Here's how the insurance complaint resolution process works in India
When you buy an insurance policy, you're entering into a contract with the insurer, expecting a safety net under unforeseen circumstances. However, there might be times when disputes or grievances arise regarding claim settlements or policy terms. Understanding the insurance complaint resolution process in India is crucial for policyholders. They must ensure their concerns are addressed effectively and efficiently.
Know your rights
Every policyholder has the right to lodge a complaint if they are dissatisfied with their insurance provider's service. This could be due to delays in claim processing or disputes over policy terms. The Insurance Regulatory and Development Authority of India has set clear guidelines for insurers. These ensure that grievances are addressed in a fair and transparent manner, adhering to established regulatory standards.
Start with your insurer
To address any insurance-related concerns, the first step is to contact your insurer directly. Most companies provide a grievance redressal mechanism. You have the option to file a complaint via email, phone, or in person at the nearest branch. It's important to provide all relevant documents and information to support your case. This ensures a thorough review and timely resolution.
Escalate if needed
If your issue remains unresolved after 15 days, or if the resolution provided by your insurer does not satisfy you, it's time to escalate the matter. You should approach the Grievance Redressal Officer of the insurance company. This officer is tasked with addressing your escalated complaint. They are expected to offer a solution within a 15-day timeframe.
IRDAI's grievance redressal mechanism
In cases where the insurer fails to resolve your grievance within 30 days, you have the option to approach IRDAI. You can use its Integrated Grievance Management System, or IGMS. IGMS is an online platform. It allows policyholders to register complaints directly with IRDAI. IRDAI then takes up the matter with the concerned insurer for resolution.
Ombudsman scheme
As a last resort, policyholders can approach the insurance ombudsman. This independent body was established by the IRDAI. The ombudsman mediates between aggrieved parties and insurers. Complaints can relate to claim settlements and policy servicing issues, among others. Policyholders must file complaints within one year from the date the insurer rejected them or sent its final reply.
