Articles 6757 views October 10, 2018

The Dos and Don’ts Of Filing Complaint Against Your Insurance Company

People frequently complain about the extent of indifference that insurance company employees exhibit towards the nominees of those who had bought insurance policies from them. Also, they refuse to honor claims, especially of term insurance plans, citing frivolous reasons. The purpose of buying term insurance, be it from any insurer, is to ensure a definite amount of financial cover to make up for the loss of income due to the sudden death of the policyholder. Refusal or rejection of the claim on grounds on facetious grounds not only dilutes the purpose of paying for insurance but also causes unwarranted harassment to the dependents of the policy-holder.

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Complaining against your insurer

Filing a complaint against the insurer may ensure justice, though the process may be tedious and time-consuming. It is important that you first approach the grievance redressal cell of the insurer before proceeding to lodge a complaint with the Insurance Regulatory Development Authority of India (IRDAI). Find out who addresses customers’ grievances at the insurer’s branch. If the branch office near your house refuses to acknowledge your complaints, you may consider the next step of writing a complaint to the head office. The complaint mentioning your grief and cause of concern must be supported by necessary documents. Make certain that you receive a “written acknowledgment of your complaint” mentioning the date on which the complaint was filed. This will make the insurance company liable to take cognizance of the complaint within three days of filing it and resolve the same within 15 days.

Approaching IRDAI

The role of IRDAI is not limited to encourage and support insurance companies in their systematic growth and working. Its realm of responsibility extends to protecting the interest of the insurance policyholders and ensuring their dependants timely and complete receipt of the insurance benefits. Insurance policyholders dissatisfied with the treatment meted out to them by their insurance company’s officials may turn to the consumer affairs department of the IRDAI to redress their grievances. To start with, they may call on the toll-free number 155255 or 1800 4254 732. Alternatively, you may write an email containing all the necessary details to complaints@irda.gov.in.

If you are not conversant with online mechanisms, you may also drop a letter to

Consumer Affairs Department
Insurance Regulatory and Development Authority
3-5-817/818, United India Towers, 9th Floor
Hyderguda, Basheerbagh
Hyderabad – 500029

You may also push fax to the IRDAI office at 040-66789768.

Complaining online on the Integrated Grievance Management System (IGMS)

Never heard of the Integrated Grievance Management System (IGMS)? Well, this is an online consumer complaint registration system launched by the IRDAI in 2010. This system acts as the grievance redress monitoring tool for the IRDAI. The IRDAI has mandated all insurers, life or non-life, to integrate their online complaint logging systems to the IGMS. Those who have filed online complaints against their insurer can log in to IGMS and track the complaint resolution process available on the site. IRDAI tracks the complaints and their progress virtually in actual times through the IGMS.

Policyholders or their nominees can file any kind of complaint against their insurer, agent or any other intermediary with regards to sales, servicing or issues related to claim the processing. However, customers must ensure that they submit all relevant details including their policy number, contact details, details of their insurance company for timely grievance redressal.

Approaching an ombudsman

If the insurance company has not responded to the customer’s complaints within the requisite 15 days of the original complaint filed or if the customer is not satisfied with the solution advanced by the insurer, then filing a complaint with the ombudsman is the next logical step. The complaint must be in writing along with the necessary documents. The complaint letter must be addressed to the insurance ombudsman prevailing in the jurisdiction under which the insurance company’s office is included in it. In the absence of the policyholder, the nominee(s) or the dependents can file the complaint.

While filing a complaint with the ombudsman, it is important to note that the ombudsman can wield its power on insurance contracts with a value less than or equal to Rs. 20 lakhs. However, the policyholders or their legal heirs can also further your complaints with consumer forums and courts of law in case they are not satisfied with the decision taken by the Ombudsman.

Important details

There is a hierarchy that needs to be followed while filing complaints against the insurance company. One cannot simply rush to the ombudsman or consumer forum. It is important to lodge a complaint with the branch office of the insurance company before proceeding to the IRDAI. Post that, one may find the need to login to IGMS to file the complaint. Approaching the ombudsman and consumer forum come last in the list of filing complaints against the insurer.

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