REDRESSING INSURANCE GRIEVANCES

Rajalakshmi Sivam, August 1, 2010
The Hindu Business Line

Are you having a problem with your insurance company? Is your insurer turning a deaf ear to your complaint? Do not worry. You have recourse to the IRDA (Insurance Regulatory and Development Authority). Whether that is an issue with a claim or an issue with the intermediating agent, you can now approach the IRDA on its toll-free number or on the contact numbers of special officers given on its website.

Along with its measures to reform the insurance sector, the IRDA has tightened grievance redressal procedures. Not stopping with the setting up of a Consumer Affairs department to handle grievances, it has issued new guidelines for insurance companies with regard to redressal of policyholders' complaints. There are now time frames within which insurance companies are required to redress issues raised by customers. By August 1 insurers are required to gear up to adhere to his new code of rules.

The insurer

Here, we discuss what the insured should do when he has a complaint with regard to the service of the insurance company.

Under the Regulations for Protection of Policyholders Interest, 2002, every insurer is supposed to have a grievance redressal system in place.

Insurers need to provide a help-line number and the grievance redressal officer's contact mail-id in their Web site.

In case you are not able to locate this information on the insurer's website, call the number given under the ‘Contact Us' link and get the details. Then, mail your complaint to the insurer.

In its new guidelines, IRDA has specified that the insurance companies should acknowledge receipt of a complaint to the customer within three days of receipt of the complaint.

Further, they should make a mention of the procedure for redressing the grievance and the time they would take for resolving it. IRDA has also set turnaround time (the time limit within which the insurer should respond to the insured) for a few common grievances. For example, in cases where the insured asks for cancellation of policy and the insurer fails to respond or in cases where the insured has paid premium for an add-on cover and paid premium but the insurer did not issue endorsement, the insurer should respond within 10 days of receiving the complaint. Also, in cases where the insurer is rejecting a complaint, they are required to provide reasons for it.

However, if you do not receive response from the insurer within two weeks, you have the following option:

The Insurance Regulatory and Development Authority recently opened a call centre for registering complaints of policyholders and taking action to resolve them.

To reach officers in the call centre you can either call the toll-free number 155 255 (from a BSNL phone) or call the Consumer Affairs Department of IRDA at (040) 6651 4888. You can get the details of the contact person (email: complaints@ This e-mail address is being protected from spambots. You need JavaScript enabled to view it ) in this department in IRDA's Web site. IRDA will take up complaints with the respective insurer.

In case of dissatisfaction in the manner the complaint was resolved or in case of dispute with the insurer, a policyholder has other options.

Insurance Ombudsman

Policyholders may approach the Insurance Ombudsman in cases of dispute over contracts of value not over Rs 20 lakh. You can find the contact mail address of the Insurance Ombudsman of your region (place of operation of the insurer) from IRDA's Web site.

To him, you can make a complaint not only on delay in settlement of claims but also repudiation of claims, dispute over premium paid or payable, non-issuance of policy document after premium payment and disputes over the way the policy document has been worded. The insurers are required by law to abide by the recommendations made by the Ombudsman. In cases of dissatisfaction with the outcome, the policyholder may go to consumer forums or even a civil court.