Insurance Regulatory and Development Authority

CIRCULAR

All Life Insurers,

It has come to the notice of the Authority that information on the Insurance Company’s Grievance Redressal Mechanism as well as the Insurance Ombudsman is not communicated properly to the policyholders. It is hence felt necessary to prescribe a common format on this aspect which would enable disclosure of specific information to policyholders and beneficiaries. It is advised that the following information at a minimum should be sent to all policyholders with the policy document.

1. In case you have any query or complaint/grievance, you may approach our office at the following address:

___________________________________

Contact No:_________________________

Email ID: ___________________________

2. In case you are not satisfied with the decision of the above office, or have not received any response within 10 days, you may contact the following official for resolution:

___________________________________

Contact No:_________________________

Email ID: ___________________________

3. In case you are not satisfied with the decision/resolution of the Company, you may approach the Insurance Ombudsman at the address given below if your grievance pertains to:

Insurance claim 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 document

Address of the Insurance Ombudsman:

___________________________________

Contact No:_________________________

Email ID: ___________________________

4. The complaint should be made in writing duly signed by the complainant or by his legal heirs with full details of the complaint and the contact information of complainant.

5. As per provision 13(3)of the Redressal of Public Grievances Rules 1998, the complaint to the Ombudsman can be made

only if the grievance has been rejected by the Grievance Redressal Machinery of the Insurer
within a period of one year from the date of rejection by the insurer
if it is not simultaneously under any litigation.

Please take necessary action in this regard and confirm the same to the Authority.

(G. Prabhakara)
Member (Life)