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View Full Version : My claim repudiated - How to appeal to insurance ombudsman?



Mayur09
01-07-2011, 08:10 PM
My Health insurance claim has been repudiated by the Iffco-Tokio General Insurance company. They are saying that the disease for which, we were treated, was pre-existing at the time of application of the health insurance. But in real, we have no idea at the time of taking the policy. So I wanted to appeal to insurance ombudsman. Please advise.

Rahul
02-07-2011, 06:07 PM
Have you received repudiation letter from the company?
You can register your case in Delhi - (http://www.irdaindia.org/ombudsmenlist.htm)

gokulr
03-07-2011, 12:34 PM
What is Insurance Ombudsmen?
What is their role?
What cases we can take to Insurance Ombudsmen?

Rahul
03-07-2011, 12:53 PM
What is Insurance Ombudsmen?
What is their role?
What cases we can take to Insurance Ombudsmen?
1 & 2- The institution of Insurance Ombudsman was created by a Government of India Notification dated 11th November, 1998 with the purpose of quick disposal of the grievances of the insured customers and to mitigate their problems involved in redressal of those grievances.

3- Cases can be lodged to Insurance Ombudsmen -

Any partial or total repudiation of claims by an insurer.
Any dispute in regard to premium paid or payable in terms of the policy.
Any dispute on the legal construction of the policies in so far as such disputes relate to claims.
Delay in settlement of claims.
Non-issue of any insurance document to customers after receipt of premium.