When is an insurance claim turned down? Know the exclusions in your policy

Also provide proper documentation to minimise the chances of your TPA recommending that your claim should not be reimbursed

If you have bought a health or motor policy, you will have to deal with intermediaries like third-party administrators (TPAs) and surveyors, respectively. In its recently published annual report, the Executive Council of Insurers (ECOI), the body that supports the office of the ombudsman, has made a few critical observations about these intermediaries.

About TPAs, the report says that their decisions on settlement of claims should not be final and the matter should be reviewed by the insurer to arrive at a judicious decision. As for surveyors, it comments that the assessment of surveyors on the quantum of loss in