Why Choose Us
We empathetically understand all your concerns however we also understand how crucially important an Insurance policy is for you. Therefore we work together with you to make ends meet and help you come out of some of the most upsetting insurance issues you ever faced.
Insurance Samadhan
The Most trusted platform for resolving Insurance Complaints in India
Policy Claim Rejection
Feeling dejected because your insurance cover got rejected?
Business Associate Partner (Franchise)
Flashstar Business & Management Consultancy Limited (Mumbai)
Misselling of Insurance Policy
Have you felt dissatisfied by the policy you purchased or believe you were scammed? While that indeed is a sad reality, we are here to tell you that you are also not alone in the fight against frauds and mis selling!
During our three years of existence, we have encountered different ways in which customers were mis sold the policy
Ways an insurance policy can be mis-sold to you:
- Promising interest free loan on mortgage of insurance policy
- Commission on your policy which can be given to you if you are not happy with your agent’s service
- Promise of Tower Installation
- Promise of free health insurance cards
- Senior citizens sold high value policy with promise of regular income
- Lapsed policy has bonus and the same can be claimed
- Sold as a Fixed deposit in Bank
There may be some other innovative ways which you may like to report to us
Claim Rejection
Did wrong representation or technical jargons get your claim rejected? Do you feel dejected? Well let us help you get your claim back. More often than not, claims get rejected due to filing incorrect or invalid information. Although once rejected, the status of your claim can still be challenged.
Reasons why your claim can get rejected:
- Non-disclosure of relevant information
- Not paying premiums on time
- If your reason to claim comes under the exclusions of the policy
- Avoiding medical tests
- Incorrect nominee details
- Delay in filing for claims
How to avoid these things to happen:
- Submit all relevant information while purchasing the policy (Especially the policies you bought in the recent 3 to 4 years).
- Pay premium on time.
- Read all policy documents carefully before purchasing.
- Do all necessary tests your insurer requires you to.
- Fill your policy document yourself and update your insurer if you want to change the nominee.
Delay in Claim Process
Sometimes we forget to pay the premium or may not have money to pay the premiums. In both the cases the policy gets lapsed and the cover is lost. A lapsed policy is when a customer misses the premium or such as in case of permanent life if the cash surrender value is worn out. In such a scenario, if your policy is lapsed then the policyholder is no longer covered for any sort of benefit enlisted in the policy.
If your insurance policy is lapsed, you can always reinstate your policy. We strongly encourage you to reach out to your insurance company and initiate the process of reinstating your lapsed insurance policy. The window within which you can revive your policy varies upon the type of policy or the insurance company. However usually you have upto two years to reinstate your lapsed insurance policy by paying the due amount of all the missed premiums. Bear in mind that while reinstating a policy is always highly encouraged, one may also have an accumulated interest on the due amount that you would have to bear.
If this sounds too complicated, reach out to us. We can understand your situation and can help you revive the policy or help recover your money by surrendering the policy.
Lapsed Policy
When a claim process gets delayed, one land in waters of hopelessness and helplessness and we couldn’t agree more. This is an unwelcome move where despite having an insurance, you had to bear all costs and now the reimbursement stands delayed. Especially in this digital age, where documents sharing and verification between the insurance company and hospitals should be a seamless process yet delays in insurance claim approval are quite common.
Bear in mind that majorly, the insurance claim approval process depends on the administrative efficiency of the insurance company and the healthcare provider. However at your end, to fasten the process of claim settlement, it is important that you inform the administrative department of the hospital to prepare all relevant paperwork needed. If possible, take an estimated discharge date and work around that date to ensure that you are prepared with all the paperwork needed beforehand. Also don’t hesitate to keep a tap on the insurance company in order to fast-track your insurance claim approval process. If you approach this process proactively, you can ensure that you get claim settlement quicker.
Policy Rejection
Feeling dejected because your insurance cover got rejected? It’s never a lost battle! More often than not, a claim is rejected due to non disclosure of pre-existing conditions. People with pre-existing conditions have to pay a higher premium for coverage, which is why some agents encourage policyholders to not disclose such diseases. However, don’t fall into this trap. It’s of the utmost importance to be honest on your application even if you have poor health or a risky hobby. If you don’t enclose information correctly your claim is bound to be rejected. We can understand all the reasons and help you get the cover you need by correct documentation with the company.
First, understand the reasons why your insurance claim was rejected and talk to us to learn what options are available to you. From there, you will have to wait a certain period before we open all available options and process your case for re-evaluation. Even if your insurance claim was flat-out rejected, we will help you challenge the claim and help you get the samadhan you needed!
