How to Tackle Life Insurance Claim Rejection? - PNB MetLife

Life Insurance Claim Rejected? Here’s what you should do

PNB MetLife 14-08-2018 04:23:39 PM
Life Insurance Claim Rejected? Here’s what you should do.

Your decision to purchase a life insurance plan stems from the desire to facilitate necessary  financial support when the need arises. But there may be multiple reasons why your life insurance plan’s claim might be rejected. If your claim is rejected – we suggest a few reactive steps to control the situation and gain the benefits of your life insurance policy.

These are the three main reasons why your claim might be rejected. Keep these points in mind when you buy your policy.

  1. Lapse – If your policy hasn’t acquired any paid-up value and you stop paying your regular premiums, then your policy will lapse once grace period for payment also has expired. A lapsed policy does not offer any life insurance cover. For the sum assured to be paid, the policy must be an active in-force policy. Call your life insurance provider to discuss options if you have missed out on payments.
  2. Material misstatements – If you have misrepresented yourself when you were purchasing your life insurance plan. You do not want to lie about age, chronic diseases or smoking history.
  3. Type of death is excluded from coverage – Some specific life insurance policies exclude certain types of death like suicide in the first year etc. So, always be aware of the specifics of your life insurance.

Now, if your claim has been rejected by the insurer, follow the steps below – 

  • Get in touch with the Customer Service Department of the insurance company.
  • If you are not satisfied, provide a written complaint to the Grievance Redressal officer of the insurance company. Keep a written proof and acknowledgement of your complaint with dates.
  • Provide all your necessary supporting documents in original but do remember to keep a photocopied set with you.
  • If the insurance company fails to address your complaint to your satisfaction, then a policyholder or the nominee can reach out to the Insurance Regulatory and Development Authority of India (IRDAI).
  • Complaint should be forwarded to IRDAI by email to complaints@irda.gov.in. They can also be mailed to the head office situated in Hyderabad. They should be compact and clear. 
  • IRDA has also created an Integrated Grievance Management System (IGMS). Policyholders or their nominees can use this grievance management system to not only register but also track their complaint with IRDAI and the insurance company. This allows all your claim documentation and written proof in an integrated system and creates a solid appeal.

Policyholders should be aware of their rights which will help them to take the best decision for future and get a suitable policy.