IRDA complaint - Health & Life Insurance Complaints

Insurance Complaints

Insurance is a means of protection from financial loss. It is a form of risk management primarily used to hedge against the risk of a contingent or uncertain loss.

It’s one of the most prominent things that ensures the user that they will be saved from a major burden. 472 million people in India have health insurance. Source

Insurance is usually brought as it gives peace to the mind of the holders. There are two types of insurance namely life insurance and general insurance. The life insurance offers compensation in case of death or disability whereas general insurance offers compensation in scenarios other than death.

Life insurance can be divided into term life, pension plans, money-back policy and unit-linked insurance plans. General insurance can be divided into motor insurance, home insurance, health insurance and fire insurance.

But no one knows what will happen next and what if you get trapped in an insurance scam? Or you are not happy with your insurance company?

Many people don’t know the exact route to file a complaint against their insurance company and often get confused about consumer rights but this article will tell you:

- What are the insurance complaints?
- Famous insurance companies in India
- Types of Insurance complaints
- How to resolve the complaints?

Yes, this article will answer all your questions. Let’s start with what exactly an insurance complaint is?

The 2017 notification on the protection of policyholders defined ‘insurance complaints’ as a written expression of dissatisfaction made by the complaint against an entity like the insurer, agent or broker.

The complaint can be about an action or lack of action, the standard of service, or deficiency of service.

Now let’s see some of the famous insurance companies in India.

Famous Insurance Companies In India

India has 57 insurance companies out of which 24 are life insurance. The following are the top 10 companies in India.

1. LIC: Life Insurance Corporation of India: LIC is the most heard insurance corporation of India. It is an investment corporation owned by the government of India and is an Indian state-owned insurance group. Having headquarters in Mumbai, It was founded on 1st September 1956 when the life insurance of India act was passed and the insurance industry of India was nationalized. They have settled 26 million claims in 2018-19 and have a total life fund of 28.3 trillion. LIC was rated as the 6th most trusted service brand of India by the Economic times brand equity survey of 2012.

2. ICICI Prudential Life Insurance: Can you guess what was the first insurance company to be listed on the Indian stock exchange? This company was the first insurance company in India to be listed on the Indian stock exchange. They started in 2001 and currently have $14 billion in assets under management. They offer long term insurance plans and work in the financial service sector.

3. HDFC Standard Life Insurance: This is a joint venture between a housing development finance corporation and standard life Aberdeen. Having headquarters in Mumbai, HDFC now has 421 branches in 980+ cities and towns in India. In 2012, it became the first private life insurance company to bring back pension plans under the new regulatory regime, with the launch of two pension plans which are HDFC Life Pension Super Plus and the HDFC Life Single Premium Pension Super.

4. Max Life Insurance: This company is a subsidiary of the public listed company called Max financial services. After the liberalization of the insurance sector, this company was founded in 2000 while the operations began in 2001. Their headquarters is in New Delhi.

Banks, individual agents, brokers, and corporate agents are some of Max Life's distribution channels. It provides linked participating and non-participating products. It also covers health, pension, and annuity. Child, protection, retirement, savings, and growth plans are offered to individuals and groups.

5. SBI Life Insurance: SBI is the largest state-owned bank in the country and SBI life insurance is the joint venture of the state bank of India and BNP Paribas. It is a public limited company and was founded in 2001. SBI Life Insurance has an authorized capital of 20 billion (US$280 million) and a paid-up capital of 10 billion (US$140 million).

6. Bajaj Allianz General Insurance: This is a joint venture between Bajaj Finserv and Bajaj Auto. It offers financial planning and security. Founded in 2001 they have headquarters in Pune, Maharashtra. To conduct general Insurance business in India Bajaj Allianz Life Insurance received a certificate by the Insurance Regulatory and Development Authority (IRDA) called the Certificate of Registration on 3 August 2001.

