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Four pending items at the branch service desk on a Monday morning

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Four pending items at the branch service desk on a Monday morning

On a Monday morning the Vasco-da-Gama branch opens with four items on the customer-service desk. (i) Meera Naik's maturity claim for ₹3,40,000: the discharge form and original policy were received 34 days ago, the credit has not been dispatched, and she flies to Dubai in ten days. (ii) Farid Khan says his account was debited twice for the same ₹12,450 quarterly premium on 28 March; the second debit has not been reversed. (iii) A death claim intimation for ₹18,00,000 received 12 days ago, where the recorded nominee is the adult widow, but the branch has asked for her minor son's school certificate 'to prove guardianship' - a document that is not on the claim checklist. (iv) An email from a policyholder who received her policy document on 3 March and wants to cancel it on 25 March because the agent promised '12% returns'.

1. Rank the four items in the order you would act on them, giving the criterion for each ranking decision and the first action you would take.

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Criteria: (a) a statutory deadline already breached or about to expire, (b) the customer's money irreversibly lost, (c) dependence of the family on the payment, (d) whether the branch itself created the delay.

  1. Meera's maturity claim - highest. 34 days exceeds the 30-day limit for settling a claim after receipt of the last necessary document, so the branch is already in breach. She is also leaving the country. Action: release the payment today by electronic credit, confirm the bank details in writing, log the case as a delay, and note that interest at 2% above bank rate is payable for the delay under the policyholder-protection regulations.
  2. The cancellation email - next, because the right is expiring. Received 3 March, written 25 March: 22 days. Whether the free-look window is open depends entirely on the sales channel, and the channel must be checked today (see next task). A day's delay can extinguish her right.
  3. The double debit - the customer's money is already out of his account. Raise the chargeback with the bank immediately and commit to a reversal date; confirm in writing.
  4. The death claim - urgent but still inside the 30-day window. The delay is of the branch's own making: the widow is an adult nominee, so a minor's school certificate is irrelevant. Withdraw the wrong demand, confirm the recorded nominee and proceed on the checklist.

Any defensible order is acceptable if the criteria are stated; 'first come, first served' is not.

2. Analyse the free-look request on its dates. What will you tell the policyholder, and what would be deducted if cancellation is allowed?

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Dates: policy document received 3 March; cancellation requested 25 March = 22 days.

Rule: the free-look period is 15 days from receipt of the policy document where the policy is sold face-to-face, and 30 days where it is sold through distance marketing or electronic means. The clock starts on the date of receipt, not the date of issue.

  • If the sale was face-to-face: the window closed on 18 March and the request is time-barred. Tell her so in writing, politely, and offer the alternatives that do exist - continue the policy, or surrender once it acquires surrender value, or make it paid-up as the plan permits.
  • If the sale was by telemarketing or online: 22 days is within the 30-day window, so cancellation must be honoured. She must return the policy document with a written request; the refund is the premium paid less the proportionate risk premium for the days she was covered, stamp duty and any medical examination expenses. Process the refund promptly once the documents are received and confirm the amount in writing.

Separately: the '12% returns' promise is a mis-selling allegation. Record it, obtain her written account and any message from the agent, and refer it for conduct action; whether or not the free look is available, that complaint must be answered.

3. Draft the reply to Farid Khan (60–80 words) and state the escalation route if the matter is not resolved.

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Draft reply:

Dear Mr Khan, Thank you for your email of 25 March about the duplicate debit of ₹12,450 on 28 March. We have registered grievance reference GS/2025/0417 and raised a chargeback with your bank. The duplicate amount will be credited to your account by 4 April, with no charges to you. We will confirm by SMS once the credit is received. If it is not credited by that date, please call our toll-free line quoting the reference. Yours sincerely, Branch Manager, Vasco-da-Gama.

Why this wording: it acknowledges the complaint, gives a reference number, a specific action and a date, and a named follow-up channel. It does not concede fault before reconciliation, and it does not promise a refund 'immediately' - a promise the branch cannot keep.

Escalation: if the customer is not satisfied or gets no reply within 30 days, he may lodge the grievance on IRDAI's Bima Bharosa portal and, if still unresolved, approach the Insurance Ombudsman having jurisdiction, whose award the insurer must comply with. Mention this proactively; it defuses the complaint and is required good practice.