New Delhi: Insurance policyholders facing claim rejection, settlement delays, mis-selling or other service-related problems have a formal escalation mechanism available, with insurers required to resolve complaints within a prescribed 14-day timeline.
The Department of Financial Services (DFS) under the Ministry of Finance on Friday highlighted the grievance redressal mechanism mandated by the Insurance Regulatory and Development Authority of India (IRDAI), detailing how policyholders can take complaints from the insurer level to the regulator if their concerns remain unresolved.
Under the process, policyholders must first approach the complaints or grievance redressal cell of the concerned insurance company. The Grievance Redressal Officer (GRO) serves as the insurer’s nodal officer for dealing with such complaints, and every office of an insurer is required to designate an official for this role.
Insurers are required to acknowledge a grievance immediately and provide a resolution within 14 days. Complaints received through digital platforms, direct correspondence or call centres are registered in the insurer’s Complaints Management System.
These complaint management systems are integrated with IRDAI’s Bima Bharosa Portal, creating a common mechanism through which policyholder grievances can be registered and monitored across the insurance industry.
Every insurer is also required to constitute a Policyholder Protection, Grievance Redressal and Claims Monitoring Committee at the board level to oversee effective handling of policyholder complaints and claims-related issues.
If a policyholder does not receive a response from the insurer within a reasonable period or remains dissatisfied with the company’s response, the matter can be escalated to the Grievance Redressal Cell in IRDAI’s Policyholders’ Protection & Grievance Redressal Department.
Policyholders can register and track complaints through the Bima Bharosa Portal. However, the prescribed process requires customers to first approach the concerned insurer before escalating the grievance to IRDAI.
For customers who may not use the online portal, IRDAI has provided other channels for lodging complaints. Policyholders can contact the regulator through toll-free numbers 155255 and 1800-4254-732 or send complaints by email to complaints@irdai.gov.in.
Complaints received through physical letters or emails are also registered on the Bima Bharosa Portal. IRDAI’s call centre provides multilingual support in 12 languages, widening access to the grievance mechanism for policyholders across the country.
DFS highlighted the mechanism as insurance adoption continues to expand in India, stressing the importance of policyholders knowing the formal channels available to challenge unfair claim rejections, delays, mis-selling and other service-related grievances.
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