Community › Forums › Legal Advice India › Insurance Company rejected my claim
- This topic has 8 replies, 3 voices, and was last updated 1 year, 3 months ago by
User_6969aec6.
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UUser_6969aec6
PARTICIPANT
March 5, 2025 at 9:00 amI’m in a really frustrating situation with Tata AIG and need some advice on what to do next.I left India on 11th February 2025 with a valid travel insurance policy from another provider. Due to multiple unexpected extensions of my trip, my original insurance expired before I could return. Wanting to stay covered, I purchased a Tata AIG travel insurance policy on 25th February 2025 while still abroad. I’m still abroad for additional context.
Recently, I filed a medical expense reimbursement claim, and Tata AIG denied it,
Has anyone else faced something similar?Mail from Tata AIG:
*Please note as per policy terms and conditions the coverage starts only when insured boards the flight overseas as per insured journey definition and no coverage exists for policy brought overseas.
The below policy wordings for ready reference:
Part A: General Definitions
Insured Journey — means any journey undertaken within Policy period and which commences when the passenger boards the aircraft for onward overseas journey and terminates when he disembarks on return to India or the Policy Expiration date whichever is earlier.
Further it is also noted that you have misrepresented during purchase of policy as per the terms and conditions it is clearly mentioned that insured is currently in India during purchase of new policy as per below mentioned screenshot.
The below policy wordings is attached for ready reference:
General Terms and Clauses
7. CONCEALMENT OR FRAUD – The entire Policy will be void if, whether before or after a loss, you have, related to this insurance,
(a) Intentionally or recklessly or otherwise concealed or misrepresented or not disclosed, what we consider to be any material fact or circumstance;
(b) Engaged in what we consider to be fraudulent, dishonest or deceitful conduct; or
(c) Made false statements.
In view of the above i.e. as no valid coverage exist as per insured journey definition and also misrepresentation done during purchase of policy; we sincerely regret that we are not able to accept any liability under your claim.*
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DDesishark6045
PARTICIPANT
March 5, 2025 at 9:25 amCan I know for what medical reason the hospital service was taken and also on what date-
UUser_6969aec6
OP
March 5, 2025 at 9:48 amEar pain that turned out to be ear abscess-
DDesishark6045
PARTICIPANT
March 5, 2025 at 12:40 pmWhich date did you first seek medical help?-
UUser_6969aec6
OP
March 5, 2025 at 12:43 pm27th. The pain was unbearable and I wasn’t able to swallow any food without it hurting. Looked for doctors immediately even though medical treatments are very expensive here because I thought insurance would cover it.
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SSilentsuhani990
PARTICIPANT
March 5, 2025 at 10:14 amThe t&c of the policy are clear. You need to be in country at the time of purchase-
UUser_6969aec6
OP
March 5, 2025 at 10:16 amSo if I extended my trip for reasons out of my control, what should I do?
Should I have to go back to India to purchase it?They weren’t clear that I wasn’t allowed to purchase the policy overseas.
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SSilentsuhani990
PARTICIPANT
March 5, 2025 at 10:26 amBuddy calm the tone down.You expect them to create a special product for your use case, you must think you are Amitabh Bachchan.?
The sane thing to do would have been to approach your existing insurer. Bet you tried to save 500 bucks or something by going with a separate vendor
They’re literally throwing the t&c at your face.
Go fight them tiger
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UUser_6969aec6
OP
March 5, 2025 at 10:35 amHey, I didn’t mean to be rude at all, I honestly wasn’t paying much attention when I wrote that reply.I was just trying to understand my options because the policy terms weren’t very clear to me.
If there was a rule about needing to be in India at the time of purchase, I must have missed it but it definitely wasn’t obvious. I’m not expecting special treatment, just some clarity. And yeah, this isn’t about saving a few hundred bucks, it’s about understanding what’s fair. But thanks for the pep talk, I guess
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