Did wrong representation or technical jargons get your claim rejected? Do you feel dejected? Well let us help you get your claim back. More often than not, claims get rejected due to filing incorrect or invalid information. Although once rejected, the status of your claim can still be challenged.
Reasons why your claim can get rejected:
How to avoid these things to happen:
Keep yourself and your insurer informed of all developments! Speaking for stats alone, one might doubt the efficacy of insurance claim settlements at all. However, we understand your claim letter by letter as it rolls out and helps you re-file your claim rejection case with your respective company. If required, we even look at legal options as per case requirement. We do not settle until your claim is settled!
Is your claim rejected basis Death Certificate is invalid?
Death within 3 years of policy and company is not responding
Life Insured committed Suicide and claim got rejected
The claim is rejected because of Non Disclosure of Material Facts
Claim rejected due to Incorrect Medical History including smoking, hypertension, diabetes etc
There is a delay in filing of the claim
The cashless claim is rejected
Is your claim rejected due to Incorrect Discharge summary
The claim is rejected due to Pre-existing disease that was not disclosed
Ported my health insurance and claim got rejected
New policy with new terms and conditions issued without my knowledge at the time of renewal
As of 2016, 80% of consumer complaints in the Insurance Sector were related to Insurance Claims alone. Ranging from fraud and lack of awareness to inappropriate documentation, imbalance in the Insurance Sector looms larger than ever before owing to the rise of the Indian middle class and a shift towards more educated investments. Despite numerous checkpoints imposed by the IRDA, an end-to-end solution for this problem seems far-fetched. New measures like the Introduction of KYC (Know Your Customer), Prohibition of Third-Party Payments, Fixing Accountability for Distributors, etc. have not yet completely resolved these issues. Due to lack of financial know-how and awareness, issues like data theft and fake calls posing as IRDA remain common. Insurance Samadhan has accepted this challenge and we aim to achieve the goal of removing these obstacles for our clients. We ensure that your case is excellently represented, protocol is followed and your life insurance complaints are resolved as quickly as possible.
The Healthcare and Medical Services sector of any country is critical for its welfare. Government, employers and the society at large need to understand health insurance clearly. Only then can they implement productive strategies for managing health and medical insurance. Presently, the majority of disputes usually occur due to misunderstandings, exclusions and non-standardization of laws related to medical insurance. Corporate Hospitals have TPA (Third Party Administration) desks but similar facilities are unfortunately not available everywhere. Additionally, incorrect declaration at the time of policy initiation and poor documentation create even more issues. Once again, we firmly believe in the transparency and integrity of the system and understand the limitations faced by the common man who has trouble understanding the “Heavy Words” of the industry, like understanding exclusions and permissible limits linked to room rent. Which is exactly why at Insurance Samadhan we work relentlessly on case representation at all forums with the intention of resolving various health insurance complaints of the very aggrieved customers we often assist.
Non-Life Insurance Policies such as Automobile Insurance and Homeowner Policies are classified as “General Insurance”. These policies provide cover and payment depending on the loss from a particular financial event. Other Examples of General Insurance include Health Insurance, Travel Insurance, Marine Insurance, Commercial insurance etc. Despite the modernization of Insurance products and practices in India consumers face a number of problems with General Insurance. The general public looks at these policies as unnecessary due to a lack of awareness. People are scared by the technical and difficult language which is hard for them to understand. Thirdly, misrepresentation and selling inappropriate policies has created a bad impression in Public. These combined with the notoriously slow claim settlement process actively discourage consumers from purchasing these policies. Insurance Samadhan works relentlessly to solve these problems by helping consumers in understanding their policies, representing them with concerned authorities and helping them recover their claims. We understand the problems well due to our experience in the industry and so our solutions for general insurance complaints are suitable and easy to understand for Indian consumers.
Insurance Samadhan is not related to IRDA/Ombudsman in any manner. Copyright © 2016-2023 Insurance Samadhan. All rights reserved.
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