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

As important as it is to buy a health insurance policy, knowing your rights as a health insurance buyer is equally important. This is because no matter how regulated and well-structured the insurance industry is, wrongdoers exist everywhere. And the best way to deal with them, while keeping your interests safeguarded, is to know your rights, which you can exercise in this regard. 

Also, it is important to reiterate that battles against insurance companies are no longer a lost battle. There is enough precedent to this in recent times, where court decisions have been made in favour of the insurance buyers who fought for their rights, be it against overcharging in the name of insurance premiums, or delay in settlement of claims.

Following is an exhaustive list of the rights that are available to every insurance buyer.

1] Right to get all information about the policy: According to the Insurance Regulatory and Development Authority of India (IRDAI) guidelines, you have all the right as an insurance buyer to ask your insurance provider for any information concerning your policy. Be it the policy features, benefits, eligibility criteria, or premium amount, the insurance provider is liable to address all your queries.

You also have the right to ask for the IRDAI-approved insurance premium chart to check if the insurance company is charging you a fair premium or not. Be an informed buyer, and if you feel you are being overcharged, do check the premium chart.

2] Right to cancel the policy within 15 days of policy issuance: Every health insurance policy comes with a 15-day free-look period, if purchased offline, and 30 days, if purchased online. During this period, you have the right to cancel the policy issued to you, if you are unhappy with its terms and conditions. No insurance company can deny such a policy cancellation, and it is bound to return the premium paid by you, after making the necessary deductions. These deductions can only be for the insurance cover provided during this period, stamp duty expenses, and medical test expenses, if any. 

It is important to note that this free-look period starts from the day when the policy document reaches you. So, if your insurance agent has deliberately delayed the issuance process, you need not worry, as the delay won’t affect any of your free-look period rights. 

3] 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 tough times, the IRDAI has defined timeframes for completion of different requests, which can be placed by a policyholder with the insurance provider. As an insurance buyer, you have the right to the following requests processed within the below-mentioned time span. 

4] Right to policy renewal: According to IRDAI’s guidelines issued in March 2009, no insurance company can refuse to renew your health insurance policy, be it on medical grounds for senior citizens, or due to a large number of claims made in the previous year. You have the right to policy renewal as long as there is no evidence of fraud, misrepresentation, moral hazard, or, the insurance company had not specified the renewal age limit at the time of policy issuance.

5] Right to grievance redressal: If you are unhappy with any terms or procedures of the insurance company, you have the right to file a complaint about the same with them. If the insurance provider is unable to provide you with a satisfactory resolution for your grievances or complaints, you have the right to flag the matter to IRDAI through its online platform called the Integrated Grievance Management System (IGMS). 

Be an informed insurance buyer and keep yourself updated with all the rights which are available to you in this regard. This will not only help you remain safeguarded against unfair treatment, but also provide you with peace of mind, which is one of the most prized possessions in today’s hustle and bustle. 

The author is co-founder and CEO, InsuranceDekho

(Disclaimer: Views expressed are the author’s own, and Outlook Money does not necessarily subscribe to them. Outlook Money shall not be responsible for any damage caused to any person/organisation directly or indirectly.)