NEW DELHI
Insurance is the first step towards financial planning. We buy policies to protect ourselves against unfortunate events. However, having insurance does not always guarantee protection.
Claims applications are often rejected, citing failure to disclose pre-existing conditions, lifestyle habits or having multiple policies.
More often than not, policyholders are caught off guard, as it is a long-standing practice in the insurance business to hide disclosure requirements in the fine print.
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Moreover, sometimes insurance agents fail to disclose complete information in the proposal form despite clients’ insistence. This happened to Kanish Kalra, a 30-year-old IT professional from New Delhi. Fortunately, he performed a quality check and found that important information was missing from his policy.
“I came to know about an app called Polyfix from Insurance Samadhan. I uploaded my health insurance policy document on the app. It pulled up my policy details and asked me questions about my health and habits. It alerted me that although I consume alcohol, it was not mentioned in the proposal form. I had told my agent to do so. I contacted the insurer and got it sorted out,” Kalra said.
Aamir Shafiq, a 34-year-old marketing professional based in New Delhi, did this for his life insurance policy. “I have an alignment problem in my lower back due to a sports injury I suffered while playing football. This information was not in the policy document. The app identified it because I mentioned it in the app during quality check,” Shafiq said.
The bonus increased slightly for Kalra and Shafiq after their revelations.
In some cases, disclosure may also result in cancellation of the policy. However, it is better than paying premiums and facing a claim rejection when the time comes.
What is Polyfix?
Insurance Samadhan, a technology-based insurance claims resolution platform, launched Polyfix in April 2023 to help policyholders identify errors and omissions in the proposal form so that they do not face claim rejection at the moment of truth.
“We help policyholders in case of fraudulent sales, if their claims are rejected or if they are paid less than they should be. We have come up with a solution that enables them to proactively correct errors in their policies, if any. We also inform them whether their insurance is sufficient or if they need more based on their income and family responsibilities. We do not sell insurance or any other financial product,” said Deepak Bhuvneshwari Uniyal, Co-Founder and CEO, Insurance Samadhan.
The app’s “know your policy” feature costs ₹199 for customers (B2C) and ₹149 for partners (B2B). Available for all types of insurance.
How it works
All you need to do is upload the PDF or image of the policy. It should include the proposal form. The app pulls in the policy details such as proposal number, company name, premium paid and medical assessment, lifestyle details such as smoking, alcohol consumption and income, contact information and nominee details. It also asks you to answer a few questions. Your answers are essential as the app checks if the disclosures made in your policy match the policy. If something doesn’t match, it alerts you in the final step. It also tells you if the missing information has a “high impact” or a “low impact” on the claim settlement.
“We divide all important information into four sections: personal, contact, nominee and policy details, including medical and financial details. We notify customers accordingly if anything is missing,” Uniyal said.
The most interesting thing is that the app writes an email on your behalf that you can send directly to the insurance company to rectify your policy. “The customer does not have to search for the contact of the insurance company. We have it saved for all insurers,” Uniyal adds.
Among other features, the “digital vault” allows you to store all your policies in one place. The app also has a feature called “health claims reimbursement” that can help you file claims professionally to avoid back-and-forth or rejection of claims for frivolous reasons.
While it is a good idea to verify policy details through Polifyx, make sure to always disclose all pre-existing conditions and lifestyle habits, such as smoking and drinking, in the proposal form. Also disclose details of related policies.
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