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

Cheating from Bharti Axa Life Insurance Company (Bharti AXA Life Insurance company) ^Open

I K.Prabhudhan Reddy have been cheated by Bharti Axa Insurance agent. I have asked for a single premium policy to support for my daughters wedding in ****, but the agent has cheated me with annual term premium policy. I haven't received my mon...

Jan 24, 2021 by Kaluva Prabhudhan Reddy

Cheating from Edelweiss Tokio Life Insurance Company Limited (Edelweiss Tokio Life Insurance Company Limited) ^Open

I K.Prabhudhan Reddy have been cheated by Edelweiss Tokio Life Insurance agent. I have asked for a single premium policy to support for my daughters wedding in ****, but the agent has cheated me with annual term premium policy. I haven't recei...

Jan 24, 2021 by Kaluva Prabhudhan Reddy

Cheating by Reliance Nippon Life Insurance (Reliance Nippon Life Insurance Company Limited) ^Open

I K.Prabhudhan Reddy have been cheated by Reliance Insurance agent. I have asked for a single premium policy to support for my daughters wedding in ****, but the agent has cheated me with annual term premium policy. I haven't received my money...

Jan 24, 2021 by Kaluva Prabhudhan Reddy

Cheating by Future Generali Life Insurance (Future Generali Life Insurance) ^Open

I K.Prabhudhan Reddy have been cheated by Future Generali Life Insurance agent. I have asked for a single premium policy to support for my daughters wedding in ****, but the agent has cheated me with annual term premium policy. I haven't recei...

Jan 24, 2021 by Kaluva Prabhudhan Reddy

LIC (Vaibhav Pariwar India Project LTD) ^Open

This is a type of LIC .We paid amount ₹***** in **-**-**** and the company promise to give amount ₹****** in **-**-**** .The company never phone or message regarding this please help us my mobile number is **********....

Dec 22, 2020 by HAJRA BEGAM

Star health Claim Issue (Star Health And Allied Insurance Company Limited) ^Open

My mother was under Star Health Insurance and she has been hospitalised for treatment of severe covid infection on **/**/**** at RTIICS, Kolkata. Our whole family was also corona effected at that time. After a huge mental stress and long serio...

Dec 03, 2020 by Debdatta Marik

Insurance Claim Not Received (Tata Aig General Insurance Company Limited) ^Open

On */**/**** My bike was stolen. After That, I Follow All the Steps to get my claim disbursed but Tata Aig Agent Keeps Fooling me that I will take time and spend * years but still I haven't received my claim.Even still they are fooling me that ...

Oct 27, 2020 by Amit Kumar

Unexpected Amount Deducted by Aditya Birla Sunlife Insurance (ADITYA BIRLA CAPITAL PVT LTD) ^Open

On *st of October an unexpected amount of *****.** INR was deducted from my account, I filed a complaint in HDFC bank and to Aditya Birla Sunlife. I got a response from HDFC bank saying it was deducted as per the mandate form submitted for Pol...

Oct 12, 2020 by Subroto Bhattacharjee

INSURANCE NOT SETTLED (HDFC ERGO General Health Insurance Co. Ltd) ^Open

Sir, With reference to C************ , damages have been done of approx **,***/- amount but only ****.** approved and I have paid an additional ****/- amount to the Garage owner. The amount that HDFC Ergo has approved (****/-) will recover ...

Oct 12, 2020 by dkmevawala

Scammed by bank and insurance company (Tata AIA Life Insurance ) ^Open

Bank officials lied and said inwas investing in a bank investment that came with an insurance policy and I could take out my money any time but reality is it was a life insurance policy that they mailed to an address I didn't live at so I could...

Oct 05, 2020 by Louise Jackson

Complaint against Renault car service centre (Renault) ^Open

Dear Sir/Madam, Last year **** i have gone to this service center for car service, they have put car horn and hazard light in my car alongwith service without my permission, but hazard light and horn was ok before car service, and at the tim...

Oct 03, 2020 by Madan mohan sharma

Bajaj mobile insurance not making claim payment (Bajaj Allianz General Insurance) ^Open

Claim raised **/*/** Policy No OG-**-****-****-******** Claim No ********** Claim history *) on **/**/** my phone display was damaged due to an accident. i opened a claim on bajaj app, i got call for same on same day and they have asked m...

