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Grievance Redressal norms unveiled by IRDAI for insurers

Posted on by Shailesh Kumar
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The IRDAI (Insurance Regulatory and Development Authority of India) has officially released its regulations pertaining to grievance redressal and customer complaints in case of insurance companies in the country. Any complaint or grievance has been classified as communication which clearly states any dissatisfaction relating to an action taken or the lack of the same with regard to service standards of insurance companies and intermediaries or deficiencies in service along with any remedial measures sought. IRDAI has directed insurers to have suitable systems for the registration, receipt and resolution of grievances of customers.

Insurers should also take care of grievances within a particular period of time. Insurance companies are required to dispatch their written acknowledgements within three days from receiving complaints. This should have the designation and name of the officer dealing with the customer’s query along with procedural information and the time that will be required for resolving the issue in question.

Insurance Samadhan

All grievances of customers must be solved within a period two weeks and insurers will have to dispatch written responses for rejection/redressal of the complaint with suitable reasons. This will also have the intimation that in case of any further issues/disputes, the customer can contact the insurer within 8 weeks from getting the response from it. The complaint will be perceived as closed by the insurer in case there is no response from the customer in this time period.

IRDAI has directed insurers to keep automated systems for the monitoring and tracking of grievances along with receiving all types of calls and e-mails, enabling the interface needed with the IRDAI’s own system of tackling e-mails and calls. Insurance companies should be swiftly taking up complaints of customers prior to emphasizing on the need to get insurance policies as per top officials of the IRDAI. Companies not working as per these regulations will have to fork out penalties as well.

Also Read:  4 Common mis-selling techniques of Insurance Agents

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Shailesh Kumar

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33 Comments

  1. I did not receive my refund for my Health Insurance Proposel
    The proposal was rejected on absurd ground without any proper communication.
    And refund has not been processed, It seems to be a fraudulent act from the company side, to trap the customers and eat the money.
    Please take necessary action and make my refund and the customer care of Niva Bupa is not responding properly and causing me a lot of mental stress each day.

  2. My name is Jacob J Tharakan. I took a health insurance from Star health But I am unsatisfied with this insurance So I informed Star health to cancel the policy and refund my money during my free look period but they have not replayed my mail. So I tried to contact them on phone but was not connected to them. My free look period expires in three days. Kindly do the needful.

  3. Sir, i have policy of new India insurance with coverage of zero dep…but at the time of claim..they agree only to pay claim with coverage for normal policy..

    Plz confirm why they collect extra premium for zero.dep coverage….

  4. I got my car Toyata corolla insured with ack.com online
    I was eligible to get no claim bonus
    My issue with the company
    I understand if eligible benifit of no claims bonus is rightfully owned by me
    By denying this to me other their online system is cheating number of consumer

  5. My Name Is Ashok Kumar. I have renewed my policy before the due date but they have not updated my policy yet. My TP is mediassist. Hospital is asking for Cash Payment but my policy is Cashless. They have stopped the treatments Of The patient. TPA is also not helping us in this case.

  7. My care health insurance policy number is 35829734 November 21 I have a fracture in my leg, whose claim amount is 13000 / I have handed over to company’s agent mr. kritigya dixit, mobile number is 9667742079, it lies continuously, now after 6 months rough threatening in abusive language I am saying take the claim from IRDA
    In light of my complaint, please take strict action against the company.
    Anand Kumar kashwani
    AGM/CAIS Engineering services pvt ltd. Noida -sector -62
    Mobile :8809886940
    mail.Anandkashwani73@gmail.com

  8. Hwo to compliant aganist एजेंट who is फ्रोड dowing with lic is chit lic and how to make rti with tha
    And how to chek marklist of tha agent fake documents doing to lic

  9. My name is Mr. Mathew Varghese, and the complaint is against the Niva Bupa Health Insurance as they are not accepting my reimbursement request.

