• Term insurance claim rejection

Respected sir/madam,

 i am balaji gn s/o late.shobha narayan residing in bull temple road cross bangalore. In the year nov-2020 my mother bought a term insurance policy on her name from your respective company and unfortunately my mother passed away on may-2021. 
I had submitted all the relevant documents for the claim of her term insurance policy and company is stating that due to non-disclosure of her medical issue the policy has been rejected and i am aware that i had disclosed her medical condition at the time of buying a policy and also we had disclosed about her diabetic in the proposal form and also we had been to the physical center alloted by the company, had given all the medical test asked by the company like ECG, BOOLD TESTS, URINE TEST, TMT TEST, BLOOD PRESSURE were given at the time of purchasing a policy but the company never took any other medicals related to thyroid but now claim is rejected due to non disclosure of her daibetic, thyroid and hypertension but my mother had thyroid in the month of feb-2020 and later in the month of june-2020 her thyroid problem was completely cured as she was under medication and that is the reason we did not disclosed to the company as it was cured completely and also we submitted the records relating to the problem and we had disclosed her diabetic condition during the time of policy and also company has taken the medicals pertaining to that and at the time of buying a policy she did not had any hypertension and when problem is solved or when problem is not there i cant mention that problem is there, so pls respond me asap and do the needfull and also i am attaching the related documents and if i am not getting a response for your side and i will fight against this as there is no any mistake of mine in this and also policy bazaar has not advised me properly at the time of buying this policy so policy bazaar is also responsibile for this case.
(sum assured is 60lakhs) and i really want to fight for this so pls do help me regarding the above case and do the needfull sir also i above complaint was sent to the company thru mail and i am not receiving any response from them. 
regarding dis case i had also submitted all de relevant documents to the company and not responding me so pls do help me and ill thankfull to you sir.
Asked 2 years ago in Civil Law

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11 Answers

file complaint against insurance company before consumer forum seek orders to direct insurance company to pay claim amount with interest 

 

2) also claim litigation costs and compensation for mental torture undergone by you 

Ajay Sethi
Advocate, Mumbai
94520 Answers
7485 Consultations

5.0 on 5.0

Hi, you need to file Complaint in the consumer forum. Before, filling the Complaint you need to issue legal notice and thereafter you can file Complaint.

Pradeep Bharathipura
Advocate, Bangalore
5604 Answers
335 Consultations

4.5 on 5.0

Contact the Ombudsman of the Insurance Company with all the relevant documents and prove that yours is a genuine case based on records.

Shashidhar S. Sastry
Advocate, Bangalore
5068 Answers
314 Consultations

5.0 on 5.0

File complaint with District Consumer Dispute & Redressal Forum.

Dalip Singh
Advocate, New Delhi
1083 Answers
36 Consultations

5.0 on 5.0

You need to first send these guys a legal notice in the matter of repudiation of your claim. This legal notice is supposed to be sent through a lawyer. If they do not budge despite the legal notice, drag them to consumer court in a complaint

Vibhanshu Srivastava
Advocate, Lucknow
9588 Answers
303 Consultations

5.0 on 5.0

- Since at the time of taking the insurance proper medical certification was received by the company and further she was not having any life threatening disease at the time of taking the insurance then the company is bound to pay the claim amount 

- You can issue a legal demand notice to the said company , and if no response then file a compliant before the consumer forum . 

Mohammed Shahzad
Advocate, Delhi
13095 Answers
195 Consultations

5.0 on 5.0

You may lodge a complaint with the Insurance Ombudsman online. They may call you for a personal/video hearing where you can present your case. Alternatively, you may send the insurance company a legal notice and file a complaint with the consumer court through a local lawyer. 

Swaminathan Neelakantan
Advocate, Coimbatore
2773 Answers
20 Consultations

4.9 on 5.0

You can give a complaint to the Insurance Ombudsman in Bangalore(No.19/19, Jeevan Soudha Building, Ground Floor, 24th Main, Jp Nagar 1st Phase, Bangalore - 560078) or can file a case in the Consumer court in your area. If you are planning to give a complaint to the Insurance Ombudsman, you should have made a representation to the Insurance Company and either an unsatisfactory reply should have been received or the representation should stand as un-replied for at least 1 month. The ombudsman calls for both parties and tries to make a settlement.  If no settlement has arrived, you can approach a civil court or the Consumer Court.

 

Muraleedharan R
Advocate, Trivandrum
373 Answers
2 Consultations

5.0 on 5.0

Dear Client,

                 As per the information provided by you about the matter, it is very unclear whether you have purchased a mediclaim policy or a health insurance policy. This information would be required to ascertain what could be your subsequent course of action in the light of the present circumstances.

You may also write your grievance to the ombudsman of the insurance company in your location.Insurance disputes can be litigated before both a civil court or a consumer forum and relevant provisions of Insurance Act,1938 will also apply.

Thanks & Regards

Anik Miu
Advocate, Bangalore
8742 Answers
109 Consultations

4.7 on 5.0

You need to send them legal notice and approach consumer court in above matter

Prashant Nayak
Advocate, Mumbai
31807 Answers
175 Consultations

4.1 on 5.0

Just sending a complaint to them will not be sufficient.


After they had rejected or repudiated your insurance death claim amount, after exhausting the remedies before the claim review committee, you send them a legal notice demanding the same (by registered post ) through a lawyer and then drag them to consumer forum for relief and remedy

T Kalaiselvan
Advocate, Vellore
84711 Answers
2172 Consultations

5.0 on 5.0

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