Insurance is an integral part of our lives. It helps protect us from financial loss in the event of an unexpected event such as a car accident, fire, theft, or death. Insurance provides peace of mind and security for individuals, families, and businesses alike. With the right insurance plan, you can protect yourself and your loved ones from the costs associated with illness, injury, and other life events.
It is never pleasant to be dissatisfied with an insurance company. After all, it is a business providing a service that helps protect you and your family. But unfortunately, there are times when things do not go as planned.
Maybe the coverage was not as promised or the process is taking too long. Whatever the case may be, it is important to know how to file a complaint against an insurance company if necessary.
This article will provide information on how to take action and get the most out of the process.
Steps involved in filing a complaint against an insurance company
The process of filing a complaint against an insurance company involves several steps. These steps are listed below:
Gather all the necessary documents
The first step in filing a complaint against an insurance company is to gather all the necessary documents related to the dispute. Such documents include copies of the policy document, premium receipts, bills, medical reports, etc. It is important to keep all these documents organized and ready in case they are needed during the complaint process.
Contact the insurance company
Once you have gathered all the relevant documents, the next step is to contact the insurance company. You can do this either by calling the customer care number provided on the website of the insurance company or visiting their branch office.
If your insurance company fails to resolve your concern within 15 days, don't worry! You can take it to the next level and escalate the issue to IRDAI (Insurance Regulatory and Development Authority of India). They will ensure that your grievance is addressed in a timely manner.
File a complaint with the Grievance Redressal Cell
After contacting the insurance company, you can proceed to file a complaint with the Grievance Redressal Cell of the insurer. This cell is responsible for resolving customer complaints and grievances.
You can either visit the nearest branch or send an email to the GRO. While approaching the GRO make sure that you give your complaint in writing along with the necessary supporting documents. Do not forget to take a written acknowledgment of your complaint with the date.
Connect through IGMS portal
IRDAI has developed an Integrated Grievance Management System (IGMS) to help policyholders register complaints with their insurers. It provides a centralised and online access for the policyholder, as well as complete control and monitoring for IRDAI.
When a complaint is registered through IGMS, it flows to both the insurer's system and the IRDAI repository, and any status updates are mirrored in the IRDAI system. If the insurer does not fully address the complaint within 15 days of its lodging, the policyholder can use the IGMS to escalate the complaint to IRDAI.
File a complaint with the Insurance Ombudsman
If none of the above options work, you can file a complaint with the Insurance Ombudsman. The Insurance Ombudsman is an independent body appointed by the IRDA to resolve customer grievances.
The Ombudsman will act as an impartial mediator and attempt to reach a fair and equitable resolution of the dispute based on the facts presented by both parties. If both parties agree to the proposed solution, the Ombudsman will communicate the decision to the company and require them to comply with the terms within fifteen days.
Filing a complaint against an insurance company can be a stressful process, but it doesn't have to be. By following the steps outlined above, you can ensure that your complaint is handled properly and that you get the resolution you deserve.