When the insurance company's surveyor inspects your claim (motor, property, or health) but does not share the report, here is the complete guide:
Step 1: What is a surveyor report? (a) for motor insurance claims: the insurer appoints a licensed surveyor to assess the damage, (b) for property insurance: the surveyor inspects the loss and estimates the claim amount, © the surveyor submits a report to the insurer with damage assessment, estimated repair cost, and claim recommendation, (d) the insurer uses this report to settle or deny the claim.
Step 2: IRDAI rules on surveyor reports. (a) the insurer must appoint a surveyor within 72 hours of receiving the claim intimation, (b) the surveyor must submit the report within 15 days (motor) or 30 days (property), © the insurer must settle the claim within 30 days of receiving the surveyor report, (d) the insured is entitled to a copy of the surveyor report — the insurer must provide it on request.
Step 3: How to get the surveyor report. (a) write to the insurer's claim manager requesting a copy of the surveyor report, (b) the insurer must provide the report within 7 days of the request, © if the insurer refuses: file a complaint with the grievance officer, (d) the grievance officer must respond within 15 days, (e) if still not provided: file with IRDAI Ombudsman.
Step 4: Why insurers withhold the report. (a) the report may support a higher claim than the insurer wants to pay, (b) the report may contain adverse findings about the insurer's handling, © the insurer wants to use the report as a negotiating tool, (d) the insurer may have modified or suppressed parts of the report.
Step 5: What to do if the report is unfavorable. (a) you can engage an independent surveyor (IRDAI-licensed) for a second opinion, (b) submit the independent report to the insurer, © if the insurer still rejects: file with IRDAI Ombudsman, (d) the Ombudsman can consider both reports and decide.
Step 6: Consumer protection. (a) withholding the surveyor report is an unfair trade practice under the Consumer Protection Act 2019, (b) file a consumer complaint seeking: (i) the surveyor report, (ii) claim settlement based on the report, (iii) compensation for delay and harassment, © the Consumer Commission can direct the insurer to share the report and settle the claim.
Step 7: File RTI. File RTI with IRDAI asking for: (a) the rules on sharing surveyor reports with the insured, (b) the number of complaints about surveyor reports not being shared, © the action taken against insurers who withhold reports, (d) the list of IRDAI-licensed independent surveyors.