• Insurance policy

Dear sir  i had taken group mediclaim policy in group's name . the policy was been issued after paying the premium as per their quote . i gave cheque with the letter head to buy the policy . after 2 or 3 months there was claims of 2 persons out of 26 covered . the claims were been rejected and policy was cancelled by bajaj allianz stating that the policy is being issued to employees and not to members of the group. we told them that all are members and nobody is employee . and also we told that at time of buying the policy you should ask this . they had not filled any proposal form nor any questionaire . even policy issued by them states that no of members covered and everywhere in the policy it is clearly mention that members covered. i feel cheated by the company as lost my money as premium and not got back my premium nor claims please assist me what to do
Asked 1 year ago in Civil Law from Mumbai, Maharashtra
1) it is necessary to peruse correspondence entered into ,terms and conditions of the insurance policy taken out by members .reasons for cancellation  etc to advice 

2) what is the premium paid by you ? 

3)if claim has been rejected you can move consumer forum against company for deficiency in service and seek the claim amount together with interest 

4) also seek compensation for mental torture undergone 

5)contact a local lawyer 
Ajay Sethi
Advocate, Mumbai
23151 Answers
1216 Consultations
5.0 on 5.0
first of all send a legal notice to insurance company and if they are not ready to settle the matter amicably within notice period then file a complaint before consumer Forum against them and claim compensation.
Nadeem Qureshi
Advocate, New Delhi
3522 Answers
129 Consultations
4.9 on 5.0
This is a gross deficiency of service by the Insurance company.  The private insurance companies adopt such unethical and cheap business tactics and once the business has come they dont bother about the service.  
You have a very good case to be prosecuted through consumer forum against the insurance company for deficiency of service.  
First issue a notice to company demanding the insurance claim and also compensation for mental agony caused by them due t this. if you get a reply or not, for non compliance of your demand you may file a case before the jurisdictional consumer forum for relief and remedy. 
T Kalaiselvan
Advocate, Vellore
13945 Answers
127 Consultations
5.0 on 5.0
Insurance company has 45 days to accept or reject any insurance policy after the signing of policy with policy holder. after 45 days (if policy is not rejected) policy is deemed to be accepted and contract has completed.

After completion of the contract, insurance company is bound to obey the contract. any altercation after completion of contract terms as breach of contract.

You should file complaint before IRDA or Consumer Forum for Specific performance of contract and compensation for mantle agony and cost of pleading. 
Shivendra Pratap Singh
Advocate, Lucknow
2731 Answers
41 Consultations
4.9 on 5.0
1. File a complaint case before your local District Consumer Dispute Redressal Forum agaisnt the insurance company alleging deficiency in service and unfair business practice claiming withdrawal of the policy cancellation letter, payment of the amount claimed with interest, damage for the agony and cost,

2. It is a good case to win.
Krishna Kishore Ganguly
Advocate, Kolkata
12077 Answers
228 Consultations
5.0 on 5.0
1. If the application form clearly mentions that the members are covered the insurance company cannot subsequently alter the rules to reject the insurance claim.

2, You should issue a lawyer's notice to the company. If the notice from your lawyer does not produce the desired result you may sue the company to claim the amount equivalent to the policy and also heavy damages.
Ashish Davessar
Advocate, Jaipur
18061 Answers
447 Consultations
5.0 on 5.0
Hi, there is deficiency of service on the part of the company so you can issue a legal notice and thereafter  file a complaint in the Consumer Forum.
Pradeep Bharathipura
Advocate, Bangalore
4104 Answers
133 Consultations
4.3 on 5.0
A. Issue a legal notice to the Insurance company to show the reason and bring the notice of the cheating and promissory estoppel.

B. Thereafter, if you fail to obtain any response from the Insurance company, you can approach the Consumer Forum under the deficiency in the Service and claim damages for mental agony and recover the whole premium amount along with interest.  
B.T. Ravi
Advocate, Bangalore
733 Answers
29 Consultations
5.0 on 5.0

Ask a Lawyer

Get legal answers from top-rated lawyers in 1 hour. It's quick, easy, and anonymous!
Ask a Lawyer

Civil Lawyers

T Kalaiselvan
Advocate, Vellore
13945 Answers
127 Consultations
5.0 on 5.0
Ajay Sethi
Advocate, Mumbai
23151 Answers
1216 Consultations
5.0 on 5.0
Ashish Davessar
Advocate, Jaipur
18061 Answers
447 Consultations
5.0 on 5.0
Krishna Kishore Ganguly
Advocate, Kolkata
12077 Answers
228 Consultations
5.0 on 5.0
Nadeem Qureshi
Advocate, New Delhi
3522 Answers
129 Consultations
4.9 on 5.0
Rajgopalan Sripathi
Advocate, Hyderabad
868 Answers
43 Consultations
5.0 on 5.0
Atulay Nehra
Advocate, Noida
433 Answers
15 Consultations
4.7 on 5.0
Shivendra Pratap Singh
Advocate, Lucknow
2731 Answers
41 Consultations
4.9 on 5.0
Ajay N S
Advocate, Ernakulam
1910 Answers
19 Consultations
5.0 on 5.0
Thresiamma G. Mathew
Advocate, Mumbai
1316 Answers
85 Consultations
5.0 on 5.0