  10. मेरा नाम कृष्ण लाल है मैंने एक क्रिटिकल की पॉलिसी ली थी रैली गियर हेल्थ केयर से लेकिन जेडी हेल्थ केयर इन्वेस्टिगेशन वाले ने जाली पेपर लगाकर टैगोर हॉस्पिटल का मेरा क्लेम रिजेक्ट करवा दिया लेकिन मेरे को टैगोर हॉस्पिटल जालंधर वालों ने लिख कर दिया है कि हमारे पास कोई भी ऐसा डॉक्यूमेंट नहीं है ना ही हमने उसको दिया है और ना ही हमारे पास कोई मेरा पिछला रिकॉर्ड है कृपा करके मेरा मेरा क्रिटिकल क्लेम सॉल्व करवाएं और जेडी हेल्थ केयर मोहाली का लाइसेंस कैंसिल करवाएं

  11. मेरा नाम राकेश कुमार है मैंने रैली गियर हेल्थ केयर से एक क्रिटिकल इलनेस की पॉलिसी खरीदी थी जब मैंने क्लेम लगाया तो जेडी हेल्थ केयर मोहाली ने जाली पेपर लगाकर मेरा क्लेम रिजेक्ट करवा दिया मैंने जालंधर में श्रीराम कार्डियक से इलाज करवाया था उन्होंने लिख कर दिया है कि उन्होंने कोई ऐसा पेपर जेडी हेल्थ केयर को नहीं दिया उनके पास मेरा कोई भी पिछला रिकॉर्ड नहीं है लेकिन जेडी हेल्थ केयर वाले ने जाली पेपर में मेरे को पहले से प्रॉब्लम है लगाकर मेरा क्लेम रिजेक्ट कर दिया कृपा करके मेरा क्लेम सेटल करवाएं और जेडी हेल्थ केयर मोहाली का लाइसेंस कैंसिल करवाएं

  12. This is regarding my policy 18827160 Care health insurance where I had got claim settled for 1 eye and for another eye which had operated exact after 5 Days later of 1st eye surgery had not reimbursement yet ( Rejected ) As am following them since last
    5 months.
    Care health insurance had rejected my another eye claim for sily reason where mine doctor had written 12 year instead of 1.2 year ( dot ) mistake for which i had already called and emailed many times and explained them for the same also given letter from Dr Shaila Patel to understand the things easily but unfortunately they don’t want to listen Nor they reply to email. They just assumed by they own self and given decisions which is really not acceptable. For policy renewal they give all false commitments and later they are not bother to serve their clients. Kindly help me for this .

  13. Why it is not CASH LESS FOR RETAILERS LIKE M IN BIG HOSPITALS, WHERE AS IT IS CASHLESS FOR BIG CORPORATES IN LILAATI MUMBAI HOSPIYAL.

    • Dear sir , Thank you for your comment. Please elaborate your query or contact us at IVR no. 9513631312.

  14. I had an policy for home loan insurance. the home loan is preclosed but now m not getting my refund. ICIC prudential say we have send you amount of Rs 2.16 lacs to the icici bank and contact them and icici bank say we have nothing to do.. please suggest what to do.

  15. CLIENT ID- G0455488, I HAVE RECEIVED POLICY FROM HDFC LIFE (HDFC BANK, BHIWANI BRANCH, HARYANA) MISGUIDED BY AGENT..

  16. Dear team ,

    Regarding my claim of vehicle no up65JT 0650 under policy no TRG/00115122.

    with reference of you mail please note down my complete details

    as follows

    Mr. Islam Raja

    S/o. Sri Ishrar Ali

    S 19/141 A Jadid Bazar Varuna Pool, Varanasi, Uttar Pradesh, Pin-221002

    mobile no :-8808990990 . 7234000065

    Policy no :-TRG/00115122

    vehicle no :- up65JT 0650

    Now i come to the point this is completely unfair for me and i am not satisfied with your solution.

    The provided statement is correct and the accident time is night and my vehicle is registered under commercial registration and driven by the driver hired he is informed me in the morning, we have submitted the vehicle to rajendra toyta service centre and at the time of purchase of vehicle and policy.

    the Toyota people assured me you have no problem during any claim. You just come to the service center and we will process all the things at the same time so I follow same thing and right now you told me that I am not informing you. That is your and Toyota people’s fault. They have missed communicating with me .

    I want resolution and my calm otherwise i will escalate this thing to higher authority as well as the judiciary .

    so it’s my request to you please solve my problem and pass the claim and do the work of my vehicle ASAP.

    Thanks

    Islam Raza

    8808990990

  17. Policy number 113706114 maturd on 28th January 2022. Documents with original policy bod submitted on 24th jan 2022 with a request of full and final maturity amount . Amount till date not received.
    Request to credit my account with full maturity amount along with penality and penal interest

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