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Mutual Funds, Financial Planning Expert - Answered on Aug 07, 2024

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Money
I have tataaig mediclaim before one year I claimed 55000+ rs. But after two month only 48000+ rs. pass and other 7000+ rs. Which are purely doctor fees and medicine are not given i already sent duplicate or Xerox as per requirement but now days they want original document which are i submitted at very first time and everytime they want original document so now what to do ?
Ans: You claimed Rs. 55,000+ from Tata AIG mediclaim.
They approved Rs. 48,000+ after two months.
Rs. 7,000+ for doctor fees and medicines not approved.

Document Submission

You've sent duplicate or xerox copies as asked.
Now they're asking for original documents again.
You've already submitted originals at the start.

Common Insurance Practice

Insurers usually keep original documents for approved claims.
They might return originals for rejected parts of claims.
It's unusual to ask for originals repeatedly.

Possible Steps to Take

Call Tata AIG customer care for clarification.
Ask why they need originals you've already submitted.
Request them to check their records for your documents.

Escalation Process

If customer care doesn't help, escalate to grievance cell.
Write a formal complaint to Tata AIG's grievance officer.
Clearly explain the timeline of your document submissions.

Document Trail

Gather proof of all your document submissions.
This includes courier receipts or acknowledgement emails.
These can support your case if you need to complain.

IRDAI Complaint

If Tata AIG doesn't respond, complain to IRDAI.
IRDAI is the insurance regulator in India.
They can intervene if the insurer is being unreasonable.

Future Precautions

Always keep copies of all documents you submit.
Get acknowledgement for document submissions from the insurer.
Follow up regularly on your claim status.

Medical Records

Ask your doctor for duplicate prescriptions if possible.
Get copies of medical records from the hospital.
These might help if you can't provide the originals again.

Time Limit

Check your policy for claim settlement time limits.
Insurers usually have to settle claims within 30 days.
Delays beyond this can be reported to IRDAI.

Finally

Stay patient but persistent in following up.
Keep all communication with the insurer in writing.
Consider seeking help from a Certified Financial Planner for guidance.

Best Regards,
K. Ramalingam, MBA, CFP,
Chief Financial Planner,
www.holisticinvestment.in
(more)
Samraat

Samraat Jadhav2096 Answers  |Ask -

Stock Market Expert - Answered on Jul 24, 2024

Asked on - Jul 05, 2024Hindi

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Ramalingam

Ramalingam Kalirajan7101 Answers  |Ask -

Mutual Funds, Financial Planning Expert - Answered on May 17, 2024

Asked on - May 17, 2024Hindi

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Money
I have taken lic of edelweise and paid 1 st premium 525000 rs. last year 28/03/2023 but current year I left my job so can not able to pay 525000 rs and I have too much financial problem I ask to return my money but company said strongly no and never for remain life so my question is can I get money back or not
Ans: I'm sorry to hear about your financial situation. Navigating through insurance policies, especially when facing financial difficulties, can be challenging. Here’s what you can do to understand your options better:

Understand the Policy Terms
Read the Policy Document:
Carefully review the terms and conditions of your Edelweiss insurance policy. The policy document will provide details about the free-look period, surrender value, and any penalties associated with early termination.

Free-Look Period:
If you are within the free-look period (usually 15 to 30 days from the date you received the policy document), you can cancel the policy and get a refund after deducting administrative charges. However, since you mentioned that you purchased the policy last year, this option might not be available.

Surrendering the Policy
Surrender Value:
Check if your policy has a surrender value. Most insurance policies have a surrender value that you can claim if you terminate the policy early. However, policies generally accrue surrender value only after a certain number of premiums have been paid, often after the first two or three years.

Surrender Charges:
Be aware that surrendering the policy before the stipulated period can attract surrender charges, which can significantly reduce the amount you receive back.

Loan Against Policy
Policy Loan:
If your policy has acquired a surrender value, you might be eligible to take a loan against it. This can provide you with immediate funds without surrendering the policy.

Contact Edelweiss Life Insurance
Customer Support:
Contact Edelweiss Life Insurance's customer support or your insurance agent. Explain your financial situation and inquire about any flexibility in premium payments, possible policy loans, or partial withdrawals if your policy allows.

Defer Premium Payment:
Some insurance companies may offer options to defer premium payments or convert the policy to a paid-up status, where the coverage amount is reduced based on the premiums already paid.

Explore Financial Assistance
Alternative Financing:
Look for other ways to manage your financial problems, such as personal loans, financial assistance from family or friends, or exploring government aid programs if available.

Legal Advice
Consult a Financial Advisor or Lawyer:
If you face resistance from the insurance company or need clarity on your rights, consulting a certified financial planner or a lawyer specializing in insurance can provide you with tailored advice.

Practical Steps to Take
Review Policy Terms: Read your policy document carefully to understand the surrender value and any charges.

Contact Insurer: Speak to Edelweiss Life Insurance for detailed information about your options and any possible assistance they can provide.

Consider a Loan: Explore the possibility of taking a loan against the policy if it has accrued value.

Seek Legal Advice: If needed, consult with a financial advisor or legal expert to explore all possible avenues.

Summary
While it may be difficult to get a full refund, understanding your policy’s terms and exploring options like policy loans or surrendering can help mitigate financial stress. Always communicate with your insurer and seek professional advice to make an informed decision.

Best Regards,

K. Ramalingam, MBA, CFP,

Chief Financial Planner,

www.holisticinvestment.in
(more)
DISCLAIMER: The content of this post by the expert is the personal view of the rediffGURU. Investment in securities market are subject to market risks. Read all the related document carefully before investing. The securities quoted are for illustration only and are not recommendatory. Users are advised to pursue the information provided by the rediffGURU only as a source of information and as a point of reference and to rely on their own judgement when making a decision. RediffGURUS is an intermediary as per India's Information Technology Act.

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