hello, i took an insurance policy in 2021 from TATA AIA SAMPOORNA RAKSHAK which has 12 premium for 12 years and the policy goes on for 80+years with 50 lakh insurance i paic my first premium of 1,35000 yearly, but my fortune change and i lost my handsome salary job and i was unable to pay that premium so i needed to stop that as my family primary expenses comes first.Mam the insurance company say you wont get this premium back as its already written in terms and condition book,but for me its an huge amount. i would like to know from you that can i get this money from company legally or not and if so how can i get it back. thankyou.

Ans: I'm truly sorry to hear about your husband's health complications and the subsequent challenges with your medical insurance. Facing such situations can be distressing, especially when dealing with unexpected denials and cancellations. It's important to take action to address this issue.

Firstly, gather all relevant documents, including policy details, correspondence with the insurance company, and any communication with the agent. This documentation will be crucial in understanding the reasons for the denial and in any potential appeals or legal actions.

Next, consider reaching out directly to the insurance company to request a review of the decision and clarification on why the claim was rejected. If you're unsatisfied with their response, you may escalate the matter through their grievance redressal mechanism or regulatory authorities.

Additionally, seeking legal advice from a lawyer who specializes in insurance matters could provide insight into your rights and options for recourse. They can help you navigate the complex legal landscape and pursue appropriate action to recover your hard-earned money.

While the situation is undoubtedly challenging, remember that you're not alone. Reach out to consumer rights organizations or advocacy groups that may offer support and guidance in dealing with insurance-related issues. Your perseverance and determination to seek justice are commendable, and I hope you find a resolution that provides the relief and security you deserve.

Ans: I understand you're concerned about Reliance General settling claims properly. It's good to be aware! Here's how we can approach this:

Claim Settlement Ratio (CSR) Check: Every insurance company has a CSR, a public record showing the percentage of claims they settle. You can check Reliance General's CSR online to see their historical performance.

Policy Review: Review your policy documents carefully. Understand the terms and exclusions related to claim settlements. If something seems unclear, reach out to Reliance General for clarification.

Network Hospitals: Using network hospitals within your policy can streamline the claim settlement process.

Remember, a single experience doesn't represent the entire picture. However, your concern is valid. Let's not worry, we can assess further!

You did well porting your policy! Health insurance is crucial, and you've taken a great step for your family.

Moving forward: If you'd like a more in-depth analysis of your health insurance options, consider consulting a Certified Financial Planner (CFP). They can assess your specific needs and recommend the best plan based on your family's requirements.

Best Regards,

K. Ramalingam, MBA, CFP,

Chief Financial Planner,

www.holisticinvestment.in

Ans: Understanding the Insurance Premium Refund Process

When you close a housing loan early, you might wonder about getting back the insurance premium. The insurance you bought covered the loan term. Now, let's explore if you can get a refund for the insurance premium paid.

Nature of Loan Insurance

Loan insurance safeguards the lender and your family. If something happens to you, the insurance pays off the loan. It’s a crucial element in securing financial stability. But when you repay the loan early, the scenario changes.

Terms and Conditions of Insurance Policies

Insurance policies come with specific terms and conditions. These conditions dictate the refund policy. Usually, insurers have clauses about refunding premiums if the loan is closed early. Reading these terms is essential to know your entitlement.

Pro-rata Refunds

Some insurance companies offer a pro-rata refund. This means you get a refund based on the remaining term of the policy. For instance, if your loan was for 25 years and you closed it in 28 months, you might get a refund for the unused period. This could be a significant amount, given the long-term nature of your original policy.

Administrative Fees and Charges

Be aware of administrative fees and charges. Insurance companies might deduct these fees from your refund. This can affect the total amount you receive back. Ensure you understand these potential deductions by reviewing your policy documents or speaking with your insurance provider.

Communication with Your Insurance Provider

To initiate the refund process, contact your insurance provider. They will guide you through the steps needed to process your refund. Having all your loan and insurance documents handy will streamline this communication.

