You are viewing the translated version of दाबी भुक्तानी सम्बन्धी उजुरी.
Section 128
Claim Payment Complaint
(1) If the insurer does not pay the insurance claim to the insured within the period mentioned in the insurance policy, if the liability is not determined or if the liability is determined in a manner that is detrimental to the insured, the concerned insured may file a complaint with the authority.
(2) In case of a complaint under sub-section (1): The authority shall conduct necessary investigation and give fifteen days time to the concerned insurer to submit a reply.
(3) If a reply is received in accordance with sub-section (2), the authority may do as follows:-
(a) To effect a settlement between the complainant and the insurer,
(b) Non-payment of claims. Ordering to pay reasonable compensation for any loss caused to the insured,
(c) If the liability determined by the insurer is not reasonable, ordering the relevant insurer to re-determine the liability,
(d) to order the insurer concerned to make payment if it appears that the insurer is liable to pay the claim,
(e) make 8 other appropriate orders.
(4) If it is determined that due to the non-payment of the claim as per the insurance policy, the claim should be paid after filing a complaint against an insurer, in addition to the insurance amount, interest at the rate of ten percent from the date of filing the complaint and an amount equal to the actual expenses incurred in obtaining legal treatment shall be paid by the concerned insurer to the complainant. (5) The insurer, the insured or any other person who is not satisfied with the order given by the authority under sub-section (3) may appeal to the relevant high court within thirty five days.
(6) According to this section, other arrangements regarding the action of the above complaint shall be as prescribed.