06 · Banking, Finance & Insurance
Insurance Disputes
Insurance disputes arise when an insurer rejects, delays or under-pays a claim under a life, health, motor, property or other policy.
What this covers
- 01Repudiation of claims
- 02Health and medical insurance claims
- 03Motor and property insurance claims
- 04Life insurance claims
- 05Complaints before the insurance ombudsman and consumer commissions
How it generally works
A complaint is first made to the insurer's grievance cell. If unresolved, it can go to the Insurance Ombudsman, which deals with claims up to a set monetary limit, or to a consumer commission for deficiency in service.
Common issues include alleged non-disclosure at the proposal stage, exclusions in the policy, and the reasonableness of the amount assessed.
The policy document, proposal form and correspondence with the insurer are the key documents.