7. Tata AIA Life Insurance: Major Insurance companies are joint ventures and so is this. Founded in 2001 they currently have headquarters in Mumbai. The organization offers general insurance. Energy, Marine, Property, and specialized Financial covers are being covered by The commercial sector. Insurance for Automobiles, personal accidents, casualty, home, health, and travel are some of the services that the consumer insurance service offers.

8. Reliance Nippon Life Insurance: This is one of the most prominent insurance companies in India. This is a joint venture and was founded in 2001. They have their headquarters in Mumbai. The company achieved a profit of Rs. 3.80 billion. 760,000 policies were sold during 2012–13 with total managed funds valuing at Rs. 181.89 billion, They managed to do this through a wide network of distribution with 1,230 offices and over 124,000 advisors.

9. Bharti AXA General Insurance: This is a joint venture between Bharti Enterprises and Axa business group. They started their operations in 2008 and currently have 104 branches around the country. They offer various products catering to retail, rural, and commercial clients. Broadly, it offers insurance for motor and two-wheeler insurance, health and critical illness, property, student and individual and family travel, crop insurance, and commercial lines.

10. Aditya Birla General Insurance: This was established in 1994 as a joint venture between the Aditya Birla Group and Sun Life Financial of Canada. Founded in 1994 they are currently serving in 26 countries.

Yes, all these were some of the most famous insurance companies in India but everything’s famous is not always good! Is it? There could be thousands of arising problems and you can be unhappy with an insurance company for various reasons.

So let’s see some of the major types of insurance complaints that are seen among the people.

Types of Insurance Complaints

1. Policy maturity issues: Plenty of people at voxya have reported that their policy has matured but the amount has not been credited in their bank accounts yet. It is usually the refusal of an insurance company to honor a request by an individual. This is one of the most common issues reported by consumers from Mumbai, Pune, Bangalore, New Delhi, Kolkata etc, at the Voxya website.

2. False commitments: This happens a lot of times if the person taking the insurance is not checking all the formalities carefully. Misrepresentation in paper works is very easily possible and takes place on a very wide scale. Also, many times insurance agents are committing wrong details of the policy in order to get sales and meet their sales target. Thus one needs to read all the paperwork carefully and clear all the concerns carefully before taking any insurance or buying any other service in general.

3. Delays: This is also one of the most common insurance complaints seen. There can be delays in listening to your concerns or in taking an action. Even Though sometimes this issue can arise because of some internal defect but if the settlement or processing of a claim does not take place in some time then it can cause problems.

4. Unsatisfactory claim settlement: If delays are not affecting you then it can be an unsatisfactory claim settlement. We don’t always get what we demand and most of the time it can be irritating for the consumers. This happens mostly in health or medical insurance where claims are not settled in full by the insurance company. Again this type of comlpaint has been reported in almost all the major cities like Bangalore, Pune, Mumbai, Kolkata, New Delhi etc.

5. Wrong Treatment: Do you like rude behavior? No one does! Not getting your concerns listened to or just being not behaved properly can make people dislike a company. Therefore creating a good relationship with the consumer is very important.

6. Negligence: This means the failure to take proper care of something. The law of negligence requires individuals to conduct themselves in a way that conforms to certain standards of conduct. If a person does not conform to that standard, the person can be held liable for the harm he or she causes to another person or property.

As we have seen the most possible insurance disputes let’s see how you can resolve them.

How to Resolve Insurance Complaints?

Step 1: File a formal complaint with your Insurer
You can send a written complaint to your insurer with all the supporting documents that you have. The contact details of all the insurance companies are available on their policy documents or their website contact pages. You can also find all of their contact details on the Insurance Regulatory and Development Authority (IRDA). The helpline number of some leading insurance companies in India are :

LIC Customer Care Number - 022 6827 6827
ICICI Prudential Life Insurance Customer Care Number - 1860 266 7766
Reliance Life Insurance Customer Care Number - 022 4882 7000
Bajaj Allianz Customer Care Number - 1800 209 5858
Birla Sun Life Customer Care Number - 1800 270 7000
SBI Life Insurance Customer Care Number - 1800 267 9090
Max Life Insurance Customer Care Number - 1860 120 5577
HDFC Standard Life Customer Care Number - 1800 22 7227
Tata AIA Life Insurance Customer Care Number - 080676 03700

The Insurance company should address your issue in 15 days, in case of not getting the issue resolved or if you are not satisfied with the solution, you can complain to the IRDA.

