‘Claim Rejection, Inflexible Policy Terms’; Govt Flags 6 Issues Of Insurance Sector; Check Details

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Edited By: Namit Singh Sengar

Last Updated: February 11, 2023, 16:54 IST

Currently, more than one-fifth of the total consumer complaints are pertaining to the insurance sector across the country.

The insurance cases pertain to mediclaim and health insurance to travel, life, home, car, marine, fire and crop insurance.

The union government has flagged six major issues, including ambiguity in insurance contracts and inflexible policy terms, before regulator IRDAI and other stakeholders, and urged them to address those to reduce the huge pendency of consumer cases.

Insurance Regulatory and Development Authority of India (IRDAI) is the insurance sector regulatory body of India.

The other issues raised before the key stakeholders include lack of powers delegated to representatives of insurance companies to take decisions during out-of-the-court settlements, agents not sharing full policy documents with consumers at the time of signing of policy, rejection of claims on the basis of pre-existing diseases and crop insurance claims tied up with a central scheme which is not flexible.

“We have raised these concerns before IRDAI and other stakeholders. We are hopeful that the insurance companies will address them voluntarily. If the need arises we will also request the regulator to make it mandatory,” Consumer Affairs Secretary Rohit Kumar Singh told media after a roundtable earlier this week.

Also Read: Budget 2023: Here’s How Insurance Sector Reacted

Currently, more than one-fifth of the total consumer complaints are pertaining to the insurance sector across the country.

He said there is huge pendency in consumer cases related to the insurance sector across the country because of these issues.

“As the industry seeks to achieve 8 per cent penetration, it is critical that we put in place the building blocks to avoid a significant build-up of complaints,” he added.

Singh asserted that consumer cases can be reduced if the insurance policy terms and conditions are made simpler, clear and in understandable language. It is also important to create awareness among consumers that they should not sign the policy document without properly understanding terms and conditions of the policy.

According to Singh, out of 5.53 lakh pending cases in consumer courts across the country, about 1.61 lakh cases are related to the insurance sector.

A maximum of 80 per cent of cases are pending in district consumer courts, 17 per cent in state consumer courts, and 3 per cent at national consumer commissions, he said.

“We want to settle a lot of litigation through mediation. However, the representatives of the insurance companies are bound by the restriction and not delegated proper powers to take a decision. We are requesting the companies to delegate powers to them so that cases are resolved expeditiously,” he said.

The insurance cases pertain to mediclaim and health insurance to travel, life, home, car, marine, fire and crop insurance.

Meanwhile, in another development, a report said that the majority feel that mental health consulting should be included in their health insurance and one-third are hesitant in reaching out to mental health experts because of the cost implication.

According to the Aditya Birla Health Insurance Report, about 85 % of the population prefer cutting down on some luxury items and spend more on health insurance, while 89 per cent of the respondents believe that mental health consulting should be included in their health insurance.

(With PTI inputs)

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Source: www.news18.com

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