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Health insurance provider is not providing the copy of proposal form

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16 Apr, 2021 by  Ravi

A relative bought health insurance from Apollo Munich in 2018 via Coverfox. He has renewed it twice is since then and the policy is in the third year now. Last year, HDFC Ergo acquired Apollo Munich and the policy was converted to HDFC Ergo accordingly. Policy name and features remained the same just the name was changed.


Recently when he was organizing his insurance documents, he realized that the company never sent him the copy of the proposal form which they are supposed to do.


After raising the request with them for receiving the copy of the proposal form they have responded saying that they are unable to locate it due to technical reasons.


That proposal form is an important document and the responsibility of locating it is on the company. If the company fails to provide this document, then how will they handle the future claims as most of the medical history of the person is mentioned in the proposal form.


In such case what should one do do? How far one should go in resolving this complaint? Raise a grievance and follow up further complaint resolution levels? If that is also unsuccessful then what next?





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17 Apr, 2021

Hello Ravi,


  1. It is your right as a customer, to get a copy of the proposal form - it will help you gain better control and clarity over your insurance plan and future claims.
  2. You will need to follow the grievance process. Write to the grievance officer at the insurance company - List of grievance officers and their email addresses
  3. If you do not get satisfactory response, you need to post your complaint on IRDAI's IGMS service : igms.irda.gov.in
  4. All this is can be done from the comfort of your home + there are no charges whatsoever you will need to incur,


Do not forget to share your experience with everyone else here. It will be extremely helpful.


Regards,

Team Beshak



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17 Apr, 2021

Hey Ravi,


Follow these steps to understand how important it is for you to followup for proposal copy.


1. Was there any past medical condition declared in proposal form? If not, then don't even sweat. Policy is in 3rd year, there would be no waiting period related to Pre existing diseases.


2. If there was something declared, then do you have documents for the pre existing medical condition. Example, if you mentioned diabetes in the form, you need to have a prescription from doctor backing the diagnosis of diabetes that was declared in proposal form. If you have prescription, your life is sorted.


Otherwise, if you want to pursue the issue against insurer, you can follow the advice given by Beshak team.

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