Step 2: Register a complaint with IGMS (Integrated Grievance Management System) of IRDA
Once your complaint is registered you will be allotted a token reference number and you can use that number to monitor the complaint. You should visit http://igms.irda.gov.in for taking action.

Step 3: Contact an Ombudsman
Ombudsman is an official who, usually appointed by the government who investigates complaints against businesses, financial institutions, or government departments or other public entities, attempts to resolve the conflicts or concerns raised, either by mediation or by making recommendations.

The official demands evidence and all the necessary information to understand the case better and see it from the eyes of both parties. They do a full assessment and give their final assessment.

Step 4: Take legal action against your Insurance company
If nothing works out well you still have the doors open for the consumer court. You can send legal notice to the insurance company if it is unable to resolve your complaint. It is one of the efficient ways to handle the issue legally.

Check below to know how to send a legal notice to the insurance company?

i) Firstly, get a legal notice drafted by a lawyer.
ii) Check it properly and make sure it is signed by a lawyer.
iii) Keep a copy of it for future purposes.
iv) Send the legal notice to the insurance company by registered post.
v) Keep the slip or delivery report for evidence.

Step 5: File consumer forum case
Consumer forum deals with consumer complaints and you should approach consumer forum if you feel that your rights as a consumer have been violated. If an insurance company is not responding to your complaints even after sending legal notice by a lawyer then you should file a case against it in a consumer court.

Here is how you can file a case in the consumer court?

Step 1: Intimate the aggrieved party via legal notice.
Step 2: Draft the consumer complaint
Step 3: Attach all the relevant documents and proofs to support your complaint.
Step 4: Select the appropriate court for filing the complaint.
Step 5: Pay the prescribed court fee that is required to be paid along with the complaint.
Step 6: Submit the case along with the affidavit & fees in the court.

Points to Remember:
Make sure you have complained to the relevant insurance company before approaching the IRDA.
The IGMS system allows the policyholder to amend his complaint midway.

If you are finding all this information overwhelming and can’t manage to do it all alone then let Voxya help you strengthen your voice and solve insurance disputes on your behalf.

Voxya is a unique platform for resolving consumer complaints against brands quickly. We help consumers in fighting against injustice, fraud, and lousy customer service.

We use social media, business networks, and legal frameworks to resolve consumer disputes. We take every consumer complaint personally and ensure that we do everything that we can to get the consumer complaints resolved.

So why take so much trouble, if you have the solution just some clicks away!
Get your complaint resolved. File your Insurance Complaint at Voxya now!

Most Common Issue Reported for Insurance Complaints

Policy issues

Policy maturity issues

False commitments

Fake insurance policy

Not settling my claim (Cpp Assistance Services Pvt Ltd ) ^Open

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Jul 24, 2022 by SUYASH TRIPATHI

Cancle policy (icici insurance) ^Open

...

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Refund money back bajaj allianz (BAJAJ ALLIANZ HEALTH INSURANCE) ^Open

Bajaj allianz fraud company I want refund back customer support very dirty and properly respond fake...

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Not able to take loan (Mpokket) ^Open

I have paid the mpokket loan of ...

Apr 24, 2022 by Max Milian

28 m0m 9k (->0$@/ @5( ,@.> (?. 6>> (M(L) ^Open

*M*@.>( .*K&/ * **M* *G '? > *./ *K /> *H *G?( -@ $ *.G *I*?*@ ,I(M! *M*>*M$ (*@ *A *H K *I*?*@ ,I(M! *M*>*M$ *A %> *.G (>. * .M* *$ %@ **@ *(G G *? ...

