Solving insurance problems just got easier……..Deepti Bhaskaran
In what could be seen as a message to the insurance companies to pull up their socks in terms of being customer-friendly, the insurance regulator is flashing a message for the customers. The Insurance Regulatory and Development Authority (Irda) has been recently capturing prime space in newspapers and news channels to circulate a toll-free number that promises to quick-fix your grievance if the insurance company turns a blind eye.
Earlier, at times, it took months before you could get even a small mistake rectified. But not anymore. If your insurer hasnt addressed your problem despite repeated reminders, you now have a direct recourse with Irdacall up toll-free number 155255 or email at complaints@irda.gov.in. And this comes only later in the chain.
Grievance redressal
Perhaps, you may not need to approach Irda at all. Before you knock at Irdas doors, you would need to take up the matter with the insurer first. But here, too, you have assistance.
At the insurer level: To further facilitate the settlement at the insurer level itself, Irda has put in place fresh guidelines, effective 1 August, which mandate a separate grievance policy for every insurer.
The grievance cell will be presided by the chief executive officer or the compliance officer of the company. Also, the insurer will now have systems that will enable you to register a complaint online, through call centres and even accept postal complaints.
According to Irda guidelines, it is mandatory for the insurers to apprise all policyholders existing and newof their grievance policy.
In a move that could prove really helpful for customers, Irda has come up with a list of common problems faced by policyholders. These pertain to servicing and claim-related issues.
With each of these problems, the insurer has mentioned a turnaround time, which could be as low as a few hours. For instance, the insurer needs to address the problem of a wrong policy issue in 10 days, while the turnaround time on the issue of non-payment of death claim is 30 days. To see full list, go to www.irdaindia.org/grievance/classifications_final.xls.
The insurer may choose to settle the claim earlier than the stipulated time, but not after that. If the insurer fails to meet the deadline in servicing your complaint, you can take your grouse once again to the insurers doorstep, but through a separate windowgrievance cell.
At this level, too, Irda has a help mechanism in place. As per the new guidelines, the company will need to acknowledge your complaint within three working days and respond within 14 days.
If you are dissatisfied with the settlement, you get about eight weeks to reply to your insurance company. In the absence of any such objection, the insurer will consider the complaint settled.
The new guidelines have standardized the whole process of tending to and settling complaints and problems. Earlier, despite having a grievance redressal policy, the process was not effective, but now the regulator has mapped the turnaround time for each category of service and has also put in place a time limit to settle grievances. The regulator will now be able to tap into our database to see how many complaints are settled leading to transparency. For the consumer, this only means speedy redressal, says
Anand Pejawar, executive director and marketing head, SBI Life Insurance Co. Ltd.
Anand Pejawar, executive director and marketing head, SBI Life Insurance Co. Ltd.
At the regulator level: If you are not satisfied with the settlement, you can approach your insurer again or can directly go to Irda. You can also approach the regulator if your insurer refuses to entertain your complaint.
The grievance mechanism we have in place is only for complaints that do not need legal intervention. We are step two after the policyholder is not satisfied with the settlement done by the insurance company or has not heard from them, says an Irda official in the consumer affairs department, who did not want to be quoted.
The regulator will ask for your complaint reference number and then will follow up with the insurer on your behalf. But does this mean a sure shot settlement? Yes. We will look into the matter immediately. Also, we may take regulatory action in case we find the insurance company is not settling the claim or is being unfair, says the Irda official.
Last resort: With Irdas new redressal mechanism in place, chances of a rift would be minimal. But if you are still not satisfied and the sum assured on your policy is less than Rs20 lakh, you can approach the insurance ombudsman.
Every area has a separate ombudsman and your insurer will have information about who is your ombudsman. The verdict of an ombudsman, which needs to be issued within three months of a complaint, is binding on insurers. But the policyholder can challenge the verdict at consumer forums or take the matter to the court.
Now that Irda has put in place a redressal mechanism, the onus is on you to get your problems solved.
