- Free look time available after receiving policy documents is 15 days.
- The charges were not fully disclosed to the customer is a common complaint against Agents.
- Kartik written to his insurer about non settlement of maturity claim, as per the regulation insurer has to reply to this within 10 working days.
- Ombudsman is created in 1998.
- Complaint council body other than IRDA grievance redressal forum & COPA would be Ombudsman.
- Total 12 Ombudsman offices located in India.
- Mr. A is working as a Nodal Officer in Insurance company dealing with handling complaints.
- De-tarrification is a process by which insurance can price their product on their self past experience.
- Consumer Affairs Department (CAD) is established by IRDA to deal with customer complaints.
- Ombudsman has to give his decision within 30 days.
- Customer can contact to forum at state level in case of any dispute for a claim more than 20 Lakh.
- Ombudsman is a complaint council body other than IRDA Grievance redress and COPA to get his grievances against the insurance company.
- Stipulated time frame within which an insurance company supposed to respond after receiving communication from its policyholder is 10 days.
- Life insurance policyholder is entitled to refer complaint to insurance ombudsman referral is made in maximum period of one year from response by insurer.
- Group insurance can be taken in employer-Employer relationship.
- As per IRDA regulations setting up IGMS would help in effectively handling Grievance of the customers.
- Insurance Ombudsman has bee appointed to protect the interest of policyholders.
- When the insured disagree with any of the term & conditions of the policy is issued, they have the option to return the policy
- On submission of complaint against an insurer to the Ombudsman decision is made in favour of the policy holder within 15 days.
- “Policy holders protect regulation” insist that all insurance companies should provide the information about the insurance Ombudsman of that region while sending the policy documents.
- Insurance companies are required to honor the award passed by insurance ombudsman within 15 days.
- If the complainant is disagree with the decision of the company on the claim then he can approached to Ombudsman in 1 month.
- Pooling of risk apply to all type of Insurance.
- Life insurance policyholder is entitled to refer complaint to Insurance Ombudsman referral is made in Max period of 1 year from response by Insurer.
- AML program of every insurer to include Inspection by Auditor General apart from procedure training & audit.
- If any consumer is dissatisfied with the customer care cell of any Insurance company then he can escalate their grievances to Nodal Officer.
- Policyholder can make complaints either via E-mail (email@example.com) or Toll free number 155255.
- Consumer can call Toll free No. for any Grievance or he can also contact consumer affair department of IRDA, Insurance Ombudsman & Insurance company.
- 5000/ is the Minimum Sum Assured allowed for Micro Insurance.
- Grievances can be taken up to the Ombudsman like Partial or Total repudiation of Claims by the insurer, Dispute with regard to premium paid or payable & delay in settlement of claims.
- As per regulation for protection of policyholder’s interest 2002(IRDA) that All insurer will have a grievance redressal system.
- Insurance contract of value not exceeding Rs. 20 Lakhs is the limit of Ombudsman claim settlement.
- If a policy holder buys a policy from the advisor and lodges a complaint, it should be treated as same for all policies sold by advisor.
- Regulation issued by IRDA required that the decision on the proposal must be conveyed to the proposer within 15 days.
- To ensure that the customer complaints are handled effectively, IRDA has established “Integrated Grievance Management System”.
Click Here for Next Chapter