In Spotlight: Insurance Samadhan
A trusted neutral for citizens with insurance-related grievances
Sujoy had received his first bonus cheque at work. It had been a good year at this company for Sujoy; it was also his first year of employment. This meant he could finally start saving up. He went to the bank with his parents’ advice to open a fixed deposit. At the bank, a very friendly agent made him do the paperwork and explained how his money would grow with this fantastic product they were selling, saying, “It’s like fixed deposit only.” It would also include insurance coverage for his ageing parents. Sujoy took it, thinking his money was safe and growing.
After the pandemic hit, Sujoy lost his job.
Over the next year, he started getting calls to pay his ‘premium’. Panicked, Sujoy called up the helpline. He was told that what he had taken was a life insurance product which required Sujoy to pay for five years, and if he didn’t, he would lose all the money he had already paid. Sujoy begged and pleaded, saying he had been told clearly that he would not be required to make further payments; it was a one-time payment only. All in vain.
He wrote to the insurance company that had sold him the product and tried reaching the agent repeatedly - all for nothing. He then called Insurance Samadhan.
Sujoy is not alone. Misselling and fraud are rampant in the insurance-selling world. Being one of the most complex financial products to sell and with customers being the common man, insurance is a field notorious for pushing the boundaries of how a product is sold. Insurance products are sold aggressively, often disregarding whether the customer requires it. Further, making insurance claims is a nightmare in itself. Very often, citizens are unaware of why their claims are rejected and getting a complete claim reimbursed is akin to winning the lottery. These issues plague millions of citizens who don’t know how to address them.
With years of experience in the insurance sector, Deepak Bhuvneshwari Uniyal (co-founder) and his team at Insurance Samadhan are out to provide citizens with the right tools and redressal mechanisms to help with their insurance issues.
On misselling of insurance in the country
“You’ll be very amazed to know that we’re the only startup in the country, which is sitting on the unique data which insurance companies also don’t have because it’s only us who know which product is missold in which part of the country, how it is missold, and how to solve that. So that is our intelligence, which insurance companies for their own product don’t have. But we have that intelligence with us.”*
People like Sujoy can approach Insurance Samadhan, a web-based platform providing grievance redressal solutions for insurance issues.
The process
Any complainant can contact Insurance Samadhan, whose experts judge the case's merit. Once accepted, they take on the onus completely. They draft the necessary complaint to be sent to the insurance company. If it is not resolved at that stage, they assist the complainant in filing a case before the insurance ombudsman. In the rare event that the ombudsman not passing a favourable order, Insurance Samadhan helps the client file a claim before the appropriate consumer tribunal. They have solved over fourteen thousand such cases, and this number is growing. People like Sujoy have gotten their money back and are relieved.
So, how do they do this?
Insurance Samadhan can achieve this because it is building an in-house tech engine and has built a strong network of partners such as insurance agents or financial advisors, hospitals and corporates. Their network of insurance agents and financial advisors reviews claims by customers facing any insurance grievance issues. They undertake the first level check on the authenticity and probability of claim settlement. Once such reviews are completed and found satisfactory, Insurance Samadhan takes over the process.
Their network of hospitals and clinics refers patients who seek to challenge medical claims that have been rejected. Similarly, their network of corporates refers any customer or employees facing issues with their insurance to them.
Insurance Samadhan, thus, acts as the one-stop-shop for any insurance-related claims.
For this, they charge a nominal fee for registering the cases to move them forward, and in case of a favourable settlement, they take a percentage of the settlement amount. About sixty per cent of the matters handled by Insurance Samadhan are related to fraud or misselling of insurance, and most of the rest relate to insurance claims. If Insurance Samadhan cannot resolve the complaint, they will refund the registration fees.
Creating financially aware citizens
While providing solutions to aggrieved clients is the primary aspect, they are also actively working on providing knowledge and helping citizens understand their insurance needs. Their app, Polifyx, does just that. By uploading a policy on the app, a customer can analyse the various terms and conditions of the insurance, including the likelihood of their claims getting accepted or rejected.
The app also allows customers to upload all their policies (or access them through their PAN or Aadhaar) to be stored in one place, such as the Government of India’s DigiLocker. Therefore, they and their nominees can efficiently navigate and manage such policies.
With access to various financial products becoming relatively more straightforward, insurance, an age-old sector, continues to thrive. With it, however, come the problems of misselling and oft-rejected claims. Insurance Samadhan provides a unique insurance management system that enables citizens to manage their insurance products and, ultimately, get due justice for themselves.
Note:
*Deepak Bhuvaneshwari, co-founder of Insurance Samadhan, in conversation with Sachin Malhan, during Agami Prize 2022.
Edited by Jahnavi Jayanth, Keerthana Medarametla and Supriya Sankaran.
 | A guest post by
|
