Settlement & Repudiation of a Claim. We shall settle the claim within 30 days from the date of receipt of last necessary document in accordance with the provisions of Regulation 27 of IRDAI (Health Insurance) Regulations, 2016. In the case of delay in the payment of a claim We shall be liable to pay interest from the date of receipt of last necessary document to the date of payment of claim at a rate 2% above the bank rate. However, where the circumstances of a claim warrant an investigation in Our opinion, We shall initiate and complete such investigation at the earliest, in any case not later than 30 days from the date of receipt of last necessary document. In such cases, We shall settle the claim within 45 days from the date of receipt of last necessary document. In case of delay beyond stipulated 45 days We shall be liable to pay interest at a rate 2% above the bank rate from the date of receipt of last necessary document to the date of payment of claim.
Settlement & Repudiation of a Claim. We shall settle a claim including its rejection within 30 days of Our receipt of the last “necessary” documents. In case of suspected frauds, the last “necessary” document shall mean the receipt of the verification/ investigation report commissioned by Us to determine the validity of the claim as stated in <<Section V.7>> above. In the cases of delay in the payment by Us, We shall be liable to pay interest at a rate which is 2% above the bank rate prevalent at the beginning of the financial year in which the claim is reviewed by Us.