Importance of Documenting Communication

Keep records of all communications with your insurance provider. Emails, letters, and call logs are crucial. This documentation can be useful if there are disputes or delays in processing your refund.

Insurance Policy Alternatives Post Loan Closure

After closing your loan, you might still need insurance coverage. Reassessing your insurance needs is wise. A Certified Financial Planner can help you determine the best coverage to protect your financial interests moving forward.

Reinvestment of Refund

If you receive a refund, consider how to use it wisely. Consulting with a Certified Financial Planner can provide insights. They can guide you on reinvesting the money in mutual funds or other beneficial financial products.

Common Misconceptions about Insurance Refunds

Many people believe that closing a loan guarantees a refund of the insurance premium. This is not always the case. The refund depends on the specific terms of your insurance policy. Understanding these nuances can save you from unrealistic expectations.

Assessing the Financial Impact

Evaluate the financial impact of closing your loan and getting an insurance refund. This analysis helps in understanding the overall benefit. You might find that the refund can be a valuable addition to your financial planning strategy.

Potential Delays in Refund Processing

Be prepared for possible delays in the refund process. Insurance companies have their procedures and timelines. Staying patient and following up regularly can ensure a smoother process.

Appreciating the Value of Insurance

Even though you might get a refund, it’s crucial to appreciate the value insurance provided while your loan was active. It offered peace of mind and financial security, which is invaluable.

Conclusion

Closing your loan early and seeking a refund on your insurance premium is a prudent financial move. Understanding the terms, communicating effectively with your provider, and planning the use of your refund are essential steps. Consulting with a Certified Financial Planner can further enhance your financial strategy.

Best Regards,

K. Ramalingam, MBA, CFP,

Chief Financial Planner,

www.holisticinvestment.in

Ans: Hello. I understand why this hurts. ?1.35 lakh is not a small amount, especially when life takes an unexpected turn. Let me explain this calmly and clearly so you know exactly where you stand and what is realistically possible.

First, the hard truth about this policy
Tata AIA Life Insurance Sampoorna Rakshak is a pure term insurance plan.
In term insurance:

There is no savings or investment component

The premium is paid only for risk cover

If the policy lapses early, there is no surrender value

Since you paid only the first year premium and could not continue, the policy lapsed. As per IRDAI rules and the policy contract, term plans do not refund premiums once risk cover has started, even for one year.

So from a legal and regulatory standpoint, the insurer is technically correct.

Can you get the money back legally?
Let me be very honest and practical.

1. Legal refund claim
Not possible, unless there was:

Mis-selling (false promises of return, savings, maturity value)

Incorrect information given in writing

Forged consent or wrong policy explained as an investment plan

If the agent verbally said things like:

“You will get money back”

“This works like an investment”

“You can withdraw later”

and you have proof (WhatsApp, email, brochure), then you may have a case.

Without proof, a court or ombudsman will side with the policy wording.

2. Free look period option
This allows refund within 15–30 days of policy issuance.
Your policy is from 2021, so this option is long gone.

What options are realistically left now?
Option 1: Escalation request (low success, but try)
You can still request a goodwill consideration, not a legal claim.

Write a calm email to:

Tata AIA grievance cell

Mention job loss, financial hardship

Request partial refund or conversion to paid-up (they will likely say no, but try once)

Do not expect much, but sometimes insurers offer ex-gratia rejection confirmation which helps closure.

Option 2: Insurance Ombudsman (for peace of mind)
You may approach the Insurance Ombudsman, but I want to be clear:

Ombudsman follows policy terms

For term plans, verdict is usually in favour of insurer

This is more for mental closure than recovery.

Why this feels unfair but is still allowed
Think of it this way:

For one year, your family had ?50 lakh protection

The premium paid was for that one-year risk

Just like car insurance, unused years are not refundable

I am saying this not to justify the system, but to help you accept reality without guilt.

One important emotional point
You did nothing wrong by stopping the policy.
Choosing food, rent, education, and survival over insurance is financial wisdom, not failure.

