For many of us buying insurance is a step toward securing our financial future, be it health, life, or even property. But what would you do if your insurance fails to cover you against any unfortunate incident? Filing a claim only to face endless delays or complete rejections can be a daunting experience for policyholders.
If this sounds familiar to you, it is important to note that there are means for you, as a policyholder, to lay claim to your rights. Let’ understand different ways in which you can get you insurance grievances addressed and ensure that your voice is heard.
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First Stop: Insurer’s Grievance Redressal Service
If you have faced any issues related to your insurance claim, the first step is to directly contact your insurance company’s customer support. Every insurance company has a dedicated grievance redressal system which is designed to resolve customer complaints. Here are some basic mediums to contact your insurer;
- Every Insurer has a toll-free number(s) which can be found on their official websites or mobile applications. You can start by reaching out to this customer support
- You can reach out via either the insurer's toll-free number, email, or even walk into their nearest branch
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While you do this make sure to keep all relevant documents handy such as policy details and claim number. Most companies assign Grievance Redressal Officers (GROs) whose job is to resolve complaints efficiently.
While contacting your insurer, remember to clearly explain the issue, whether it’s a claim denial, delay, or incorrect premium charges. This ensures your complaint is documented properly and helps in quicker resolution. If your insurer’s GRO is unable to resolve your issue within 15 days, you’re entitled to escalate the matter further.
Escalation Through Bima Bharosa Portal
When direct communication with the insurer doesn’t work, it’s time to move to the next level. The Insurance Regulatory and Development Authority of India (Irdai) offers a centralised platform called the Bima Bharosa portal. Launched in 2022, it has replaced the earlier Integrated Grievance Management System (IGMS) and provides a streamlined approach to handling insurance grievances.
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You can access this service through this link; https://bimabharosa.irdai.gov.in/
The Bima Bharosa portal is easy to navigate and allows you to lodge complaints, track their status, and even escalate them if necessary. As per the website, the portal addresses the policyholder’s complaint within 14 days.
This transparency ensures that both the policyholder and the regulatory body have a clear view of the grievance resolution process.
However, it’s advisable to use this platform only after you’ve exhausted all options with your insurer.
Turning to the Insurance Ombudsman
If your complaint remains unresolved even after escalating it through the insurer’s system and the Bima Bharosa portal, you can approach the Insurance Ombudsman. This independent authority was established to mediate disputes between policyholders and insurance companies in a fair and impartial manner.
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You can file a complaint with the Ombudsman under the following conditions:
- If your grievance has not been resolved within 30 days by the insurer
- If your claim has been outright rejected
- If the issue is related to individual policies with a claim amount not more than Rs 30 lakh
The Ombudsman’s office is not only for mediation between the insurer and the insured but also for a quick resolution. Most cases brought before the Ombudsman are resolved within a few months, saving policyholders from lengthy legal battles.
Be Careful Of These:
Though it is essential to understand the avenues that are at your disposal, it is also equally important to know your rights as a policyholder. For instance, insurers are obligated to provide clear and transparent communication regarding your policy and claims. If you ever feel misled or mistreated, don’t hesitate to seek help through the channels outlined above.
Additionally, the Irdai frequently updates regulations to protect customers, therefore staying informed is going to be your best defence.
Here’s How To Ensure A Smooth Resolution Process
- Keep records to maintain copies of all correspondence, including your documents and communication trails such as emails, letters, and call logs
- If possible, maintain a timeline that can help you clearly state the issue and your desired resolution amid long trails of communication
- Don’t hesitate to follow up regularly especially if the grievance system keeps missing the timeline of the resolution period
- Lastly, if your grievance is complex, you can also consult financial, legal or insurance experts who help policyholders resolve their claim delays.
