Insurance Basic

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INSURANCE Grievances Redressal Basics

• Prabhat Kumar
• M 98110 66664
• E-mail ltmr.prabhat.kumar_at_gmail.comgt

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3 tier complaint redressal mechanism

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Consumer Forum

• COPRA has created a three-tier quasi-judicial
  system to deal with the consumer related issues,
  i.e. the District Forums,
• the State Commission or
• the National Commission with final appeal lying
  before the Supreme Court of India.

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Regulator is IRDAI
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Insurance Grievance Redrssal

• The Consumer Affairs Department of the Insurance
  Regulatory and Development Authority (IRDA) has
  introduced the Integrated Grievance Management
  System (IGMS) which is an online system for
  registration and tracking of grievances.

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Insurance Grievance Redrssal

• You must register your grievance first with the
  insurance company and in case you are not
  satisfied with its disposal by the company, you
  may escalate it to IRDA through IGMS by accessing
  www.igms.irda.gov.in.
• In case you are not able to access the insurers
  grievance system directly, IGMS also provides you
  a gateway to register your grievance with the
  insurer.

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Apart from registering your grievance through
IGMS (i.e., web),

• you have several channels for grievance
  registration-through
• e-mail (complaints_at_irda.gov.in),
• through letter (address your letter to Consumer
  Affairs Department, Insurance Regulatory and
  Development Authority, 3rd Floor, Parishram
  Bhavan, Basheerbagh, HyderabadAndra Pradesh )

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Apart from registering your grievance through
IGMS (i.e., web),

• or simply call IRDA Call Centre at
• Toll Free 155255 through which IRDA shall, free
  of cost, register you complaints against
  insurance
• companies as well as help track its status.

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IRDAI Call Center assists in

• The Call Centre assists by filling up the
  complaints form on the basis of the call.
  Wherever required, it will facilitate in filing
  of complaints directly with the insurance
  companies as the first port of call by giving
  information relating to the address, telephone
  number, website details, contact number, e-mail
  id etc of the insurance company.

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IRDAI Call Center assists in

• IRDA Call Centre offers a true alternative
  Channel for prospects and policyholders, with
  comprehensive tele-functionalities, serving as a
  12 hours x 6 days service platform from 8 AM to 8
  PM, Monday to Saturday in Hindi, English and
  various Indian languages.

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When a complaint is registered with IRDA

• it facilitates resolution by taking it up with
  the insurance company.
• The company is given 15 days time to resolve the
  complaint. If required, IRDA carries out
  investigations and enquiries. Further, wherever
  applicable, IRDA advises the complainant to
  approach the Insurance
• Ombudsman in terms of the Redressal of Public
• Grievances Rules, 1998.

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Regulator is IRDAI
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TAT as prescribed by IRDAI
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(No Transcript)
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So, let us view a U-Tube presentation Duration
3.38 mins

• https//www.youtube.com/watch?vcyw3owBZiOA

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IRDAI directlyas regulator

• In case the customer is not satisfied with the
  response received from the insurance company or
  if they have not received any response you may
  contact IRDA (Insurance Regulatory Development
  Authority) or Insurance Ombudsman for further
  resolution.

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IDRA Grievance Details IRDA Grievance Call
Centre (IGCC)

•  TOLL FREE NO 155255
• Email ID complaints_at_irda.gov.in
• You can also register your complaint online
  at http//igms.irda.gov.in
• Address for communication for complaints by
  fax/paper
• Consumer Affairs Department
• Insurance Regulatory and Development Authority
• 9th floor, United India Towers, Basheerbagh
• Hyderabad 500 029, Telangana
• Fax No 91- 40 6678 9768

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Insurance Ombudsman

• In case the insured/ policyholder is not
  satisfied with decision/ resolution of the
  company, they may approach the Insurance
  Ombudsman of their state or an appropriate
  judicial/ quasi- judicial authority having
  jurisdiction over the matter for redressal of
  your grievance.

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the Insurance Ombudsman if

• Insurance Claims that has been rejected or
  dispute of a claim on legal construction of the
  policy
• Delay in settlement of claim
• Dispute with regard to premium
• Non-Receipt of your insurance documents

• The Insured or Policyholder may approach the
  Insurance Ombudsman if the grievance pertains to

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FEED BACK and Yr INQUIRIESare invited

• Please communicate with
• PRABHAT KUMAR
• M 98110 66664
• E-mail ltmr.prabhat.kumar_at_gmail.comgt