The insurance industry is one of the sectors facing the most consumer complaints. From non-payment of claims to partial payment, customers are ready to share their claim experience with the consumer insurance company, especially during the COVID-19 crisis, which has increased the number of insurance claims. According to the data, about 40% of the cost of treatment of Kovid-19 was spent by the policyholders out of their own pocket. In such a case, if you wish to pursue your complaint with the insurance company, here’s how:
Grievance Redressal Cell
Policyholders who have grievances against the insurers must first approach the grievance redressal cell of the insurer concerned. If they do not get any response from the insurer till the reasonable time period or are not satisfied with the response of the company, they can approach IRDAI.
Integrated Grievance Management System (IGMS)
One can also lodge a complaint with IRDAI on the Integrated Grievance Management System (IGMS), which acts as a central repository of Insurance Grievances data. This is an initiative of IRDAI where you can register your complaint on the system along with your policy details. From here the complaints are sent to the respective insurance companies. Meanwhile, IGMS tracks the complaints and the time taken for their redressal.
One can approach the Insurance Ombudsman, which was set up by the Government of India in November 1998. Its main objective is to remove all the problems faced in the settlement of claims.
consumer dispute redressal agency
You can file a consumer complaint by going to the consumer court or online. Redressal agencies are set up in every district and state and at the national level.
The Forum has jurisdiction to consider complaints where the value of the goods or services and the compensation claimed is up to Rs 20 lakh. Court fees range between Rs 100 to 500.
Cases in which the goods or services value is more than Rs 20 lakh but less than Rs 1 crore can be registered. The orders of the District Forum can be challenged here within 30 days of the passing of the order. For cases above Rs 20 lakh and up to Rs 50 lakh, the court fee is Rs 2,000, while for cases up to Rs 1 crore, the court fee is Rs 4,000.
The aggrieved consumer can appeal against the decision of the State Commission within one month from the date of the order. It will consider disputes where the goods or services and the claim exceeds Rs 1 crore. The court fee is Rs 5,000.