Apr 19, 2022 by PRADEEP KUMAR GUPTA

Fake commitment of Company (Star Health And Allied Insurance Co Ltd ) ^Open

Dear sir, Greetings for the day I had purchased a Health plan from company Star health and Allied insurance co Ltd. When I submitted documents for reimbursement claim Firstly they send a mail and post letter as well as for cance...

Feb 17, 2022 by Aman Kumar Sainy

Fraud on insurance loan (Shriram Finance Vijayawada) ^Open

Shriram finance company called and asked if i needed a personal loan, if needed they asked me to take policy with Shriram life insurance. I have taken the policy and submitted the loan documents to process the loan in the month of November but...

Feb 01, 2022 by Abinaya

PREMIUM DEBITED INSTEAD OF PRIOR INTIMATION TO COMPANY (Bajaj Allianz Life Insurance ) ^Open

I asked Bajaj Allianz to stop my premium payment which is ECS/SI method on **/**/**. They raised the ticket and assured me they will not debit the premium during the month of December but Instead of this they have debited the Amount from my Ban...

Dec 28, 2021 by MALAY CHAUREY

Future maker life care Pvt Ltd (Future Maker Life Care Pvt. Ltd.) ^Open

Invested ****** rs in FMLC but not a single rupee got in return as the director and chairman of the company got arrested by telangana ED. Pls help me to get my money back. ...

Nov 26, 2021 by Uday Baburao Mahajan

Harassment and unfair business practices of LIC (LIC) ^Open

I, a senior citizen of Bharat, applied to LIC for loan against my fully paid policy no.********* in Jan'**. LIC asked me to submit documents physically. As per the Govt's SOPs, the senior citizens should not go in public and risk their lives in...

Nov 02, 2021 by UDAY BALKRISHNA JAMBHEKAR

Mis Sale of insurance Policy (Future General India Insurance Company Limited) ^Open

Below Claims Were Promised By Your Agent - Health Insurance Of Rs ****** Will Be Covered As Part Of This Policy - If Insured Person Dies Due To Any Reason, Nominee Will Get Sum Assured And Policy Will Continue For The Whole Policy Period And ...

Oct 29, 2021 by Kranthi Kumar

False policy commitments (Iifl Insurance Brokers Limited) ^Open

Insurance agent called me from IIFL and explained about Bharti Axa Elite Advantage. Below things he has mentioned. Policy will be covering up to *.* lacks of hospitilaztion charges annually which includes me and my parents. Policy term * yea...

Oct 11, 2021 by Preetam Huddar

Wrong plan sold to noneligible customer (Tata AIA Life Insurance ) ^Open

I am writing on behalf of my father, Shri Sailendra Nath Banerjee, Age - **. I want to raise a severe grievance and complaint against HDFC Agent Bhagyashree Basak (B****) and TATA AIA Agent Onker Bose (Employee ID -*******) who together misg...

Sep 25, 2021 by Mohona Banerjee

Death claim rejected by sbi life insurance (Sbi Life Insurance Company Ltd) ^Open

My father visited sbi bank branch to do a FD but their agent mr Roushan forcefully and deceively done sbi life smart wealth builder policy in the name of my father who is no more now.policy was of ****** insured.we paid all premium on time also...

Sep 13, 2021 by Ajit kumar

Insurance Claim (Times Global Assurance) ^Open

I Ve Taken Mobile Insurance *year Cover On Sep-* **** I Called Abhishek +************ For Further Assistance He Said Mail To Support@Mymobileinsurance.Com & I Mailed But No Responce Till Now & Even Calls Are Not Answering... I Contacted Samsu...

