You have the option of filing a complaint if you are not happy with your insurance company. Here’s how to file a complaint.
Insurance companies, like any other business, can leave you dissatisfied with their services. As a long-term contract between you as a policyholder and the insurer, insurance can sometimes lead to conflict, complaint or grievances that may develop over a period of time. You always have the option to file a complaint related to services or any claim-related dispute.
IRDAI And Complaint Resolution With Insurers
Insurance regulator, Insurance Regulatory and Development Authority (IRDAI), has put in place various safeguard mechanisms to ensure any such complaints or differences between policyholders and insurers are resolved swiftly. As per IRDAI regulations, a policyholder can first complain against any dispute or grievance with the insurer itself. Each insurer is mandated to have a dedicated grievance resolution department catering exclusively to handle complaints and grievances. A fixed timeline of 15 days is mandated for the insurance company to act on the possible resolution of the complaint.
IRDAI on its part has also created a dedicated ‘Grievance Redressal Cell’ which entertains all complaints which are not resolved by the insurance company timely or to the satisfaction of the policyholder. To make things easy, IRDAI offers an Integrated Grievance Management System (IGMS) allowing users to track the status of their complaints and possible resolution online.
Steps Involved In Filling a Complaint Against An Insurance Company
Here are the various steps involved to file a complaint or seek a resolution for any grievance against any insurance company, be it a life insurer or a general insurer.
Step 1: Initiate a written complaint to the insurer
The first step involves writing to the insurer for possible resolution of any complaint along with the relevant documentation. Smaller grievances or complaints like any manual errors etc. are usually addressed at the local branch or regional level. It is wise to maintain a written record of all communication between you and the insurer along with relevant acknowledgements.
Step 2: Contact grievance redressal officer of the insurer
If the complaint is not resolved at the local level, the next step is to write to the grievance redressal officer of the insurer concerned. Each insurer lists the details and address of its grievance redressal officer in all office branches and on their official website. You can email or submit your complaints in writing and seek proper acknowledgement from the office of the grievance redressal officer. The grievance redressal officer will respond to your complaint within a stipulated timeline of 15 days.
Step 3: Escalate the matter to IRDAI if complaint persists
If for some reason the insurer’s grievance redressal officer fails to respond to your complaint within 15 days or offers a resolution which does not satisfy you, you reserve the right to escalate the matter with the Grievance Redressal Cell of IRDAI. You can make use of the Toll Free No.155255 or submit your relevant complaints using the email at firstname.lastname@example.org. You can also register and monitor your complaint at igms.irda.gov.in for easy tracking.
Step 4: File for a civil complaint
If you are not satisfied with the resolution offered by IRDAI, you have the option to file a civil complaint and seek the services of an insurance ombudsman, consumer forum or even escalate the matter to a civil court under relevant sections of the Indian Penal Code (IPC). While there is no limit to approach the consumer forum or a civil court, you must approach an insurance ombudsman within one year of rejection of your complaint by your insurance company.
To make insurance transparent, IRDAI offers a streamlined complaint resolution process for any complaints between policyholders and insurance companies.