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False papers, skipping medical test may lead to hassles in claims

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IF YOU are planning to buy a life insurance policy this tax saving season, make sure that you submit all the documents and payments as prescribed by the insurance company.

On several occasions, it has been noted that the insurance adviser, in an attempt to get new business, makes false commitments about documents or medical examination required. All this adds to policyholder's agony and frustration that could further make him jittery about buying any new policy.


Cautious approach: A person planning to buy an insurance policy should communicate clearly with the insurance adviser about all documentation requirements. Also, he should contact the insurance company directly to know if the insurer will be processing the proposal based on those documents or not.

Another issue is the requirement for medical examinations. Policyholders must always discuss their past medical history with the insurance agent in case he had gone through any medical procedure.

An agent's first duty is to identify customer needs by understanding the client's family history, dependants, present earnings and future earnings potential, short as well as long-term liabilities and future aspirations, to name a few, and then, recommend a policy that satisfies his needs. Once the customer agrees to buy a policy, he is then expected to support and handhold the customer in satisfying all formalities in completing policy documentation and facilitate the medical examinations if required.

Once the documents are received, the insurer has up to 15 days for underwriting the application and dispatch the policy bond to the policyholder. However, the insurers generally take fewer than 15 days to complete the process if it is a non-medical case.

In cases where a medical examination is required, the insurer has to schedule a meeting with any registered physician or medical centre close to the policyholder's locality. In addition, it is the agent's responsibility to coordinate between the medical centre and the policyholder. For most insurance companies, the medical examination cost has to be paid by the insurer and should be deducted from the premium, in case the proposal is rejected by the insurance company.

In case of service deficiency, the customer can register a complaint with the insurer through various channels, such as the nearest branch office, call centre or write to the customer support team. In case the customer is not satisfied with the response of the company, the complaint can be escalated with the call centre of the regulator or an ombudsman.


Complaint redressal: A customer may also register a complaint on the Insurance Regulatory and Development Authority (Irda) grievance redressal portal, http://www.igms.irda.gov.in, or, send a written complaint to the regulator. All such complaints have to be resolved within 15 days by the regulator. Any service deficiency reported by the customer against the agent could result in suitable disciplinary action by the insurer, which could even lead to termination of the agent's licence.

The insurance companies should make the customer feel that their insurance proposal is important and should maintain continuous communication with the policyholder.

 

 

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Some of the best Tax Saving Mutual Funds available ( ELSS Mutual Funds )

  1. HDFC TaxSaver
  2. ICICI Prudential Tax Plan
  3. DSP BlackRock Tax Saver Fund
  4. Birla Sun Life Tax Relief '96
  5. Reliance Tax Saver (ELSS) Fund
  6. IDFC Tax Advantage (ELSS) Fund
  7. SBI Magnum Tax Gain Scheme 1993
  8. Sundaram Tax Saver

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