Punjab Consumer Forum Raises Alarm Over Baseless Claim Rejections by Insurance Companies
The Punjab Consumer Forum has brought to light a troubling trend where insurance companies are rejecting claims on insubstantial and often baseless grounds. This issue has become pervasive, prompting the forum to call for immediate intervention by the Insurance Regulatory and Development Authority of India (IRDAI).
Widespread Complaints from Policyholders
Policyholders across Punjab have reported instances where insurance companies have denied claims citing minor technicalities or unrealistic documentation requirements. In one notable case, the Supreme Court criticized an insurance company for refusing to settle a claim due to the non-submission of a duplicate certified copy of a stolen vehicle’s registration certificate. The court labeled this rejection as a deficiency in service and mandated the insurance company to fulfill the claim along with additional costs【8†source】【9†source】.
Consumer Forum’s Stand
The Punjab Consumer Forum emphasized that such rejections are not just isolated incidents but reflect a broader, systemic issue within the insurance sector. The forum highlighted that many policyholders are unable to meet the stringent documentation demands imposed by insurers, which are often beyond their control. This not only undermines the trust policyholders place in their insurance providers but also violates the fundamental principles of fair and reasonable claim settlement.
IRDAI’s Role and Responsibilities
The IRDAI, as the regulatory body overseeing insurance practices in India, has been urged to take a more proactive stance in addressing these grievances. The forum insists that the IRDAI must enforce stricter guidelines to ensure that insurance companies cannot reject claims on flimsy grounds. The IRDAI has previously issued circulars aimed at preventing claim rejections based solely on delayed intimation or minor discrepancies, but the enforcement of these guidelines remains inconsistent【10†source】.
Steps for Policyholders
Policyholders who find their claims unjustly denied have several avenues for redress:
- Registering Complaints: Complaints can be filed through the IRDAI’s Bima Bharosa Portal, which facilitates the efficient tracking and resolution of grievances.
- Insurance Ombudsman: If the insurer fails to resolve the complaint satisfactorily within a specified period, policyholders can escalate the matter to the Insurance Ombudsman. This scheme provides an impartial and cost-effective resolution process for disputes involving claims up to ₹50 lakh.
- Consumer Courts: For claims exceeding the ombudsman’s jurisdiction or for those seeking further legal recourse, policyholders can approach consumer courts for adjudication【9†source】【10†source】.
Conclusion
The Punjab Consumer Forum’s call for IRDAI intervention underscores the need for greater regulatory oversight to protect policyholders from arbitrary and unfair claim rejections. As insurance companies continue to face scrutiny, it is imperative for regulatory bodies to enforce transparent and fair practices, ensuring that the interests of policyholders are safeguarded.
For more detailed information on how to lodge a complaint or seek redress, policyholders can visit the IRDAI’s official website or the Bima Bharosa Portal.