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Advice related to Term Insurance

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13 Jun, 2021 by  Bhavin Sutaria

Hello,

My name is Bhavin Sutaria. I have a situation about term insurance for which I need your advice.

I purchased a term insurance policy of 1 crore with Tata AIA Life Insurance in March 2020. I brought the policy via an insurance agent. While filling up the form, the agent was aware that I am overweight (92 kg. in weight, 5’11” in height) as per standard insurance norms. He had mentioned that no medical test is required for the policy approval. I got the policy documents in a week’s time.

After paying premium for 2nd year, the company sent an email on 26th April stating that they have information that I applied for policy with another company along with Tata during the same period. On this basis, they directed me to get medical test done within next 15 days and disclose the details of the policy that I have applied for in the past and whether any of them were declined/postponed/rejected/not accepted/issued at extra premium. I had applied for ICICI prudential life insurance via online portal. They declined issuance of policy – I called up their customer care and asked the reason. They said that they find me overweight and that is why they declined approval of my application.

Due to covid situation, I requested the company employee, through whom the policy was issued, to extend the time given for getting the test done. I eventually got the tests done. At that time, I came to know that there is possibility of hypertension in my case based on the TMT test.

After this, the company did not communicate any decision about my policy. On 9th June, I got a system generated email stating that my account is being deactivated as my policy status is inactive. I reached out to the company employee to help me understand what is decision taken for my policy. He said he has sent an email to HO to get information on my policy status. It has been 4 days and he has not responded to my query.

My questions are:

1.     On what grounds can an insurance company ask the insured to go for medical tests after one year from the issue of policy? Is it valid in my case?

2.     The company issued the policy despite knowing that I am overweight. Was it wrong on their part to not ask question about my weight at time of issuing the policy?

3.     What are the standard guidelines of IRDA to issue a policy to an insured who is overweight?

4.     If the company has cancelled my policy, can I get a refund of my premium?

5.     How to proceed further if the company refuses to pay the premium back?

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Term Life Insurance

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13 Jun, 2021
Bhavin Sutaria

I want to attach my documents as well in regards to the query posted. Please advise how I can do the same. Thank you.

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14 Jun, 2021

Dear Bhavin

Answers

1. Section 45 allows an insurance company to revirw the policy in first three years . Insurer can ask questions , revise terms or cancel the contract. So action by Tata is valid . Thry can demand your medical .

1a : your case is not alone , Covid scare has pressurised all insurer to review their term insurance portfolios and lot of rejection are taking place under section 45 .


2. Each policy of high sum assured go to common reinsurance and all insurance history is transparent . When things were good , no one was bothered but post covid insurer as we as reinsurance are reviewing portfolio and rejecting any adverse risk . They would have found any reason even if your medical was good .


3. There is no guidelines on overweight . There are BMI tables to clsssify Standard life and sub standsrd life . Premium is rated up on the basis of sub standard life . Reinsurer also plays an important role as they underwrite risk .


4. Yes , they will have to refund your premium as thry hsve cancelled contrsct .


5. You can write to company or ombudsman or approach us at Insurance Samadhan . Check our website .


Shailesh

Insurance Samadhan




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19 Jun, 2021
Bhavin Sutaria
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