Aug 10, 2021 by Seetharamarao ravulapati

Car Claim Is Rejected (Bharti Axa General Insurance ) ^Open

Respected sir /Madam, I have purchased Insurance policy Online from Bharti axa general Insurance website: https://www.bharti-axagi.co.in/ on dated **-**-**** for my Car Maruti Suzuki Baleno (GJ**-BH-****). The policy no. is SC******. Due to ...

Aug 10, 2021 by jatin Vankar

Mediclaim reimbursement is not cleared (Universal Sompo General Insurance) ^Open

My Mediclaim reimbursement ID ****** is not cleared from since last * months has gone ,, even though i have intimated within ** hours and i have already send original documents file as well as scanned copy to their registered office...i am very...

Aug 09, 2021 by pratik shah

Insurance Claim Rejected without reason (ICICI Lombard Insurance company) ^Open

Hi, I’m Sumalya Barman, a Fashion and Graphic Designer. I wanted to shift from Hyderabad to Tamluk, WB, ******, thus I contacted Ekta Packers and Logistics. They came to my Hyderabad House on **th May’** and took away my belongings and hand...

Jul 17, 2021 by Sumalya Barman

HDFC ERGO (HDFC Ergo General Insurance) ^Open

It is very unfortunate to know that your insurance company is looting by quoting double the car insurance premium than previous year. After mailing multiple times, I did not receive any response from the customer support team. Why has the OD pr...

Jun 17, 2021 by Abhai Bajpai

Delay in settle my Critical Illness Heart Cancer Cover Claim (Icici Prudential Life Insurance Company Limited) ^Open

More than ** months Delay in settle my health claim for Critical Illness cover under ICICI Pru iProtect Smart Term insurance & Heart/Cancer Cover under ICICI Prudential Life insurance co. After heart attack I had submitted raised claim form o...

Jun 09, 2021 by Jashim Debbarma

Forcing to pay insurance fee which i dont want (RBL bank credit card) ^Closed

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Jun 29, 2022 by Rajeeb Tamudia

Insurance no rnp2111205021998 vailid date 06112021 05112022 (LG WATER PURIFIED ) ^Closed

&*M* $* >* **,*&@ %>(> .>(*A* .H *>* *? **@ +>/* > AMC */* G *? (M*A*G* **>/> %> **** *A*/G > ?*> *H*?! **/**/**** *G **/** /**** *H -@ *?M* .% *A .G.*G( ^?*M* &K ,>* G *A *H ?*.G *(@ ONE /*M* G *? (M*A*G* **>...

Jun 22, 2022 by adrash antash

Refund insurance (BAJAJ ALLIANZ HEALTH INSURANCE) ^Closed

I want refund money from Bajaj allianz fake company and dirty company kindly against him script action...

Jun 17, 2022 by Deepak Ojha

ECS refund not processed (Max Life Insurance) ^Closed

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Jan 01, 2022 by Manish Arora

Insurance imposed on me (Sbi) ^Closed

Insurance imposed on me...

Dec 12, 2021 by Shishu Kumar

Maxlife denying to provide surrender value amount (Max Life Insurance) ^Closed

I am a Maxlife policy holder and I have completed * year with the policy on * September ****. Due to some financial reason I planned to surrender the policy. At the time of opting for the policy I was informed by Maxlife Agent that in any ca...

Nov 01, 2021 by Wasim khan

Fraud by max life insurance and Yes bank agents (Max Life Insurance) ^Closed

I had opened my salary account with yes bank agent Ved prakash. After some some time , he brought an yes bank agent with him both of them convinced me that I should buy max life insurance policy with premiumof ***** rs quarterly. The terms expl...

Oct 09, 2021 by Atul sain

After payment of term insurance no action has been taken (Policy Bazaar) ^Closed

I called policy bazar and enquired about various term insurance plan. After assurance by policy bazar that medical test faciity is available in Dharmanagar, i made payment of **** on *th of September ****. Thereafter i got a call that medical...

