Policy Cancellation, Grievance Redressal And Three Other Rights Health Insurance Buyers Can Exercise

Purchasing a health insurance policy is insufficient. It is also critical to understand your rights as a buyer. The IRDAI has established certain rules for insurance businesses to follow. Learn about them in order to assert your legal rights.

As crucial as purchasing a health insurance coverage is understanding your rights as a health insurance customer. This is due to the fact that, no matter how well-regulated and organized the insurance market is, bad actors exist everywhere. And the best approach to deal with them while protecting your interests is to be aware of your rights in this respect, which you may exercise.

It is also crucial to emphasize that conflicts with insurance companies are no longer a lost cause. There is sufficient precedence in recent times when court judgements have been issued in favor of insurance purchasers who battled for their rights, whether it was against overcharging in the name of insurance premiums or delay in claim payment.

The following is a comprehensive list of the rights that every insurance buyer has.

1] Right to get all policy information: Under the Insurance Regulatory and Development Authority of India (IRDAI) standards, you have the right as an insurance buyer to request all policy information from your insurance provider. The insurance provider is responsible for answering any of your questions about the policy’s features, benefits, eligibility conditions, and premium amount.

You also have the right to request an IRDAI-approved insurance rate chart to determine whether or not the insurance firm is charging you a reasonable price. Be a knowledgeable buyer, and if you believe you are being overcharged, use the premium table.

2] Right to cancel the policy within 15 days of policy issuance: Every health insurance coverage includes a 15-day free-look period if bought offline, and a 30-day free-look period if acquired online. During this time, you have the option to cancel the coverage if you are dissatisfied with its terms and conditions. No insurance company may refuse such a policy cancellation, and it is obligated to refund your money after making the appropriate deductions. These deductions may only be used for insurance coverage supplied during this time period, stamp duty expenditures, and, if applicable, medical test fees.

It is vital to remember that the free-look time begins on the day the policy paper is delivered to you. So, if your insurance agent has purposefully delayed the issuing procedure, you need not be concerned since the delay will not impact any of your free-look period privileges.

3] The right to receive a response within a specified time frame: To ensure that an insurance policy serves its true purpose of providing relief to its buyers in difficult times, the IRDAI has established timeframes for the completion of various requests that a policyholder may make to the insurance provider. As an insurance buyer, you have the right to have the following requests handled within the time frame specified below.

4] Right to policy renewal: Under IRDAI rules established in March 2009, no insurance firm may refuse to renew your health insurance policy, whether on medical grounds for elderly persons or owing to a high number of claims filed in the preceding year. You have the right to renew your policy as long as there is no proof of fraud, misrepresentation, moral hazard, or the insurance company did not specify the renewal age restriction at the time the policy was issued.

5] Right to remedy grievances: If you are dissatisfied with any of the insurance company’s terms or processes, you have the right to submit a complaint with them. If the insurance provider is unable to resolve your grievances or complaints satisfactorily, you have the option of reporting the situation to IRDAI using its online portal, the Integrated Grievance Management System (IGMS).

Be an educated insurance buyer and be aware about all of your rights in this respect. This will not only protect you from unjust treatment, but will also offer you with peace of mind, which is one of the most treasured commodities in today’s hectic world.