and post hospitalization, diagnostic, medicines, ambulance and various other expenses.
*All savings are provided by the insurer as per the IRDAI approved insurance plan. Standard T&C Apply
*Tax benefit is subject to changes in tax laws. Standard T&C Apply
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The health insurance policy acts as the shield to your savings bank account in case of any medical-related emergencies during the policy term. There is a common notion wherein people believe that a health plan only covers hospitalization expenses. However, this is not true. The right health insurance plan in India will provide a cover for every incurred medical expense such as the everyday hospital charge, ambulance, medicines, and so forth. You can compare the health insurance quotes online before making the purchasing decision. In case you face a problem in regards to the health insurance claim process, then you have all liberty to file the complaint against the health insurer.
In this article, we are going to discuss and understand the process of lodging the complaint against the health insurance claim.
In recent times, health insurance has become a fast-growing market. However, the fraud in this segment is also one by representing false fact representation and obtaining the amount for anything else and then claiming it’s the health-related needs.
These frauds are executed in wider aspects and can be done by the insurer and the insured. In case you do not know, the government also provides the provision of filing this complaint against the health insurer. Let us now understand the common types of prevalent frauds listed below:
Further, let’s discuss what if the insurance provider executes any sort of fraud against the policyholder. Let us understand what the insured needs to do.
In case you are not content with the insurance provider and have evidence to substantiate that the company is at fault and not you, all you need to do is file a complaint against the health insurance company in the IRDAI.
As per the directives of IRDAI, for the interest of the policyholders, the companies have been put in for the turnaround times for the services it renders. On the premise of the redressal system of the complaints, there is a fixed turnaround time for all the insurance companies.
In case the company is not resolving in time from where you got insured within the set TAT by the IRDAI, then you can directly approach the governing authority for instant solution. The IRDAI does not delay the process and will discuss the matter with the company at the earliest. In case of any other inquiry, the insured needs to lodge a formal complaint in the consumer court.
For the redressal of the complaint, you simply cannot reach the IRDAI directly. To begin with, visit the grievance cell of the company, which is located inside a branch. The complaint needs to be in writing and submitted along with all the supporting documents. After this, the company will provide the written cognizance of the complaint with the date of submission. The companies take 15 days to resolve the problem. If it is not addressed then you can request the governing body to address the grievance and likewise provide the solution.
You can also file the complaint against the health insurance company in IRDAI by dropping an email or get in touch on the helpline number.
|You May Like to Read: How to File a Complaint Against Your Health Insurer|
When it comes to buying the health insurance policy in India, you might have certain doubts. Listed below are some factors that you need to contemplate before you zero down the health plan. By adhering to them you might reduce the chances of getting disappointed by your insurer:
When you are exploit with many health insurance options available in the market, the chances of getting mis-leaded is also higher. It is your duty to research thoroughly before buying a plan, especially about the background of the insurer, so that you don’t face any harsh time while claiming the policy.