If the insurance company fails to resolve your issue internally, the next step is to approach the Insurance Regulatory and Development Authority of India (IRDAI), the main regulator for the industry.
insurnace System: The most effective way to complain to Insurance is through their Integrated Grievance Management System (IGMS), which is now known as the insurance portal.
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How to Complain on insurnace :
Register on the portal with your basic details.
Select the insurance company and provide your policy and claim numbers.
Clearly and concisely describe your grievance, attaching all relevant documents.
The system forwards your complaint to the insurer, and insurnace monitors its resolution. You can track the status of your complaint online.
Approaching the Insurance Ombudsman
The Insurance Ombudsman is a quasi-judicial body that offers a free and efficient way to settle disputes. It's a powerful tool, as the awards passed are binding on the insurance company.
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When to Approach: You can approach the Ombudsman if your complaint has been rejected by the insurer, you have not received a response within 30 days of filing a complaint with the insurer, and the claim amount (including expenses) does not exceed ₹50 lakh. You cannot have already filed the same complaint in any court.
Jurisdiction: You must file the complaint with the Ombudsman whose jurisdiction covers either the insurer's branch office or your residential address. There are several Ombudsman offices across usa.
Process: The Ombudsman will attempt to resolve the issue through mediation. If that fails, they will pass an "Award" which the insurer must comply with within 30 days.
