Widely read:
Have you been mis-sold insurance? Do you have a dispute with your insurer? There could be several grievances that an insurance consumer has with the insurer. And there is a system in place to address your complaints.
Where to complain
At first, you are expected to lodge a complaint with the grievance redressal office of the insurance company and wait for at least 30 days for a response. You can also file a complaint through the Integrated Grievance Management System (IGMS), which has been set up by the Insurance Regulatory and Development Authority of India (Irdai).
If the insurance company does not address your complaint in 30 days, or you are not satisfied with the response, you can go to the ombudsman under whose jurisdiction your insurance provider falls.
Ombudsman
The insurance ombudsman, a quasi-judicial body, was created to quickly dispose the grievances of customers. The ombudsman has the mandate to attempt conciliation between the two parties and make awards accordingly.
The complaints can relate to any grievance against the insurer, including those on claims and dispute with regard to: premium paid or payable, legal construction of the policy wordings, delays in settlement of claims and non-issuance of any insurance document to customers after receipt of premium. The ombudsman's powers are restricted to insurance contracts of up to Rs20 lakh. For value above this limit, disputes can be taken to courts or consumer forums.
How to lodge a complaint
The complaint by an aggrieved person has to be in writing, and addressed to the insurance ombudsman of the jurisdiction under which the office of the insurer falls. The complaint can also be lodged by the legal heirs of the insured. The consumer cannot approach the ombudsman if the insurance company's response to the original complaint is older than a year. Also, if the dispute is pending with any other court or consumer forum, it will not be entertained by the ombudsman.
The ombudsman is expected to decide on a complaint within 3 months from its receipt.
In arrangement with HT Syndication | MINT
This article was originally published on December 15, 2016.
Disclaimer: This content is for information only and should not be considered investment advice or a recommendation.
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