Oct 02, 2020 by Vikas Jeenagar

Maturity amount Rsnot received after the completion of Policy tenure Certificate of property fromREF (Alchemist Township India Ltd.company) ^Open

This is to bring to your kind notice that I had invested money in Alchemist Township India Ltd. scheme of Rs. *****/= (Rupees Forty thousands) dated **.**.**** for a period of * (Six) years with maturity date of **.**.**** towards a “Certific...

Sep 22, 2020 by Ranjan Bhaumik

Fake commitment at the time of paying premium (National Insurance ( Medicare ) T P A SERVICES(I) Pvt Ltd) ^Open

Hello, iam an infosys employee. I was informed by the insurance company company that you can add dependent by paying premium. i have paid premium approx **,*** and was informed on our website network hospital are cashless. when i searched josh...

Sep 15, 2020 by Puneet Sabhlok

LIC paying less amount on matured policy not as promised on taking Policy (Life Insurace Corporation Of India) ^Open

Hi, I took the policy on female child keeping her feature in mind for Higher Education and marriage. At the time of taking policy, the agent assured and guaranteed a Sum of Rs.*,**,***/- while taking Policy in the year ****. But receiv...

Sep 14, 2020 by Ragumoorthy K (F/O R Rajalakshmi)

Cheating Car Insurance IDV Value (Bharti Axa General Insurance Company Limited) ^Open

Have received a quotation towards renewal of our car insurance from M/s Bharti AXA General Insurance Company Ltd., as per the quotation it is clearly mentioned IDV Value of Rs.******/- for which a premium amount of Rs.*****.** was paid thru onl...

Aug 18, 2020 by M Srinivas Rao

Mobile insurance not covered (Times Global Assurance) ^Open

I took three years insurance of mobile from my mobile insurance dot com Mr. Karan assured me over mail that refund of repairs will be credited in the account. But the same is not credited todate....

Aug 14, 2020 by Bharat jayaswal

INSURANCE CLAIM (ORINTEAL INSURANCE COMPANY) ^Open

I am Mrs. Priyanka Agarwal Partner in M/S. Jajodia Roadlines, Hyderabad. We have purchased new Ashok Leland vehicle ** Feet MXL in the month of Nov **** from Ganganagar, Rajasthan. The same has been insured at The Oriental Insurance Ltd. The ...

Aug 14, 2020 by priyanka agarwal

About mediclaim renewal (The New India Assurance Co Ltd) ^Open

i am a policy holder of the new india assurance co ltd from more than ** years. but due to the lock down and my shifting from ahmedabd to vadodara , i was not able to pay my renewal also courier and other sources were not working. now i request...

Aug 04, 2020 by gunvantlal bapalal rasania

Capping on health insurance claim (United India Insurance Company Limited) ^Open

Need help in raising my complain to complaints@irda.gov.in. I have a valid insurance policy with sum assured of * lacs and paid regular premiums for * years. When my Dad was hospitalized, company capped the bill amount to **,***/- and breaki...

Jul 17, 2020 by Salil

SBI Policy Refund (State Bank of India ) ^Closed

Hi, I have three policy brought from SBI agents in the year **** state here *) Policy Number *W********* (**/**/****) *) Policy Number- *R*********(**/**/****) *)Policy Number- *N*********(**/**/****) Due to my personal financial issues I with...

Dec 03, 2019 by Madanu Lucas

Maturity amount not received for me (Adarsh Credit Co Operative Society Limited) ^Closed

My policy is mature but payment not given me by the society...

Dec 01, 2019 by Yeah change bansal

Twice the amount credited (Bharati axe insurance ) ^Closed

Due network problem. Two times amount was debited in credit card. ...

Nov 15, 2019 by Muthumari

Accidental bike claim amount not received (Hdfc Ergo General Insurance Company Ltd) ^Closed

I have met with an accident on ** Aug **** while coming towards my resident in Meerut Cantt Area between Railway Phatak and RAM Canteen Road. In that accident I got some minor injury in my leg and shoulder and my motor cycle badly damage. A...

Nov 14, 2019 by Amar Parl Singh

Policy not issued (Wise Finserv Private Limited) ^Closed

I have paid INR ******.** on **th Aug **** towards issue the insurance policy of Max Life. The executive from WFS Mr. Vivek told me that policy will be issued within a week's time and a soft copy will be sent on email. But after more than a mon...

Oct 01, 2019 by Ramesh Choudhary

Medical policy claim not Reimburse (Creater Infotech ) ^Closed

Creater infotech & Bharti AXA advisor Mrs Poonam are not settling my claim waiting from *th August **** All original document for claim were submitted to Mrs Poonam through nasik DTDC courier and received by her. But after that don't kno...

