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Kotak Health Premier
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Cover Note Related
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Dispute regarding quantum of premium refund.
Refund of premium due under policy not received by Insured.
Insurer collected premium – Issued policy without any proposal or confirmation in writing from Insured
Insurer accepted premium and then rejected the proposal
Insurer not furnishing proposal copy after acceptance of risk
Insured does not know the scope of coverage and other terms where Proposal form was filled up by Agent
Proposal form given by Insured was tampered by Agent / Insurer
Proposal papers submitted but misplaced by Insurer
Excess proposal deposit not refunded
After submission of all requirements, no communication was received.
Policy bond not received.
Mistake in age.
Mistake in Date of Commencement (DOC).
Mistake in Term of the policy.
Mistake in name of the Nominee/ Beneficiary.
Mistake in Date of Maturity (DOM)/DOLP/others.
Mistakes in the name and address of the insured.
Mistakes in any other policy schedule item.
Mode of payment not shown correctly.
Next Premium due is not shown correctly.
Wrong Policy Bond is issued
Misleading Advertisement issued by Insurer. Product was different from what it was advertised.
Product (policy) received by insured is not what it was negotiated at the time of sale.
Premium receipt not received by Insured
Insurer loaded premium arbitrarily
Premium paid through electronic modes/cheque not accepted
Premium cheque bounced. Without giving intimation to Insured Insurer. cancelled the policy
Insurer calculated premium wrongly and over charged the Insured.
Where provisional premium is collected, final adjustment is not carried out
No Response for recording Change of address
Response for noting an assignment is not sent
Statement of account not received
Premium payment position statement not received
Response for issuance of duplicate policy is not sent
Payment of premium not acted upon or wrongly acted upon
Reinstatement requirements raised by Insurer not acceptable
Requirements for revival not communicated or raised
Non-receipt of Premium receipt
Non-receipt of Duplicate policy
Insurer failed to send lapse intimation
After submission of all reinstatement (revival) requirements, there is no response from the Insurer.
Notice of assignment or nomination change not acknowledged
Request for Servicing Branch transfer is not effected
Auto Cover continuation option not effected
Policy conversion option not effected
Policy Benefit option not effected
Alteration in policy not effected.
Dispute concerning statement of account or premium position statement
Response for processing or payment of Policy Loan is not sent
No Response for noting a new nomination
Certificate of Insurance / Policy not received by the Insured
Endorsement for modification of policy/add on not issued by the Insurer
Important clauses deliberately shown in small print
Insured asked for issue of a duplicate policy – Insurer failed to issue
Insurer cancelled policy arbitrarily without serving notice
In the renewal policy, Insurer changed the terms & conditions without informing the Insured
Change of address not noted
Details incomplete in the policy.
Details shown in policy different from the Cover Note.
Insured asked for cancellation of policy, Insurer failed to respond
Details shown in policy or Add-on are incorrect.
Insurer forced Insured to switch over to a new policy.
Insurer refused to accept Insured’s request to enhance coverage mid-term.
Insurer refused to renew the policy without giving any reasons.
Product no longer available with Insurer
While renewing the policy Insurer refused to enhance the Sum Insured sought by Insured.
Without the consent of Insured Insurer debited customer’s bank A/c / credit card and issued policy.
IDV related disputes
Higher deductible imposed by Insurer
Deductible wrongly imposed by Insurer.
Insurer imposed additional conditions wrongly.
Insurer not given no claim bonus
Insurer gave premium quote but later went back on acceptance of risk.
Insurer failed to clarify the queries raised by Insured.
Insurer not given eligible discount in premium
Misbehavior of surveyor towards the Insured
Financier’s interest not reflected in the policy.
Insurer not taken any loss prevention measures upon reporting of a claim by Insured.
Failure of online transaction though premium was deducted through credit card.
Rebating resorted to by Agent.
Rebating resorted to by Insurer.
Fraudulent behavior on the part of Agent in claim matter
Alleged misconduct of officials of Insurer.
Alleged misconduct of surveyor / investigator.
Unsolicited calls made to Insured in spite of DNC registration.
Complaint of Insured relating to pre-inspection / pre-acceptance survey
Cashless facility first sanctioned and withdrawn.
Where claim is repudiated Bills / reports not returned to the customer.
Refusal to renew Insurance
Unable to register Grievance due to faulty systems
Dispute relating to Interpretation of perils/exclusions/conditions/warranties
Dispute relating to policy extension of term for Long term policies
Wrong add on policy wording
Insured asked for add on coverage and paid premium. Insurer did not issue Endorsement.
Insurer did not attach any clauses to the policy – coverage given under the policy not known to the Insured.
Cover Note not received
Scope of cover not explained
Dispute on mode of claim settlement – Total loss / cash loss vis-à-vis repair basis.
Dispute on obsolete factor.
Dispute between Insured and Insurer on amount allowed towards Labour charges.
Dispute on deduction of salvage value.
Insurer not issued claim form.
Insurer repudiated the claim due to alleged breach of policy condition / warranty.
Claim denied due to alleged non-cooperation of Insured
Insurer refusing to register claim
Insurer asking for irrelevant claim documents
Insurer asking for claim documents on a piecemeal basis.
Delay in appointment of surveyor
Delay in conducing survey.
Surveyor delayed issue of his report.
Survey report copy not issued to the Insured by the surveyor.
Difference between assessed loss and amount settled by Insurer.
Insurer reduced the Quantum of claim for reasons not indicated in the policy.
Insurer failed to make offer of settlement to Insured after receipt of survey report.
Insurer not disposed of the claim
Insurer not issued claim cheque inspite of offer of settlement.
Cheque issued by Insurer is bounced.
Name of Insured wrongly written in the claim cheque.
Insurer paid claim to a wrong person.
Insurer closed the claim without advising the Insured any reasons.
Dispute on rate of depreciation applied.
Insurer repudiated claim due to delay in intimation of claim by Insured.
Insurer repudiated claim due to delay in submission of claim documents by the Insured.
Insurer repudiated the claim based on 2nd surveyor’s recommendation.
Insurer repudiated claim due to dispute on premium paid.
Insurer repudiated claim due to alleged fraud.
Claim repudiated without giving reasons
Claim repudiation by Insurer due to bouncing of premium cheque presented late by Insurer.
Insurer repudiated claim due to alleged carelessness of Insured.
Delay on the part of TPA to provide cashless facility.
TPA refuses to extend cashless facility to the Insured.
Date of Intimation
You will be redirected to the website of Wellogo Services Private Limited, our wellness service provider, to facilitate your request. This link is provided only for your convenience. Kotak Mahindra General Insurance Company Limited does not undertake any liability, responsibility or reliability of any service, statement or other information displayed or provided through the website of Wellogo Services Private Limited.
Request you to refer the policy wordings pertaining to “Health and Rewards” and “Value Added Benefits” covers.
You agree to share your policy information with Wellogo Services Private Limited for the purpose of facilitation of the Wellness services.
You authorize Wellogo Services Private Limited to make a contact you over phone call/sms/ email for providing the Wellness services
You agree that by clicking on the link, you will redirected to Wellogo Services Private Limited website.
Kotak Health Premier UIN: KOTHLIP18089V011718
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