The Dark Side of Insurance: What They Don’t Want You to Know

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Navigating an insurance claim can be a frustrating experience, especially when you feel like you're being "left in the lurch" by your insurer. When an insurance company drags its feet, gives you the runaround, or denies a claim without a valid reason, it's a clear breach of trust. In India, policyholders have a well-defined process to follow to ensure their grievances are heard and resolved.

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Here's a guide to what you can do if you feel your insurance company is handling your claim poorly:

Fast, Immediate Actions on Your End

Before escalating, make sure you've done everything right from your side. This will strengthen your case significantly.

Document Everything: Maintain a meticulous record of every single interaction with the insurance company. This includes the date and time of calls, the name of the person you spoke with, a summary of the conversation, and copies of all emails and letters.

Keep Your Documents Organized: Ensure all your documents are in order. This includes the original policy, premium receipts, the claim form, a detailed timeline of the incident, and all supporting documents (e.g., medical reports, repair bills, FIR, etc.).

Send a Formal Written Communication: After a call or a meeting, send a formal email or a letter to the company's grievance redressal department, referencing your claim number. This creates a clear, undeniable paper trail.

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The Internal Grievance Redressal Mechanism

The first and mandatory step is to complain directly to your insurance company. Every insurer is required to have a dedicated grievance redressal officer (GRO).

Contact the GRO: Find the contact details of the Grievance Redressal Officer on the insurer's website or in your policy document. File a formal, written complaint detailing the issue with your claim.

Acknowledge and Resolve: The insurer is required to acknowledge your complaint within three working days and must attempt to resolve it within 30 days. If they don't respond within this timeframe or if their response is unsatisfactory, you can escalate the matter.

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