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

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

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

Denial of Genuine Health Insurance claim ID (Max Bupa Health Insurance) ^Open

Me, Sunil Kumar Baburam Srivastava and my wife , INDU SRIVASTVA are covered by health insurance policy no. **************( valid till **.**.**) for a sum of ** Lacs and ************* (valid till **.**.**). She COVID infection confirmed by RTPC...

May 20, 2021 by Sunil Kumar Srivastava

My car clime is rejected (Liberty General Insurance) ^Open

General My name is NS RAJU, ( this ls my wife car her name is narra veena ) My car no is TS **HE****, policy no is************************,this month **th my car is damaged due to when parking at my apartment,causes car right tail lamp an...

Apr 27, 2021 by N shalem raju

cancelled this insurance policy (R Shield Insurance Premium) ^Open

I don't active any insurance policy but they debit****form my RBL credit card so kindly request to you please cacelled this insurance policy....

Apr 14, 2021 by Sanjay kallu manjulkar

Complaint against the Insurance company ICICI Lombard General Insurance Company (Complaint against the Insurance company ICICI Lombard General Insurance Company ) ^Open

Sub: Complaint against the Insurance company (ICICI Lombard General Insurance Company). Sir With reference to the aforesaid subject, I would like to submit the following facts about the fraudulent activity and deficiency of service of ICICI L...

Apr 06, 2021 by Ved Prakash Saini

Unable to claim warranty properly (Msi) ^Open

MSI after-sale service is so bad. As the graphic card/Video card isn't working while in the warranty period, I have sent it to the service from the authorized service center (Vijayawada, A.P). MSI service provider isn't resolving the issue and ...

Mar 23, 2021 by Sai Chandu

Close my account (R Shield Insurance Premium) ^Open

Plz my R shield Insurance premium Cancellation Plz refund my cash ......

Mar 23, 2021 by Akib Ayub Nadaf

Third party Insurance Claim (Sushila Transport Pvt Ltd) ^Open

I mrs. Janaki Ramanjali W/o. B V Sanyasi Rao Residing at Kasturi Nagar *st Lane, Po/Ps-Rayagada, Dist-Rayagada. Pin ******. Ph No :**********. We are proceed from Rayagada to Rajamundry in NH-**. One of the truck hits our Car. vide truck nu...

Mar 19, 2021 by P Manjubala Sree

Illegal Denial of Service and Cashless Claim (SBI General Insurance) ^Open

SBI General unfairly and possibly illegally denied us Cashless treatment service in a time of Emergency, their treatment without explanation has caused us a lot of mental and financial distress. ...

Feb 18, 2021 by Soumitra Choubey

PMFY not giving (Agriculture Insurance Company Of India Limited) ^Open

I bought PMFY Bima Policy in **** and I claim it but company does not give anything ...

Feb 03, 2021 by Vijaysinh Chudasama

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

श्री मान जी मैंने फरवरी महीने मे Bharti Axa life Elite Advantage Policy No.: ***-******* saving purpose के लिये ली थी। जिसका मैनें साल...

Jul 15, 2020 by RAVI PRATAP SINGH

Aditya birla finance not giving Moratorium relief on EMI and presented ECS on bank (Aditya Birla Finance Limited) ^Closed

Due to covid **, I have applied for a Moratorium for the month of June, July and August ****,As per the RBI latest notification on **nd May ****. Almost over ** emails and tons on calls, Aditya Birla Finance Limited is not giving me any morator...

Jul 15, 2020 by Abhishek Yadav

Fraud agent took money but didn t provide policy (Lic Of India) ^Closed

Lic agent Ajeet Kumar Tripathi took Rs. **,*** from me for one policy but till date he didn't deliver policy. Now I doubt whether he has filed policy or not. ...

Jul 13, 2020 by Priyanka Madan

Fraudsters call me to know my details (ADITHYA BIRLA CAPITAL PVT LTD) ^Closed

** days before I raise my request for personal loan in Adithya birla finance site...and today I got a call from +************ and they said they calling from Adithya birla group regarding my loan request..and they want to send my personal detai...

Jun 27, 2020 by Anvesh kumar reddy

Sold insurance on false promises (Reliance Nippon Life Insurance Company Limited) ^Closed

Life insurance policy was sold by the company based on false promises. First the policy seller lured my parents by telling that come to a place(office) to claim a prize and to take it. Then after reaching there, they started persuading for po...

Jun 15, 2020 by Bibekanand Thakur

Amount Refund (Max Life Insurance) ^Closed

Hi, I took an Insurance premium during **** in Max Life Insurance.I paid one premium at the start and the next year I was not able to due to medical emergency of my grandparents. I have approached the Max Life office in Salem,TamilNadu fe...

Jun 07, 2020 by Santhanuraj

Regarding serious discrepancies in Health Insurance policy agreement (Policy Bazzar) ^Closed

I have purchased a health policy# ****/********/**/*** under the name of Mr. Ramesh Chandra Rawat(self) and my wife Mrs. Anita Rawat for * years dated **nd March **** from Policy Bazaar (people advisor was Gaurav Mehta PW*****). At that time w...

Apr 05, 2020 by Ramesh Chandra Rawat

Vehicle Insurance Policy details not reflecting in RTO site (ICICI Lombard Insurance company) ^Closed

I am unable to apply NOC for my vehicle due to renew policy number is not reflecting in RTO Vahan portal. I checked with insurance company they asked is pending with RTO team but RTO authority said to check with insurance company. I have renewe...

Mar 11, 2020 by SOUMYA RANJAN

CLAIM REJECTED (STAR HEALTH CO ) ^Closed

To, consumer forum court jamshedpur jahrkhand i like to lodge a case against star health insurance co because they reject my claim with wrong reason also bimalokpal given worst decision in favor of star health insurance co. ...

Mar 09, 2020 by NIKHAT BANO

Health Insurance Claim Not approved (Mediassist) ^Closed

I have submitted Health Insurance claim from Mediassist from **st August,**** on behalf of my parents who are retired HAL Personnel. I have been following up with them for the same but they are not giving me any response and they are delaying t...

Jan 30, 2020 by Swayamsiddha

Mediclaim rejected by company (Oriental Insurance Company Ltd) ^Closed

My wife has undergone a surgery of umlical hernia at Shri Sankalp Hospital, Raipur. I had paid * years of medical insurance premium and now they have repudiated my claim. please help...

Jan 27, 2020 by Amit Kumar Dewangan