How to file complaints against insurance company in India?

• Introduction
• How To File Insurance-Related Complaints In India?
  • Grievance Redressal Officer of the Insurance Company
  • Grievance Redressal Cell of the Consumer Affairs Department of IRDAI
  • Insurance Ombudsman
  • Consumer Court

What would you do if you had a complaint related to insurance? You'd call the insurance company's call centre and explain your situation, right? What if you don't get a proper response or the response you get is not satisfactory? What would you do then?

Well, in such a situation, many people merely turn to social media. In an effort to contact the insurance company and have their complaint resolved, they simply complain on social media platforms like Twitter or Facebook, and tag the insurance company in their posts. This, however, is not the right way to file an insurance complaint.

What is the right way then? What are the various grievance mechanisms available to file insurance-related complaints in India?

Let's see! 

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Generally, you must raise a complaint with your insurance company first. If you do not receive a response from your insurance company or if the response you receive is not satisfactory, you can contact the Grievance Redressal Officer (GRO) of your insurance company. 

🤔Who can file a complaint with the Grievance Redressal Officer of the Insurance Company? 

Policyholders can file a complaint with the insurance company's GRO. 

🤔How to file a complaint with the Grievance Redressal Officer of the Insurance Company? 

To raise a dispute with the Grievance Redressal Officer (GRO) of your insurance company, you can either visit the branch office or send an email to them. 

You can get the email address of the Grievance Redressal Officer on your insurance company’s website or on IRDAI’s website. 

To find the email address, search for the grievance link in the footer of insurance companies. For instance, here’s the footer of LIC of India.

You will have to submit your complaint in writing, along with documents requested by the insurer. After you do that, make sure you get a written acknowledgment of your complaint through a letter or email (as per the communication mode you chose). You can use this to track the complaint or for future reference. The acknowledgment you receive will include information on the GRO who will handle your complaint, the policy number, the complaint number, etc. 

🤔Are there any charges/fees involved? 

No, there are no charges or fees required to be paid for filing a complaint with the GRO of an insurance company. 

As per IRDAI’s guidelines, the GRO of your insurance company is required to address your complaint within 15 days of receiving it. If you don’t get any response or are unsatisfied with their response, you can escalate further to redress the complaint - you can approach the Grievance Redressal Cell of the Consumer Affairs Department of IRDAI.

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The Grievance Redressal Cell of the Insurance Regulatory and Development Authority of India's Consumer Affairs Department will investigate the complaint/grievance and take them up with the appropriate insurance company for resolution. 

🤔Who can file a complaint with IRDAI's Grievance Redressal Cell of the Consumer Affairs Department? 

Only the insured or claimant can file a complaint with IRDAI's Grievance Redressal Cell of the Consumer Affairs Department. IRDAI will not address any complaints written on the policyholders' behalf by advocates, agents, or third parties.

🤔How to file a complaint with IRDAI's Grievance Redressal Cell of the Consumer Affairs Department? 

When filing a complaint with IRDAI, you will have to fill out a Complaint Registration Form. If you do not provide the requested details in the form, IRDAI may not register your complaint.

You can also file a complaint using other offline and online methods - 

• Online Methods: 
• You can -  
  • Call the toll-free number 155255 or 1800 4254 732 
  • Send an e-mail to complaints@irdai.gov.in
  • Register and monitor your complaint on IRDAI's Bima Bharosa Portal - all you need to do is visit the Bima Bharosa Portal and click on ‘Register Complaint’.

• Offline Method: 
• You can send a duly-filled Complaint Registration Form to IRDAI along with a letter or enclosures (if any) by post or courier to - 

🤔Are there any charges/fees involved? 

No, there are no charges or fees required to be paid for filing an insurance-related complaint with the IRDAI. 

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The Insurance Ombudsman scheme was implemented by the Government of India to help policyholders resolve their complaints outside of the court system in a cost-effective, efficient, and impartial manner. There are currently 17 Insurance Ombudsmen located throughout the country. 

🤔Who can file a complaint with the Insurance Ombudsman? 

You, your legal heirs, nominee, or assignee can file a complaint with the Ombudsman. The complaint with the Insurance Ombudsman can be raised only if - 

• You have first approached your insurance company with the complaint and - 
  • They have rejected it, or 
  • Not resolved it to your satisfaction, or
  • Not responded to it at all for 30 days
• Your complaint pertains to any policy you have taken in an individual capacity. 
• The quantum of loss payable under the insurance policy does not exceed ₹30 Lakhs.

🤔How to file a complaint with the Insurance Ombudsman? 

The complaint can be registered either online on their website here or through written communication, i.e., through email or letter, along with the following documents - 

• Copy of representation submitted to Insurance Company/ Insurance Broker 
• KYC particulars: Aadhar card, Pan Card, Driving License, etc 
• Photograph (in case of online registration of complaints)
• Letter from Insurance Company/ Insurance Broker rejecting the representation / repudiating the claim
• Copy of Insurance Policy
• Any other document(s).

If you are registering the complaint online, all you need to do is visit the website of the Council of Insurance Ombudsmen and click on ‘Register Complaint’.

The complaint must be directed to the Insurance Ombudsman whose territorial jurisdiction includes the branch or office of the insurer that has been the subject of the complaint, or the complainant's residential address or residence. You can find the territorial jurisdictions of the respective Insurance Ombudsman in your policy document.

🤔Are there any charges/fees involved? 

No charges or fees are required to be paid for lodging a complaint with the Insurance Ombudsman.

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If your complaint or grievance is still unresolved, you can take it to the Consumer Court.

🤔Who can file a complaint with the Consumer Court? 

You, or your legal heir, nominee, appointee, etc. can file a consumer complaint. 

🤔How to file a complaint with the Consumer Court?

In a Consumer Court, the complaint is filed based on the value of the claim.

You can file the complaint online through the website authorized by the Government of India. Alternatively, you can also write the complaint offline, attach the required documents, and register it in person or send it by post to the Redressal Agency. You'll also need to file an affidavit in court, stating that the facts presented and statements you've made are true and correct.

🤔Are there any charges/fees involved? 

Yes, you'll need to pay certain fees if you file a complaint with the Consumer Court. The fees may vary depending on the amount pleaded and the court you are filing the complaint in, i.e district, state, or national. Generally, the fees may range from ₹100 to ₹5000.

That is all about how you can file insurance-related complaints in India. If you found this overwhelming, you can talk to professional advisors at Beshak, who will make it all easier for you! :-)