Insurance Policy Terms and Exclusions Not Explained Before Purchase
You bought an insurance policy but the agent did not explain key exclusions (diseases not covered, waiting periods, sub-limits). When you filed a claim, it was rejected citing these exclusions you were never told about.
⚖️Your Rights Under RBI Regulations
Insurers must provide all material information about the policy including exclusions, waiting periods, and sub-limits before purchase.
If an exclusion was not communicated and you would not have bought the policy knowing about it, this is mis-selling.
You can file a mis-selling complaint with IRDA within 3 years of policy purchase.
💰 What You Can Recover
Claim amount that was rejected + premium refund for mis-sold policy.
⏱ Response Deadline
Within 3 years of policy purchase for mis-selling complaints.
📋Step-by-Step — What to Do
Gather any pre-purchase communication — brochures, emails, illustrations provided.
Document all representations made by the agent (in writing if possible, or note dates/times of verbal conversations).
File complaint with IRDA at igms.irda.gov.in citing mis-selling.
File at Consumer Forum for the actual claim amount.
🏛 Where to Escalate If Bank Doesn't Respond
IRDA IGMS + Consumer Forum + Insurance Ombudsman
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