How do you raise a grievance regarding your policy?

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Key Takeaways

  • The first and foremost thing you should do is to register a complaint with your insurance company to get your grievance addressed.
  • Every insurance company has a Grievance Redressal Officer (GRO). If your complaint is not addressed at the local level, you can escalate it to the GRO of the insurance company.
  • You should approach the IRDAI only after you’ve gone through your insurance company’s grievance redressal channel.

Introduction

 

By now, you must have a basic idea of what is insurance and what it does. However, what happens when you want to make a claim and are not happy about the outcome? Who can you go to?

 

Today, we’ll be discussing the various authorities you can approach to be heard so you are equipped with all the information. While most of you will not need it, as most insurers take care of their customers. However, bookmark this for the future.

 

Now, imagine you have bought a new car and have taken an insurance policy on it. The car got damaged and you filed the claim with your insurance company. However, several times insurance companies don’t accept claims for several reasons. This can leave you angry and dissatisfied. What do you do then? The simplest answer? Contact your agent.

 

You might want to file a complaint about any of these reasons:

  • Rejection of claim
  • Premium hike
  • Negligence on insurer’s part
  • Denial of the policy renewal request
  • Mis-selling of insurance plans
  • Additional policy features costing more
  • Unsatisfactory payouts

 

Here’s how you can file a complaint and report a grievance against your insurance company:

 

Contact your insurance agent

 

Your insurance agent is your go-to person for everything related to your insurance. In most cases, an insurance agent can help you out and it need not go further than this.

 

Send a written complaint to the insurer

 

The first thing you will need to do is register a complaint with your insurance company to get your grievance addressed. Write to the company at the local/regional level to resolve your complaint along with the relevant documentation. Sometimes, smaller complaints like manual errors can be addressed at a local level. Ensure that you maintain a record of all your communication with your insurance company.

 

Approach the GRO

 

Every insurance company has a Grievance Redressal Officer (GRO). If your complaint is not addressed at the local level, you can escalate it to the GRO of the insurance company. You can either visit the GRO at the nearest branch or email them. Here is the list of email ids of all insurance companies – grievance website details.xlsx (live.com)

 

Fill out this complaint registration form – policyholder complaints registration form.pdf – and ensure you take back a written acknowledgement of the complaint with the date on it.

 

Every insurance company has its own set of rules and regulations to deal with complaints. The IRDAI requires the companies to disclose this process publicly. Click the following link to know about registering a complaint with your insurance company – IRDA – Insurers’ Grievance Policies (policyholder.gov.in)

 

Wait for the company to resolve the issue

 

Now that you have filed your complaint, wait for 15 days for the GRO to respond to your grievance. If the company doesn’t resolve your grievance in 15 days or if you are dissatisfied with the solution they provide, as a policyholder you can escalate the issue and take it to the insurance regulator in India i.e. Insurance Regulatory and Development Authority of India (IRDAI).

 

Complain to IRDAI

 

You can approach the Grievance Redressal Cell of the Consumer Affairs Department of IRDAI through two ways –

  1. a) You can call the toll-free number 155255 / 1800 4254 732 (or)
  2. b) Send them an email at complaints@irdai.gov.in.

You can also register the complaint through IRDAI’s online portal – Integrated Grievance Management System (IGMS). You can access it here: igms.irda.gov.in

 

You should approach the IRDAI only after you’ve gone through your insurance company’s grievance redressal channel. If for any reason, you are unable to contact the insurance company, IGMS allows you to connect with them and acts as a gateway to register your complaints with those companies.

 

How to use IGMS

 

IGMS, the online consumer complaint registration, was launched in 2010. It also acts as a monitoring tool for IRDAI. You should make sure that you submit all relevant details including your policy number, details of the insurance company and contact details for timely grievance redressal.

 

IGMS assigns, stores and tracks your complaint IDs and also intimates various stakeholders within the workflow. Complaints on the IGMS will remain the website’s repository as well as the insurer.

 

Send a letter to IRDAI

 

If for any reason, you are unable to make the complaint online, you can even write a letter to IRDAI after filling up the complaint form and send it via post or courier. You can send it to this address:

 

General Manager

Consumer Affairs Department- Grievance Redressal Cell,

Insurance Regulatory and Development Authority of India (IRDAI),

Sy.No.115/1, Financial District, Nanakramguda,

Gachibowli, Hyderabad-500032

 

Approach Insurance Ombudsman

 

If your insurance company has not responded to your complaint within 15 days or you are not satisfied with their decision, you can file a complaint with the Insurance Ombudsman. An ombudsman is an official who is appointed to investigate individual people’s complaints against an organization or company, especially a public authority.

 

You will need to approach the Insurance Ombudsman for your jurisdiction, under which the insurance company’s office is located or the residential place where the policyholder is located. In the policyholder’s absence, a legal heir or a nominee can file this complaint too.

 

But before you reach the Ombudsman, you have to make sure you’ve approached the insurance company with your complaint and if they don’t respond to your complaint within 15-30 days, then you can go down this path. Additionally, your complaint should be related to a policy you took out in your individual capacity and the claim doesn’t go beyond Rs 30 lakhs.

 

File case in consumer forum

 

After availing all of these options, if your complaint is still not resolved, and you feel strongly about your claim, you can approach the consumer forum or a civil court to redress your issue. You can file a claim with the consumer affairs department here – eDaakhil – Case Filing Made Easy

 

Conclusion

 

As you can see, there are many channels to assist you if you want to file a complaint against your insurance company. However, it is very important to note that you should approach agencies like the IRDAI / IGMS / Insurance Ombudsman/consumer court only after you’ve filed the complaint with your insurance company.

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