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Insurance Article

Know Your Rights as a Policyholder

November 30 2015
Stay aware and get the best out of your policy

Are you aware of your rights?

As a smart and informed policyholder, you must be aware of some basic rights. Knowing your rights and understanding your policy better is essential to make full use of your insurance policy.

Here are 6 rights that you may have been overlooking as a policyholder:

1. Access to Policy Documents

You have the right to access to policy-related documents within 60 days of submitting your proposal to the insurance company. The breakdown of these 60 days is as follows:

  • Insurer confirms the proposal within 15 days
  • Dispatch the documents to the policyholder within 30 days
  • Documents reach the policyholder within 10-15 days

2. Clarity of Policy Documents

Policy documents can be mindboggling with their technical terms and conditions and most policyholders often don’t go through the document in detail. It also makes it hard to understand the real meaning at times. In such cases, you have the right to demand clarity regarding the policy document wordings. You will be provided with policy documents in simple and lucid language. These simplified documents will include a comprehensive summary, illustrations, and clearly explained terms and conditions.

3. Free Look Period

A vital right of policyholders, the free look period offers a 15-day window to study your policy in detail and get an understanding of the services you will receive.

If you are dissatisfied with the service and wish to discontinue, you can do it within these 15 days. The insurance company can only deduct the charges incurred for the medicals (if any) and the charges related to the stamp paper on which the deed was finalized.

4. Policy Modification

Over time, our requirements from insurance policies tend to undergo changes. You can modify certain features of your existing policy, such as the policy term, the sum assured, the inclusions, etc. to suit your needs. However, remember that these changes could impact the premium payable.

5. Making a Claim

Making a claim against your policy is your most basic right. It is the duty of the insurance company to obtain your details, complete the paperwork, etc. within 15 days from the date of filing the claim. Your claim must be settled within 30 days if no investigation is required, and 180 days if investigation is required. In case of delays, the insurance company will be required to pay penalties.

6. Seeking Grievance Redressal

In case you are unhappy with the claim settlement process, or if you feel your claim has been rejected on unfair grounds, you can seek recourse by registering your complaints at the Insurance Regulatory Development Authority of India (IRDAI) Grievance Redressal Cell.

If you are unsatisfied with how your complaint is being addressed at this level, you can move to the higher authority, the Insurance Ombudsman, for claims under 20 lakh, and subsequently place your complaint at the consumer court. You can also choose the latter option directly without taking your claim to the Ombudsman.

While purchasing policies in the future, or for policies that you hold currently, exercise your rights and make informed decisions.

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