HOW TO MANAGE YOUR INSURANCE FOR KEEPING YOUR BUSINESS PROTECTED.

Talk to your brokers to discuss which insurance policies are best for your business. Insurance brokers can access policies from multiple insurance companies to help you get the best deal

Understand your insurance policy

An insurance policy is a legal contract between you and the insurance company. Both Insurer and Insured need to comply with your responsibilities for the contract to be valid.

Insured need to understand:

·        What the policy covers and any exclusions any definitions.

·        How a claim is settled. For example, repair, replace or cash

·        Any excess amount you’ll need to pay

·        Your and the insurer’s cancellation rights

·        The complaints process

·        What you need to tell the insurer when you take out the policy

·        What information you need to keep updated.

·        Ask professional help from the broker or Agent if you don’t understand something in the policy

Your insurer may not pay your claim if you haven’t met the terms and conditions of your insurance contract. Check your policy for the terms and conditions. It could be something you need to do or information you need to keep up to date.

 

Review your policies periodically to make sure you stay covered.

It’s good practice to review your policies when your business changes or before you renew a policy.

Think about any changes that could affect your current policy or the type of cover you need.

For example:

·        Your business moved to a new property

·        The number of employees changed

·        You’ve started offering new goods or services

·        You’re using new business practices

·        You bought or sold equipment, including vehicles.

 

Check the value of your assets

The insurable value of many assets goes down over time.

Whether Insurance contracts will compensate for depreciation or a change in market value due to inflation. Review the value of your assets to make sure you have the right level of cover.

 

Make a claim

Contact your insurer as soon as possible if you need to make a claim. Check your policy for anytime limits to lodge a claim.

Tell your insurer:

·        How the incident happened

·        When it happened

·        How it will affect your business.

·        Your insurer will depute surveyors who will ask you for supporting documents.

This might include:

·        Photos of damage

·        Proof of ownership

·        Copies of computer records

·        Contracts between you and a claimant.

·        Some events also need to be reported to the police or other authorities. Refer your policy or ask your insurer if you’re not sure who else to report the incident to.

 

Emergency repairs

Check with your insurer before you make any emergency repairs. If you arrange the repairs, keep copies of all invoices and bills for submission to your insurer.

 

Dispute of an Insurance claim

You can dispute a claim if you disagree with your insurer’s decision. Contact your insurer and tell them:

·        that you’re lodging a dispute

·        what the problem is

·        what you would like them to do to fix the problem.

 

Grievance Redressal Mechanism as per IRDAI

Step 1: Contact the insurer

• First, file a formal complaint with the insurance company's Grievance/Customer Complaints Cell or Grievance Redressal Officer.
• Most complaints must be handled by the insurer, which has a 14-day timeline to respond. 

Step 2: Escalate to IRDAI 

• If you do not receive a satisfactory response from the insurer within a reasonable time, or if they fail to respond, escalate the complaint to the IRDAI.
• You can register a complaint with IRDAI through these channels:
• Online: Use the Bima Bharosa system or the Integrated Grievance Management System (IGMS).
• Email: Send an email to complaints@irdai.gov.in.
• Phone: Call the toll-free numbers 1800 4254 732 or 155255. 

Step 3: Approach the Insurance Ombudsman 

• If you are still dissatisfied with the resolution from the insurer after escalating to IRDAI, you can approach the Insurance Ombudsman for a fair disposal of the complaint. 

Key timelines

• Insurer: 14 days to respond to the complaint.
• IRDAI: Takes up the complaint with the company if the insurer does not respond or if the policyholder is not satisfied with the resolution.
• Insurance Ombudsman: Provides a channel for a fair and timely resolution of complaints.
• Time for redressal: While specific timelines for the Ombudsman and judicial forums vary, IRDAI guidelines aim for a structured process. 

 

Step 4: Legal recourse

·        If the policyholder is not satisfied with the Ombudsman's decision, they can file an appeal in the appropriate judicial forum, such as a civil court. 

 

Alternative options

·        File a complaint with the District Forum: If the insurer does not resolve the complaint to your satisfaction, you can file a complaint with the District Consumer Disputes Redressal Forum.

·        Determine the forum's jurisdiction: The District Forum has jurisdiction for cases where the value of goods, services, and the compensation claimed is up to 𝑅𝑠.20 lakhs. If the claim is higher, you will need to approach the State or National Commission.

·        You can file the complaint yourself.