Term of the week: Insurance ombudsman

The institution of insurance ombudsman was created by the Government of India for speedy disposal of policyholders’ grievances. These complaints can relate to any grievance against the insurer, including premiums paid or payable, dispute on the legal construction of the policies, non-issuance of insurance document and delay in settlement of claims.

If a policyholder wants to file a complaint against any insurer, he/she must send a written complaint along with supporting documents to the insurance ombudsman. The ombudsman has to be within the territorial jurisdiction of the branch or the office of the insurer against whom the complaint is being made. The address, e-mail and phone number of the ombudsman can be found in IRDAI’s website.

The ombudsman doesn’t charge any fees and the policyholder shouldn’t have approached any other forum or court for the same issue.

The complaint has to be filed within a year from the date of rejection or repudiation of claim by the insurer.

The ombudsman shall pass award (final judgment) within three months of receiving all requirements from the policyholder.

The insurer will have to comply with the award within 30 days of the receipt of the award.

Published on August 04, 2019

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