Insurer didn't pay interest on delayed payment of claim
Milind
(Querist) 22 February 2014
This query is : Resolved
Policy - Group Insurance Scheme for L.I.C's agent(GIS)(find more detail on enclosed article)
Decease Agent - DA1
Insurer - LIC
Date Of intimation and claim form submission date - 13/02/2012
Deceased DA1 was the top agent of LIC ,who passed away on January 27,2012 due to road accident and then claimant approached to LIC for earlier settlement of aforesaid claim,However repeated visit to nearby branch office,Insurer replied to claimant that premium for aforesaid policy has been not deducted from Financial Year 2008-09 2009-10,2010-2011 and therefore no claim would be given.
However prior to taking LlC agency DA1 had given all right to insurer for deduction and as mentioned earlier DA1 was the top agent and gained smart commission so there was always enough amount presented into DA1's account for deduction but LIC Branch office said due to technical mistake premium was not deducted.
Having suffered from LIC procedure claimant approached to IDRA and filed a complaint and due to IRDA interference claimant received claim amount after 1 year and 10 months.
and as on IRDA guide line Insurer is liable to pay interest on delayed payment of claim,however when claimant contacted to CRM-LIC they says claim has paid to claimant as ex-gratia Payment and in such case insurer isn't bond to pay interest on delayed payment of said claim.
On this regard claimant again approached to IRDA and requested to escalate existing complaint but they recommended that you may present aforesaid case to insurance ombudsman .
should claimant approach to insurance ombudsman ? or what would be another remedy for this ?
Please download L.I.C -GIS-Booklet from following link, I have tired to upload many times here but donno why it says connection unplugged .
http://www.4shared.com/web/preview/doc/MQ-egYVEba?
T. Kalaiselvan, Advocate
(Expert) 22 February 2014
As IRDA suggested to approach Insurance Ombudsman for interest amount, you may approach the authority by enclosing the IRDA's suggestion letter, if you do not get a proper response from Insurance Ombudsman too, you may approach the Consumer Forum.
ajay sethi
(Expert) 22 February 2014
agree with MR kalaiselvan
Rajendra K Goyal
(Expert) 22 February 2014
First approach Insurance Ombudsman and in case no relief file complaint to consumer forum or Permanent Lok Adalat (Public Utility Services if established in your district.).
Dr J C Vashista
(Expert) 23 February 2014
I agree with the expert advise of Mr. T. Kalaiselvan and Rajendra K Goyal ji.
Milind
(Querist) 25 February 2014
Respected Experts,Thank you very much for your quick suggestion,I've dropped a complainant application into Insurance Ombudsman's email address as provided by IRDA and download claimant's complainant form through IRDA website and having fulfilled the form the same will be sent to insurance ombudsman address . again thank you very much !!
R.K Nanda
(Expert) 05 May 2014
take help of lawyer.
