Insurance Samadhan: Perfect Platform to Resolve Insurance Complaints?

• 28 July 2020 | 1997 Views | By Abhinav Mishra

Nothing is certain in this world, the current situation says it all. The world we have created for ourselves is full of risks and uncertainties. None is free from risk, be it individuals, families, properties, or businesses, all are exposed to different types and levels of risks. We cannot always prevent unwanted events from occurring and for that financial world has developed products to protect businesses and individuals against such losses by compensating them with financial resources. Insurance is a financial product that eliminates and reduces the cost of loss caused by different types of risks.

Whenever there is a gap in a system, a startup takes that challenge and solves the problem of people. Insurance Samadhan has accepted this challenge and their aim is to remove the obstacles of their clients related to insurance complaints and claims. The firm currently operates in verticals including retail, hospital, microfinance, and corporate.

Misselling of Insurance Products

Back in 2015, an insurance agent from a reputable bank approached me with an insurance plan. He offered me a one-time premium payment policy that he claimed will offer better returns than the fixed deposits. The historical data showed good numbers and I agreed to go ahead with a premium of Rs 50,000. Later on, I realized it was not a one-time payment but I needed to pay a premium of Rs 50,000 for five consecutive years. When I approached the insurance company, they were non-cooperative and did not do much. The insurance can be canceled within -15- days of receiving the documents. By the time I came to know about the 5-year payment 10 days had already passed. The next 10 days were full of struggle.

Types of Life Insurance Policies: Traditional Policies

Types of Life Insurance Policies: Non Traditional Policies

Back then, there was no platform that looked into such cases. Today, Delhi based Insurance Samadhan takes up such cases and draft formal complaint, communicated on behalf of you with the insurance company and moves the complaint via their tech engine. All you need to do is connect with them via Customer Care Number, Website, Social Media channels, and get your claim amount in your account.

The company was started in 2018 and in 18 months they have worked over 13,000 complaints. Deepak Bhuvneshwari Uniyal, co-founder & CEO, says, “We don’t work on each complaint but only take forward the ones that we know are genuine. On average, we only select three-four cases out of 100.”

Although there is a standard procedure to make a complaint against an insurer, often in the want of time or lack of knowledge, aggrieved policyholders accept insurance company’s rejection of their claim. According to Uniyal, it’s important to keep emotions aside and communicate in clear legal terminology with insurance companies.

80% of consumer complaints in the insurance sector were related to insurance claims alone by 2016. The claims ranged 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.

The Ideology

The Insurance Samadhan was formed with a vision to be the most trusted platform for resolving insurance complaints and claims. The customers are continuously losing confidence in the product sold by insurance companies due to mis-selling or injustice being served in terms of a genuine claim being rejected. The team at Insurance Samadhan understands the concerns of its customers and also how important is the policy to them. They work together with customers to make ends meet and help them come out of some of the most upsetting insurance issues customers ever faced. You will find testimonials of happy customers and MFC’s, hospitals on their website where Insurance Samadhan has resolved their cases.

Different types of complaint they take are–

Mis-selling of Insurance Policy

The example above falls under this category where incorrect information was provided at the time of selling insurance. Despite numerous checkpoints imposed by the IRDA, an end-to-end solution for this problem seems far-fetched. Insurance Samadhan takes such cases and resolves the case with an insurer.

Claim Rejection 

We buy insurance for the protection of our family members but when the claim gets rejected due to technical jargon or due to wrong representation, we feel helpless. For example, in the case of health insurance policy, a claim may be rejected if you have a pre-existing disease which was not disclosed. The team at Insurance Samadhan not only understands your claim but also help you file your case again with the insurance company.

Delay in the claim process

Most insurance companies aim to settle claims at a fast pace for better customer experience but in some cases, they come back with a set of questions that are difficult to answer for an individual, and hence the claim disbursal gets delayed. The team helps its customers answer the questions in the correct manner so they receive the claim with no further delay.

Lapsed Policy

Some people don’t have the money to pay the premiums of their policy or they forget to pay the premium. In both cases, the policy has lapsed and they lose the cover. Insurance Samadhan understands its customer situation and helps revive the policy or help recover money by surrendering the policy.

Policy Rejection

You feel dejected when the insurance company rejects your insurance cover. The company understands the reasons for rejection and helps you get the cover you need by correct documentation with the company.

NRI Services

For people who bought policies in India and do not know how to keep track of premium payments and claims, they can register with Insurance Samadhan, and the company will help them with all concerns.

They accept insurance-related complaints across all verticals of health, life, and general Insurance.

Charges

Insurance Samadhan charges Rs 500 registration fee even if there are multiple cases of the aggrieved policyholder or in the policyholder’s family. The start-up takes a 9 percent success fee in the amount of the claim that has been resolved post the resolution of the complaint. As per Sanjay Aggarwal, Co-Founder & Legal Expert, “Our success rate is 80 percent. We manage to resolve 70 percent of cases at the insurance company level. Rest are resolved at the ombudsman or consumer court level.”

Funding

The company has raised capital as part of its seed funding round from startup incubator and accelerator Venture Catalysts. The startup has not disclosed the amount it raised.

“Insurance Samadhan is leveraging modern technologies and the expertise of its board members to organize this fragmented market. The funding will help the company build its tech stack and realize its business targets,” Apoorv Ranjan Sharma, Co-founder and President at Venture Catalysts.

The company so far has done a fabulous job in solving the insurance-related cases of its customers and with recent funding the company can expand with better technology.