Apr.18: CERS MEDIATES
- Posted by CERC India
- Posted in April
LIC corrects its mistake
Insurer’s error
Meena Tahiliani had a policy with Life Insurance Corporation of India (LIC) for which she regularly paid the premium. After 10 years, LIC gave her the option of either surrendering the policy or going for a pension scheme. She opted for getting the surrender value and submitted all the relevant documents. As a result of an error by LIC staff, the policy was converted into a pension scheme. When Meena enquired about the sum due to her, the staff confessed their mistake. They requested her to either submit a medical certificate to get the money or continue with the pension scheme.
Distressed, Meena refused to give a medical certificate as it was no fault of hers. She wrote to the LIC branch manager and marked a copy to LIC’s head office in Mumbai. She also approached Consumer Education and Research Society (CERS), Ahmedabad for help. CERS wrote to LIC requesting to resolve the matter at the earliest. LIC responded that it had initiated the process for surrender value payment to Meena. Regular follow-up by CERS paid off and Meena got her dues of Rs. 7.57 lakh.
RememberÂ
- Consumers should keep a record of the option that they have exercised for their insurance policies.
- If there is a mistake on the part of a Public Sector Unit (PSU) you can protest and assert your rights.Â
Rightful duesÂ
New India Assurance loses documents, made to pay claimÂ
Callous attitudeÂ
Amarsinh Chavda took a mediclaim from New India Assurance in 2001. He underwent treatment for gallbladder problems and lodged a claim of Rs. 70,984. The insurance company had changed the third-party administrator (TPA) from E-meditek to Raksha but had not informed him of this. After several visits to the Raksha office, Amarsinh came to know that Raksha had misplaced his file twice. Aggrieved by this callous attitude, Amarsinh wrote to CERS.
A couple of letters and constant follow-up by CERS led to the resolution of the case. Amarsinh informed CERS that he had got the claim for Rs. 70,000. He thanked CERS for helping him get his rightful dues.
Tips
- Inform the TPA as soon as possible if you are hospitalized, preferably within 24 hours of admission.
- Always keep a copy of policy documents, bills and other papers with you.
- If your claim is rejected, file a complaint with the insurance company within 15 days.
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 Claims cleared