Sep 21, 2019 by Rahul Karbhari Sonawane

Fraud by max life insurance (Max Life Insurance) ^Closed

We purchased the policy from max life insurance with policy no. Policy No. : ********* from axis bank Matak Majri Indri Karnal. On purchase time axis bank manager mislead us to pay three premium of nearly ***** each which we pay on time. He tol...

Sep 02, 2019 by Sunil Nagpal

My claim rejected by TPA of insurance company (New India Assurance) ^Closed

I submitted my medical-claim after emergency hospitalization but to my utter dismay, the TPA rejected my claim giving unconvincing reasons. i) When asked for further elaboration on the reasons given for rejection the TPA changed tacks and st...

Jun 19, 2019 by Menath Rajgopal Krishnan

Cyber crime by the company (Bajaj Finserve) ^Closed

My Bajaj card limit used for ***** by Flipkart and my EMI is cutting from my account without informing me. How can it happen? Its a type of cybercrime with me....

May 14, 2019 by Vishal madaan

Package delivered but not fulfilling the promises (Investment Reasearch Advisor) ^Closed

I paid ***** Rs to this company first. They told me to get registered with the company. After that, they offer me a package which is costing *.* lakh. I denied for that package that I said I cannot afford so please leave me. Then Ms Rajesari tr...

May 06, 2019 by G RAJENDRA PRASAD

Insurance fraud done (syncNscan) ^Closed

I brought mobile insurance from syncNscan online and followed all the instructions provided to complete insurance registration. After that, I am trying to contact the company on their customer support no. They said all over customer services ar...

May 02, 2019 by SandeepKumar Verma

Non receipt of household claim (New India Assurance) ^Closed

I have a household policy at New India Assurance Company Chittur, Palakkad branch. My policy number is ********************. Yearly premium is ****. On **.**.**** my Godrej air conditioner outdoor unit compressor failed. I informed the branch b...

Apr 30, 2019 by MURALIDAS A

LIC agent sold policy by providing wrong information (LIC) ^Closed

I had given ₹***** to the agent named Vickey from Vikaspuri Delhi (mob. no. **********) for buying * policies of ***** (approx) New Jeewan Anand *** for a period of ** years. But when I received the policies, they were of ₹***** (policy no....

Apr 28, 2019 by Bhupendra Singh

Unnecessary charges levied by Company (Bajaj Finserve Ltd) ^Closed

I had a Home loan from Bajaj Finserve. I wish to close down it and for the same I have requested the company to provide me with the foreclosure amount letter on **nd Mar ****. Even after multiple follow-ups on emails and customer care I did not...

Apr 27, 2019 by Marcellus Joseph

Harassment and miss selling (Ndm Bajaj) ^Closed

I want to register a complaint against the oriental insurance company ltd and NDM bajaj agency Chandigarh. I bought Bajaj Pulsar NS *** from NDM Bajaj dealer Chandigarh industrial area phase *on **/**/****. They gave me an insurance policy issu...

Apr 25, 2019 by Avinash Kumar

Poor customer support (Bajaj Finserve) ^Closed

I have * ongoing loans from Bajaj Finserv. My monthly EMI goes around ****. I requested bajaj to change my EMI dates so that I can pay the EMI on time without any hassle because my salary date is late where I work. But they charged fine for eve...

Apr 25, 2019 by Paulina Khess

Victim of chits (Shriram Chits ) ^Closed

My mother opened chits of * in Shriram Chits Fund Company stating Rs. ****** of ** months EMI. After a bid of Rs. ****** they deducted Rs. ***** as insurance for each respective chits. We received Rs. ******. We paid ** months EMI of approx Rs...

Apr 23, 2019 by Chintada satish

Cheated by the company (Deal Money) ^Closed

Sub:- Regarding cheated by Deal Money for selling the health product for resolving my dispute life insurance of different ** company now these all products to be returned back and release the amount to undersigned With the reference of above s...

Apr 18, 2019 by PARTHA BEJOY CHATTERJEE

Back my amount (SBI Life Insurance ) ^Closed

sir this is my police details my policy is lapes my total amount ****** rs something iam also paid by premium per months but sbilife insurance told your total amount is lapes anything are not so please help me registered my complement...

Jun 06, 2018 by Sanjay Pal