Sep 13, 2021 by ABHISHEK KUMAR

Toomuch Delay in repair claim (Times Global Assurance) ^Closed

I ve taken mobile insurance *year cover on sep-* **** In feb **th **** i noticed some lines on my display & i called abhishek +************ for further assistance he said mail to support@mymobileinsurance.com & i mailed but no responce till n...

Apr 02, 2021 by Seetharamarao ravulapati

PNB METLIFE FROUD POLICY (PNB Met Life Insurance) ^Closed

I am Sanjay Babulal Kudale, a policy holder of PNB Metlife. on the basis of pnb metlife executives (Mr.Rishab Verma) explanation i had purchased policy on the date of **.**.**** (policy number-********)(Client ID-********). till date i didn't...

Apr 01, 2021 by SANJAY KUDALE

Cancel this insurance (R Shield Insurance Premium) ^Closed

I have been calling to cancel this insurance,but bank is not taking any action. Customer executive said I will get a call regarding cancellation,but they are very expert in giving misscall. Call comes and get's disconnected. Please help me to c...

Mar 19, 2021 by Lokendra Khatri

Refund not progress (Medlife) ^Closed

Plz issue my refund Medlife refund nhi kaarhi h * month hogyaa.....

Mar 12, 2021 by Avinash goyal

HDFC Ergo scam (HDFC ERGO General Health Insurance Co. Ltd) ^Closed

I opened policy **************** on September,****.I provided credit card for easy EMI debit.My credit card got expired on December and i asked them to update new card details.They confirmed they did it.But in December they didnt take EMI from ...

Mar 05, 2021 by shaaeli gupta

Max Life insurance cheating NRI customers (Max Life Insurance Co Ltd) ^Closed

I am NRI customer of Max Life Insurance. In October at the insistence of my Yes bank manager, I was forced to buy a policy No. ********* (Max Life Smart Wealth Plan) from Max branch No. BYDA* using my NRE account fund. While selling the policy,...

Dec 11, 2020 by Sujit C

Claim not settled 4 months since registered worst UNITED INDIA INSURANCE (Policy Bazzar) ^Closed

Dear team, I had a claim for motor accident on united india insurance limited * months ago. the claim amount has not been settled still, though it has been more than * month since documents submitted. There has not been a single reply to a...

Nov 04, 2020 by Gopi prasanth

POLICY BAJAAR (POLICY BAJAAR) ^Closed

Manoj Agrawal <nainynaman**@gmail.com> Oct **, ****, **:** AM (* day ago) to care, customercare It is disgusting that Tata Aia and Policy Bajaar both are cheating to genuine applicant for insurance. Firstly a sales representative sugges...

Oct 30, 2020 by SANDHYA AGRAWAL

LIC Policy matured not repayed (LIC HFL) ^Closed

I have taken a ** year policy in LIC and is matured now after ** years. The policy is attached to the loan taken in LICHFL. The maturity amount is not credited to the Loan even after several request to close the loan with the policy matured am...

Aug 26, 2020 by Manivannan R

Policy Premium Paid But Is Not Updated (CIN Policybazaar Insurance Brokers Private Limited formerly known as Policybazaar Insurance Web Aggregator Private Limited ) ^Closed

I had purchased Insurance of Bajaj Allianz Life (Policy number-**********) & Hdfc Life (Policy number-********) through the Insurance aggregator Policy Bazaar and as usual my amount was deducted from my account every month but in the month of A...

Aug 25, 2020 by Dhiraj Chhetri

Deduction of mediclaim approval amount (THE NEW INDIA ASSURANCE CO. LTD.) ^Closed

Instead of informing the TPA more than ** hrs prior to hospitalization, they deducted **% of total estimated amount by the hospital. Reason is mentioned by the TPA that I've not inform them **hrs before. Before admitting my mother also I asked ...

Aug 23, 2020 by Sanjay Nath

Surrender Policy (Bharti AXA Life Insurance) ^Closed

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Jul 15, 2020 by RAVI PRATAP SINGH