Service Issues
Nominee Change, Address Change or issues with respect to legal hires. As
NRI Services
Most NRIs have insurance portfolios in INDIA. This portfolio is either managed remotely or left as lapsed. NRI also add insurances in their portfolio when they visit INDIA, such insurance may also come in the form of fixed deposits or investment schemes. Later they realize that investment schemes or fixed deposits has been mis-sold and they do not know the actions to be taken. NRI also buy health insurance for their family members in INDIA and they always seek support whenever a family member needs medical assistance. Insurance Samadhan understands these pain points and offers multiple services to our NRIs on two fee systems.
- The annual subscription of INR 3500 (USD 50).
- Service fee of INR 1000 (USD 15), for any one time service request.
- Case resolution- Representing the case of mis-selling/fraud or claim rejection in Life/Health/General insurances and recovering the money on 9% success fees. For Example we had a case where NRI deposited INR 10,00,000 in fixed deposits and realized later that INR 10,00,000 has been paid as Insurance premium. We represented the case and got INR 10,00,000 credit in respective NRI account. You can find the testimony of the NRI, Ms Gupta staying in London.We charged a success fee of 9% post monet got credited to her account.
Our Process....
Get in touch with us
Fill up the form with your name, email and contact number
Or
Call us on our toll-free number - 72760-23680
Share Documents
We listen to your issue and ask you to share copies of case relevant documents with us.
Case confirmation
After reviewing your documents, we will confirm if your case qualifies our criteria.
Registration
We do not charge any fee in advance except a one-time registration fee of INR 500. Once the registration fee is paid, our experts will guide and assist you through the process of getting your claim resolved.
Claim Resolved
Once the claim is resolved. We will expect only two things from you
1) A 12 % commission + GST on the claim amount
2) And your review on how your experience was with us.
Grievance Redressal
As of 2016, 80% of consumer complaints in the Insurance Sector were related to Insurance Claims alone. Ranging from fraud and lack of awareness to inappropriate documentation, imbalance in the Insurance Sector looms larger than ever before owing to the rise of the Indian middle class and a shift towards more educated investments. Despite numerous checkpoints imposed by the IRDA, an end-to-end solution for this problem seems far-fetched. New measures like the Introduction of KYC (Know Your Customer), Prohibition of Third-Party Payments, Fixing Accountability for Distributors, etc. have not yet completely resolved these issues. Due to lack of financial know-how and awareness, issues like data theft and fake calls posing as IRDA remain common. Insurance Samadhan has accepted this challenge and we aim to achieve the goal of removing these obstacles for our clients. We ensure that your case is excellently represented, protocol is followed and your life insurance complaints are resolved as quickly as possible.
The Healthcare and Medical Services sector of any country is critical for its welfare. Government, employers and the society at large need to understand health insurance clearly. Only then can they implement productive strategies for managing health and medical insurance. Presently, the majority of disputes usually occur due to misunderstandings, exclusions and non-standardization of laws related to medical insurance. Corporate Hospitals have TPA (Third Party Administration) desks but similar facilities are unfortunately not available everywhere. Additionally, incorrect declaration at the time of policy initiation and poor documentation create even more issues. Once again, we firmly believe in the transparency and integrity of the system and understand the limitations faced by the common man who has trouble understanding the “Heavy Words” of the industry, like understanding exclusions and permissible limits linked to room rent. Which is exactly why at Insurance Samadhan we work relentlessly on case representation at all forums with the intention of resolving various health insurance complaints of the very aggrieved customers we often assist.
Non-Life Insurance Policies such as Automobile Insurance and Homeowner Policies are classified as “General Insurance”. These policies provide cover and payment depending on the loss from a particular financial event. Other Examples of General Insurance include Health Insurance, Travel Insurance, Marine Insurance, Commercial insurance etc. Despite the modernization of Insurance products and practices in India consumers face a number of problems with General Insurance. The general public looks at these policies as unnecessary due to a lack of awareness. People are scared by the technical and difficult language which is hard for them to understand. Thirdly, misrepresentation and selling inappropriate policies has created a bad impression in Public. These combined with the notoriously slow claim settlement process actively discourage consumers from purchasing these policies. Insurance Samadhan works relentlessly to solve these problems by helping consumers in understanding their policies, representing them with concerned authorities and helping them recover their claims. We understand the problems well due to our experience in the industry and so our solutions for general insurance complaints are suitable and easy to understand for Indian consumers.