If beneficiary is not satisfied with the service provided by Kotak Life Insurance at claims stage or with the amount of benefit paid to whom he can refer the case?

If beneficiary is not satisfied with the service provided by Kotak Life Insurance at claims stage or with the amount of benefit paid to whom he can refer the case?

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Kotak Life Insurance has internal ombudsman (Grievance Redressal Committee). Beneficiary can write to Kotak Life Insurance claims department and Claims department would put the matter before internal ombudsman for resolution. The decision taken by internal ombudsman would be communicated to the beneficiary. Beneficiary can also get in touch with Life Insurance Ombudsman (list of Ombudsman is available with Kotak Life Insurance and can be provided on request).

Claims under unusual events:

Missing Person

Any person, whose whereabouts are unknown whatever be the circumstances or causes of disappearance would fall under this category. Such person/s shall be considered as "MISSING" until located and their well-being or otherwise being duly established. In the normal process of life insurance claim settlement, filing an insurance claim without a death certificate can create problems. In this connection, we shall follow provisions of Sec. 108 of the Indian Evidence.

Act and a Supreme Court ruling, which are as under:

Provisions of Section 108 of The Indian Evidence Act, 1872:

Burden of proving that person is alive who has not been heard of for seven years:

Provided that when the question is whether a man is alive or dead, and it is proved that he has not been heard of for seven years by those who would naturally have heard of him if he had been alive, the burden of proving that he is alive is shifted to the person who affirms it.The Supreme Court Ruling is based on the provisions of Section-108 and states that "The presumption as to death in the absence of any evidence would arise only on lapse of seven (7) years". In other words, it would mean that a missing person is not presumed dead until he or she has been missing for seven years. Thus the presumption of death of the Life Insured shall be taken into account only on completion of 7 years from the date of the person having gone missing. Moreover, this has to be by way of an order from a competent authority/court. The date of order of such authority/court shall be considered as the date of death.

Unforeseen Circumstances / Natural Calamities:

The company shall look at cases of natural disasters or one-off major incidences like Tsunami, Mumbai Floods, 9-11 attacks etc., on an exception basis. We shall make basic checks/enquiries to ensure that there are no mal-practices, invalid claims are not being incorrectly honored by the Company or benefits are not unfairly/wrongly paid to third persons, not fairly eligible for the claims against the interests of the Policyholders at large. Based on these sanity checks, the company shall waive certain documentation to ensure a smooth claims process for the benefit of the Policyholders at large.

Based on a Death Certificate issued by the Municipal Authorities or equivalent or based on a typical statistics/gazette issued by the State/Central Govt., claims can be processed on the presumption that the Life Insured has expired, irrespective of other documentation.

An indemnity may be collected from the nominee in each case.

In all cases, we would need complete documentary evidence of the relationship of the nominee/legal heir.

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