Mediation : Online Dispute Resolution Mediation : ODR new Call to vidhikarya care phone number+917604047601
Request Consultation
Free Legal Advice
Request Consultation Free Legal Advice

Home > Free Legal Advice > Question Details

Vidhikarya Legal Questions Answered

100,000+ Legal Questions Answered

100,000+ Legal Questions Answered
Ask Your Question
Insurance

Insurance Broker Miscommunication: Need Help with Denied Treatment Coverage

An insurance broker confirmed to me via email that a treatment was covered, but after availing the treatment, the insurance company denied payment. Now the broker is not taking responsibility for their communication. What should I do in this case? I proceeded with the treatment solely based on the broker's communication.

( Bangalore, Karnataka )

1 year ago

Reply to this question

Reply
A.
Dear Client,
Misleading information by an Insurance agent or broker is termed as professional misconduct under Regulation 21, Schedule - III of IRDA (Insurance Brokers) Regulations, 2002. So on repudiation of a claim by the Insurance Company, you may file a complaint against the Insurance Broker for professional misconduct to the concerned Insurance Company and IRDA for redressal of your grievance.
S. K. Dutta Advocate S. K. Dutta
S. K. Dutta
Callto vidhikarya advocate S. K. Dutta Call to advocate S. K. Dutta Send whatsapp message to vidhikarya advocate S. K. Dutta Send whatsapp message to advocate S. K. Dutta Send mail to vidhikarya advocate S. K. Dutta Send mail to advocate S. K. Dutta
View All Answers
Was the answer helpfull

Helpful

Share
A.
Dear client,
You may approach the insurance ombudsman.
Under Rule 12 of Redress of Public Grievances 1998 Insurance Ombudsman has power under Section 12(1)(b) in the Redressal of Public Grievances Rules, 1998to act as a counsellor or mediator which are related to any partial or total repudiation of claims by an insurer.

b.The person in authority shall give in writing about the settlement done between in the policyholder and the insurer.

c.The decision made by the Insurance shall be binding and final on both the parties.

d.If policyholder wants to approach Insurance Ombudsman, he can approach without a lawyer too.

You can also approach the IRDA.
Grievance Redressal Cell in the Consumer Affairs Department of the IRDA looks into complaints/grievances from policyholders. Before approaching the IRDA Cell, the complaints against insurers are required to be first registered with the Complaints/Grievance Redressal Cell of the concerned insurer.
Vidhikarya
Was the answer helpfull

Helpful

Share
Submit request

Submit Request

Post Your Legal Issue to connnect with Lawyers Online

Submit
Talk to a lawyer

Talk to a Lawyer

Connect Now

Read Related Answers

Vehicle loan

Dear Client, The credit life insurance is typically a insurance that pays off the remaining loan on a car or bike if the borrower passes away during the loan term. It protects the borrower's family...

Need Legal Advice: STAR Health Asking for Claim Refund

Dear Client, The terms and conditions of an insurance policy are the most crucial and vital to go through before raising a claim against the policy. Based on the self-declaration of the policy buyer...

Unreasonable clause for maternity and delivery coverage

Dear Client, When an insurance claim is repudiated/rejected by the Insurance company, they inform the insured person of the reason/ground behind the rejection of the claim. Your query lacks that info...

Insurance claim rejection

Dear Client, When an insurance claim is repudiated/rejected by the Insurance company, they inform the insured person of the reason/ground behind the rejection of the claim. Your query lacks that info...

RC and DL DIGITALLY IMPOUNDED

Dear Client, Digitally impounded RC and/or Driving License is considered deemed suspension of the documents usually done in case of violation of traffic rules and involves potential risk and complexit...
Ask a Question

Ask a Question

Ask Now
Settle Your Dispute without going to Court

Settle Your Dispute without going to Court

Vidhi Samaadhaan

Vidhikarya Center for Dispute Resolution
Apply Now

Read Blogs on Insurance

7 Steps to File a Consumer Case Against an Insurance Company
Posted On : May 13, 2024

7 Steps to File a Consumer Case Against an Insurance Company

Supreme Court lifts the requirement of PUC certification for third-party insurance
Posted On : May 13, 2024

Supreme Court lifts the requirement of PUC certification for third-party insurance

Lawyers’ Profession – Trial and Tribulations associated with it and the Need for Supportive Welfare Scheme.
Posted On : May 13, 2024

Lawyers’ Profession – Trial and Tribulations associated with it and the Need for Supportive Welfare Scheme.

Categories

Insurance Lawyers

Abhimanyu
Call to Abhimanyu Send whatsapp message Send whatsapp message Send mail to vidhikarya Send mail to vidhikarya

Abhimanyu Shandilya

Kolkata

Shrikrushna
Call to Shrikrushna Send whatsapp message Send whatsapp message Send mail to vidhikarya Send mail to vidhikarya

Shrikrushna Tambde

Nagpur

Meenakshi
Call to Meenakshi Send whatsapp message Send whatsapp message Send mail to vidhikarya Send mail to vidhikarya

Meenakshi Periyahkaruppan

Chennai

Jaswant
Call to Jaswant Send whatsapp message Send whatsapp message Send mail to vidhikarya Send mail to vidhikarya

Jaswant Singh Katariya

Gurgaon

Find Lawyers by Location

Insurance Lawyers in Anand

Insurance Lawyers in Bangalore

Insurance Lawyers in Bhopal

Insurance Lawyers in Chennai

Insurance Lawyers in Delhi

Insurance Lawyers in Faridabad

Insurance Lawyers in Goa

Insurance Lawyers in Gurugram

Insurance Lawyers in Hyderabad

Insurance Lawyers in Indore

Insurance Lawyers in Kolkata

Insurance Lawyers in Lucknow

Insurance Lawyers in Mumbai

Insurance Lawyers in Nagpur

Insurance Lawyers in Noida

Insurance Lawyers in Patna

Insurance Lawyers in Prayagraj

Insurance Lawyers in Pune

Insurance Lawyers in Ranchi
Find Lawyers by Location Find Lawyers by Location

©2025 Vidhikarya. All Rights Reserved.

Disclaimer

The Bar Council of India does not permit advertisement or solicitation by advocates in any form or manner. By accessing this website (www.vidhikarya.com), you acknowledge and confirm that you are seeking information relating to VIDHIKARYA LEGAL SERVICES LLP (The LAW FIRM) of your own accord and that there has been no form of solicitation, advertisement or inducement by VIDHIKARYA LEGAL SERVICES LLP or its members.
The content of this website is for informational purposes only and should not be interpreted as soliciting or advertisement. The User agrees that he/she is visiting the site on his own volition to seek more information about the firm and its Advocates.
The contents of this website are the intellectual property of VIDHIKARYA LEGAL SERVICES LLP.

OK Cancel
Vidhikarya Official support e-mail Contact Vidhikarya by phone Number vidhikarya whatsapp Number