Policy matters
On October 20, 2014, I requested AXA Insurance Gulf to cancel and refund (on pro-rata basis) my wife’s health policy. They denied the refund, mentioning that it was not possible, as there have been claims under the policy. The policy has been used once.
The issue was discussed with their insurance partner relation management e-system. But AXA has again denied the refund, mentioning that an AXA sales executive is not required to inform customers about the refund policy before buying or paying the premium of the policy. Sales executives are only required to inform about the benefits of the policy. This was informed in the handbook supplied after purchasing the policy.
I would like to raise following questions:
1. Is it fair for AXA to inform customers about terms and conditions after they buy the policy?
2. Why was a copy of terms and conditions not supplied to customers before they bought the policy? Why are the terms and conditions not mentioned in sales brochures?
3. Is it of any benefit for both the parties, if the customer cancels the policy after reading the handbook? There is no refund in case of claims.
I believed AXA had provided me with all the information (benefits and terms and conditions) before I bought the policy. Thus, action needs to be taken in this regard, in order to promote transparency in the market. I request Gulf News sort out this matter with AXA and provide me a refund from October 20, 2014 onwards.
From Mr Ravish Agrawal
Ras Al Khaimah
The management of AXA Insurance Gulf responds:
While it is unfortunate that our valued customer chose to cancel his insurance policy, at no time did we intend to mislead him.
In our sales brochure, we do have a disclaimer mentioning that this document provides only a summary of information about coverage and that the customer should refer to the Policy for Full Terms and Conditions and that a copy of this policy is available from any AXA branch in the Gulf. Please find the excerpt from our sales brochure below:
“Disclaimer: This leaflet provides only summary information about coverage. The liability of AXA Insurance (Gulf) B.S.C. (c) does not commence until the Proposal has been accepted and the Premium has been paid. AXA Insurance (Gulf) B.S.C. (c) reserves the right to ask for special terms or decline the Proposal. Please refer to the Policy for full terms, conditions and exclusions.”
As part of the application form under the signature and declaration, it is mentioned that the customer should read the AXA Insurance Healthcare Series Membership Agreement when received. Please find the excerpt from the membership application form:
“Signature and Declaration: I declare that to the best of my knowledge and belief the statements on this application form are full, true and correct, that I shall read the AXA Insurance Healthcare Series Membership Agreement when received and that I agree to be bound by it. In the event of any dispute, I agree to follow the AXA insurance (Gulf) B.S.C (c) arbitration process in the first instance. I agree that the acceptance of my application shall be on the basis of these statements. I agree that AXA may contact my/our medical practitioner(s) for further details of my/our medical history and authorize such practitioner(s) to release any information AXA may require.
I have understood that to incept my policy, I must provide a passport size photograph, passport/visa copies and the latest medical reports if needed for each member.”
The Healthcare Series Membership guide also mentions the Cancellation policy and process:
“What happens if you wish to cancel your policy?
You may cancel your policy at any time by giving us no less than 30 days notice in writing.
Bearing in mind that this is an annual contract we will not refund premiums if any claim, however small, has been made in the current policy year.”
During the sales process, we do not normally go through all the terms and conditions and this is why we encourage the customer to read all of the membership documents upon receipt. After reading this, if the member requires any clarification on any cover, exclusion, condition, etc, our Customer Service team is happy to provide the necessary information. If the member is not happy with the policy and wishes to cancel same, and before making a claim, they may do so with a full or pro-rated refund.
Mr Agrawal responds:
Is it fair for AXA to send a copy of the brochure mentioning the cancellation policy after the customer has paid the premium? As a customer, I believe that it’s totally unfair. I would like to again ask for a necessary refund for my health policy.
The management of AXA Insurance Gulf responds:
In response to the complaint, we have nothing more to add, except to say that if our customer still wishes to cancel the policy, the refund will be according to the policy conditions which was communicated to him in the earlier correspondence. Kindly note that any client has every right to ask for our sales brochure and get a clear explanation on all his/her doubts and questions before buying the product and the policy document is sent after signing the contract and paying the premium. The full terms and conditions is also available on our website and can be viewed by anyone at any stage of the process.
(Process initiation: June 25. Response from organisation: July 2. Process completion: August 24.)
Editor’s note: Do you have similar issues that you would like to raise with us? You can write to us at readers@gulfnews.com.