Many people continue policies out of fear and end up in debt. You didn’t.

You handled a tough phase responsibly. That matters more than a lost premium.

Ans: Q1. Old Bajaj Allianz health insurance policy. Can anything be recovered now?

You had a health insurance policy, not a savings or investment product. Health insurance premiums are paid only for protection during the policy year. They do not accumulate or become refundable like LIC, ULIP, or endowment plans. Once a policy lapses and a claim is not settled, there is no automatic refund of premiums, even if premiums were paid for several years.

In your case with Bajaj Allianz, the claim itself appears genuine, but the handling failed.

What happened

Hospitalisation claims were submitted.

The agent collected originals and they were reportedly lost in courier transit.

You escalated the issue, raised grievances, and filed an FIR.

Communication eventually stopped.

Premium payments were discontinued and the policy lapsed.

This amounts to deficiency of service, but the long time lapse has weakened the case substantially.

Why the duplicate document route mattered
When original discharge summaries and bills are lost, insurers normally accept duplicate hospital records, provided they are:

Issued by the hospital on official letterhead

Marked as certified true copies

Supported by a loss declaration or FIR

Hospitals maintain records for many years and routinely issue such duplicates. In many cases, additional bank attestation is used to strengthen authenticity and avoid insurer objections. This process keeps the claim procedurally alive. The agent should have guided and executed this reconstruction at that stage. Since this was not done in time, the insurer later had procedural grounds to disengage.

Is recovery possible after 8–10 years?
Realistically, it is very difficult, though not completely impossible. Normal customer care routes are closed. Only legal or regulatory escalation remains.

What can still be tried

Insurance Ombudsman: Cost free, but chances are low due to delay.

IRDAI grievance portal: File a detailed complaint with FIR and whatever documentation is available. Correct route, limited expectation.

Consumer Court: Possible only if negligence and harassment can be proven. Time consuming and costly. Given premiums paid were around ?1.2 lakh, effort versus outcome must be weighed carefully.

Expectation setting

Full refund of premiums is highly unlikely.

At best, there could be claim consideration or partial compensation.

Missing documents and broken follow up significantly weaken the case.

Practical advice
Do not depend on this money for current medical needs. Treat any recovery as incidental, not planned.

Q2. Home loan insurance added by HDFC. Is it mandatory or worth it?

Short answer: No, it is not mandatory.
Banks often push such insurance aggressively.

In your case with HDFC:

Home loan of about ?1 crore

Insurance of roughly ?15 lakh added

Premium loaded into the loan as a top up

EMI increased by about ?14,000

This is a bundled selling practice.

Regulatory position

A bank cannot force a borrower to buy insurance from the bank or its partner.

RBI and IRDAI allow borrowers to choose any insurer, as long as adequate risk cover exists.

Loan approval cannot legally be linked to purchasing the bank’s insurance.

Is insurance itself needed?
Yes, risk cover for a large loan is sensible. But not in this structure.

Better structure

Pure term insurance on your life

Sum assured equal to or slightly higher than the loan outstanding

Policy assigned to the bank if required

This option is cheaper, transparent, flexible, and fully under your control.

Why bank loan insurance is poor value

Single premium plans are expensive

Interest is paid on the insurance premium

Coverage often reduces while cost does not

Exit and modification are difficult

Options available

If within free look period, cancel immediately and adjust the premium against the loan.

If outside free look, review surrender terms and assess exit loss.

Take independent term insurance and formally inform the bank. They cannot reject valid alternate cover.

If time permits, explore nationalised banks, which are often more flexible on insurance conditions.

Final summary

The health insurance claim issue is emotionally justified but legally weak due to time lapse and missed procedural recovery steps.

The home loan insurance issue is correctable, and action taken early can significantly reduce long term cost.

Best regards,
Naveenn Kummar, BE, MBA, QPFP
Chief Financial Planner | AMFI Registered MFD
https://members.networkfp.com/member/naveenkumarreddy-vadula-chennai