Insurance products, be it life, health or motor-related can be somewhat difficult to understand in terms of coverage, exclusions and other aspects such as sub-limits, co-payments and no claim bonus. The awareness about insurance products is still low compared to developed nations. This leaves room for misrepresentation, misselling and sometimes even fraud.
For instance, recently some “policyholders” of Bajaj Allianz General Insurance tried to make a claim on their motor insurance policy. But the insurer didn’t settle their claims as the policies held by policyholders were fake. Though this insurer is said to have taken the necessary steps against the fraudsters, it was the “policyholders” who were left in the lurch. While these individuals will have to fight it out in court, others who hold a genuine policy have recourse in case of any issues.
So, if you are an aggrieved policyholder, here is how you can file a complaint.
If you have any issue or a complaint against an insurer, the first step is to inform the respective insurance company’s grievance redressal cell. All life and general insurance companies provide contact details (phone number and email address) on their website and the policy document.
You can reach out to insurers through their digital touch points such as WhatsApp, mobile apps, chatbots and e-mails. Alternatively, you can directly connect with the insurer and raise a complaint by calling the toll-free number provided on the website and in the policy document.
The insurer should acknowledge the complaint within three days and provide a solution within 15 days or as per the time limit set by the insurance regulator, IRDAI. The regulator has defined the maximum turnaround time (TAT: time taken for completing a task or process) for different services provided by the insurers. For instance, the maximum TAT for life insurers when it comes to settlement of maturity claims or survival benefits is 15 days.
If your issue is unresolved, you can write to the grievance redressal officer of the respective insurer. The contact details available in your policy document and on the insurer’s website.
If your complaint is still not addressed within the time limit or you are not satisfied with the resolution offered, you can contact IRDAI directly. You can register your complaint in one of the three ways.
First, call the toll free number (available on the IRDAI website/insurers’ websites). Two, send an email along with the resolution offered by the insurer, if any, and your policy document and other relevant documents, if any. Three, you can register your complaint online using Integrated Grievance Management System.
Alternatively, you can write to the regulator’s grievance cell with the requisite documents. For this, you need to fill the complaint registration form (IRDAI’s website) and post the same to the Consumer Affairs Department- Grievance Redressal Cell, IRDAI.
Beyond this, you have the right to lodge your complaint with the insurance ombudsman or a consumer/civil court. The details of the same available on the respective insurers’ websites.
However, before you escalate the matter with IRDAI or the ombudsman, you must first write to your insurer. Do note that, you don’t have to pay a fee for making a complaint.
