How to complain against insurance companies ?
Complaints against Insurance Companies
Grievances against insurance companies :
Indian insurance companies receive a wide range of complaints from policyholders. Some of the most common types of complaints include:
Claim-related issues:
Delay in settlement: This is one of the most common complaints, as policyholders often experience delays in receiving claim settlements.
Partial or total rejection of claims: Insurance companies may reject claims based on various reasons, such as lack of sufficient documentation or non-compliance with policy terms and conditions.
Disputes over claim amounts: Policyholders may disagree with the amount of compensation offered by the insurance company.
Policy-related issues:
1. Misleading information: Policyholders may complain about being misled by insurance agents or companies regarding policy terms and conditions.
Unfair terms and conditions: Some policies may contain unfair or unreasonable terms that disadvantage policyholders.
Non-issuance or delay in issuance of policy documents: Policyholders may face difficulties in obtaining their policy documents.
Service-related issues:
Poor customer service: Policyholders may be dissatisfied with the quality of customer service provided by insurance companies.
Inconvenience in dealing with insurance companies: Some policyholders may find it difficult to contact insurance companies or resolve their issues.
Other issues:
Unfair business practices: Insurance companies may engage in unfair business practices, such as charging excessive premiums or engaging in deceptive marketing.
Intimidation or harassment: Policyholders may face intimidation or harassment from insurance companies or their agents.
HOW TO LODGE A COMPLAINT AGAINST INSURANCE COMPANIES ?
If you are not satisfied with the services of your insurance company, you may Walk into any office of the Insurer and lodge a complaint Or Approach the Grievance Redressal Officer(GRO) of the Insurance company . Give your complaint in writing along with the necessary supporting documents . Take a written acknowledgement of your complaint with the date. The insurance company should resolve your complaint in any case not later than two weeks of receipt of complaint.
In case if it is not resolved within two weeks or if you are not satisfied with their resolution you may approach the Grievance Redressal Cell of the Policyholder's Protection & Grievance Redressal Department of IRDAI through the following means:
Register complaint directly in of IRDAI's online portal - Bima Bharosa System
Send the complaint through Email to complaints@irdai.gov.in
Call Toll Free Number 155255 (or) 1800 4254 732
Apart from the above options, if it is felt necessary by the complainant to send the communication in physical form, the same may be sent to IRDAI addressed to:
General Manager , Policyholder's Protection & Grievance Redressal Department- Grievance Redressal Cell,
Insurance Regulatory and Development Authority of India(IRDAI),
Sy.No.115/1,Financial District, Nanakramguda,
Gachibowli, Hyderabad-500032
Only complaints from the insured or the claimants shall be entertained. The Cell shall not entertain complaints written on behalf of policyholders by advocates or agents or by any third parties. Complainants are requested to submit complete details of the complaint as required in the complaint registration form.
Once the complaint is registered in to Bima Bharosa System, then details of complaint are passed on to respective insurance companies. Policy holder receives the confirmation email after registering the complaint along with IRDAI token no which helps in tracking of the complaint through Bima Bharosa System.
HOW BIMA BHAROSA WORKS ?
IRDAI has implemented the Bima Bharosa (an Integrated Grievance Management System earlier known as IGMS). Bima Bharosa Portal provides a gateway to register complaints with insurance companies and track their status. It uses Web interface to ensure that it is accessible at all places and is on real time. It has also a mechanism to capture complaints received in physical as well as email form or voice calls received by IRDAI Grievance Call centre (IGCC).
To make a complaint in Bima Bharosa , CLICK HERE .
Once you fill your personal details , you will get an OTP to confirm your mobile number . On validating with OTP , you can fill other details of your complaint .
1) In case the complaint is not attended to within 15 days of registration of complaint in Bima Bharosa or the Resolution provided by Insurer is not satisfactory, you may approach the Insurance Ombudsman as per the procedure laid down under Insurance Ombudsman Rules, 2017.
2) Insurance Ombudsman is a quasi judicial body which provides a cost effective and impartial grievance redressal mechanism, (for more information about Insurance Ombudsman Rules and Procedures etc. please visit: http://www.cioins.co.in/
IRDAI Grievance Call Centre (IGCC) can be accessed through a toll free number 1800 4254 732 / 155255 for voice calls and complaints@irdai.gov.in through e-mail. The IGCC also provides details of the redressal systems of insurance companies whenever policyholders require them. Further, the IGCC also educates policyholders about the Insurance Ombudsman who provides a channel for fair disposal of complaints falling within the jurisdiction laid down.
HOW TO MAKE A COMPLAINT TO INSURANCE OMBUDSMAN ?
In case you are not satisfied with the result of making complaint to the insurance company directly or through Bima Bharosa , you can make a complaint to the Insurance ombudsman .
Ways to submit/lodge the complaint to the ombudsman :
Online : click here for registering
Offline : a) using email, b) via post or c) walk-in to Insurance Ombudsman Office (click here for details) of centres, email id, address and jurisdiction.
For tracking your complaint click here
Before you submit your grievance to Insurance Ombudsman:
You should have made a complaint to Insurance Company/Insurance Broker
Insurance Company/Insurance Broker has failed to furnish reply to you within a period of one month of your complaint;
OR You are not satisfied with the response given by Insurance Company/Insurance BrokerThe complaint is being made to the Insurance Ombudsman within one year from
(a) Date of rejection of the complaint by the Insurance Company/Insurance Broker
OR(b) Expiry of one month of filing the complaint if the Insurer fails to reply
The amount of Compensation sought in Insurance Ombudsman should not exceed Rs. 50 Lakhs.