National Consumer Day Health Insurance Frauds in India

National Consumer Day: Health Insurance Frauds in India and 8 Ways to Avoid Them

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Celebrated each year on 24th December, the National Consumer Day aims to create awareness about consumer rights. This, however, must not be confused with World Consumer Day, which is celebrated on 15th March. The National Consumer Day was formed in 1986 under the Consumer Protection Act.

Before we talk about health insurance frauds in India and how to protect the buyer, let us first understand who a consumer is.

Who is a consumer or buyer?

 Any person who receives goods and services in return for money is a consumer or a buyer.

How to protect the consumer rights of the buyer?

Any service that involves monetary transactions can invite trouble. The seller may demand more than the printed price or sell defective products in order to make a profit by unfair means. To guard a consumer against such malpractices, the Consumer Protection Act was formulated in 1986. Following are the consumer rights you should be aware of –

  • Right to Safety
  • Right to Choose
  • Right to Be Informed
  • Right to Consumer Education
  • Right to Be Heard
  • Right to Seek Redressal

Health Insurance Frauds in India

With the growing awareness amongst citizens to buy an insurance policy, frauds in insurance are also on the rise.

Insurance that provides coverage for a policyholder’s medical expenses is known as health insurance. It has been noticed that health insurance frauds in India usually witness some sort of a trend – they are usually telecallers who try to lure you into too-good-to-be-true products.

How to spot health insurance frauds in India?

Purchasing health insurance for yourself is not an easy task, as it may involve terminologies that seem unfamiliar and difficult to understand. Dishonest companies take undue advantage of this. Following are some red flags to help you spot health insurance scammers.

I Am Calling from The Government

Beware of phone calls that are trying to sell health insurance and claim to be agents of the Government. The Government does not sell health plans over phone calls nor does it have its own army of agents.

Health Insurance Companies Not Registered with IRDAI

The government body that regulates and promotes insurance policies in India is called, ‘The Insurance Regulatory and Development Authority of India’ (IRDAI). There are 30 health insurance providers in the country, of which, 25 are general insurance companies and 5 are standalone health insurance companies. Always check whether your health insurance provider is registered with IRDAI.

Overaggressive Salespeople

If a salesperson is being too pushy, then take it as a warning. You may even ask the salesperson to disclose their employee ID and call the insurance company to cross-check.

Insurance Plans that Offer Better Deals for Quick Sign-Up

Insurance companies keep their prices competitive. But if you are being offered too-good-to-be-true deals and blink-and-miss offers, then you need to bear caution. IRDAI regulations prohibit such behavior.

Unbelievable Low Cost

If premiums are way low as compared to the industry standards then take it as a red flag. Understand that the premiums charged are an income to the company and very low premiums are not sustainable.

Benefits that Seem Too Good to Be True

If your plans are offering you a lot of benefits for very little, then the odds are high that it is a bogus offer. Wherever you can, make calculations to verify that the benefits enlisted are, in fact, genuine.

The Company Insists on Cash Payment

We are in a world where the mode of payment is being revolutionized and digital mode of transaction is being adopted increasingly. So, if a company insists on ‘cash only’, do you not think it is a little fishy? Insurance premiums can only be paid via cheque/ DD/NEFT/RTGS/IMPS/UPI, etc. Additionally, if you want to avail of a tax benefit under Section 80D, you cannot do so if you pay your health premium in cash. So, if your insurance agent persuades you to only make a cash payment, step back because it may be a fraud. Once your health premium has been paid, ensure the receipt of the payment is received, and verify that there is a ‘received’ stamp on the company letterhead.

Fraudulent Companies Showing as If Genuine

When we have to search about anything new, we take to the internet and online frauds have become a menace. If you are looking for a health plan online, make sure the web portal you are on is genuine. Fake websites have become common, and this malpractice is known as spoofing.

  • Scammers use the company’s name and logo and pose as a genuine company.
  • Prefer to meet the company’s executive face-to-face to make an enquiry or learn more about the benefits of the plan. If they avoid meeting in person and insist on making an immediate online payment, they might be scammers.

A secure payment website will have its internet URL beginning with HTTPS:// and not HTTP://. Always check with the IRDAI to verify the company’s web address. If you sense that something is not right, file a complaint with the Cyber Cell.

Concluding Note

Being aware is the best weapon against scammers. Here are a few tips if you are looking to buy health insurance –

  • Always compare health plans that different companies have to offer before finalising.
  • Ask for a copy of the policy document, and thoroughly read the benefits provided and the illnesses covered.
  • Read about the company online and speak to your peers about their experience if they are existing policyholders of your preferred company.

Health insurance is an important instrument to protect yourself and your family members from unforeseen illnesses. But make sure you protect yourself from health insurance frauds in India by being vigilant.

Vital is offering one of the most comprehensive coverage in a transparent manner – everything is available online on their website. You can register yourself and buy a plan in less than a minute – all the information is given very clearly which helps you make a decision very easily. The plans are super affordable, even while offering up to 50L insurance coverage, and is built to cater to your individual needs.

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