The committee will be headed by Shalini Prasad, former special secretary, NITI Aayog and will have tenure of two years. The other members of the panel are- Rakesh Joshi, former whole-time member, IRDAI, Kuldip Singh, former Insurance Ombudsman, Pushpa Girimaji, consumer rights advocate and director, ministry of consumer affairs.
Hyderabad:
Insurance regulator IRDAI has formed a high powered panel to review the performance of the existing insurance ombudsman scheme.
The committee will be headed by Shalini Prasad, former special secretary, NITI Aayog and will have tenure of two years.
The other members of the panel are- Rakesh Joshi, former whole-time member, IRDAI, Kuldip Singh, former insurance ombudsman, Pushpa Girimaji, consumer rights advocate and director, ministry of consumer affairs.
The panel will review the performance of the insurance ombudsman and other matters related to enhance efficiency of institution of insurance ombudsman.
“The advisory committee will generally meet at least twice a year and will submit a report to IRDAI on an annual basis for review and further action as deemed necessary, said the IRDAI official note signed by BC Patnaik, member(Life).
The insurance ombudsman disposed of over 92 per cent of the complaints it received from the insured during 2022-23 across India. It received 55,946 complaints during the year across its offices in the country, of which 51,625 were disposed of.
There are currently 17 insurance ombudsman in different locations of the country and one more office of insurance ombudsman will be opened in Thane, Mumbai, shortly.
After Thane, Maharashtra will have three offices of Insurance Ombudsmen. The state has already offices of Ombudsmen in Mumbai and Pune.
The government has already advertised to appoint eight new insurance ombudsmen which will lie vacant shortly.
The insurance ombudsman can entertain complaints where the quantum of loss payable under the insurance policy does not exceed Rs 50 lakhs. No charges are required to be paid for lodging a complaint with the insurance ombudsman.
Complaint can lodged with the insurance ombudsman within one year from date of rejection of the complaint by the insurance company/insurance broker or expiry of one month of filing the complaint if the insurer fails to reply.
Insurance ombudsman needs to dispose of the complaint by way of an award within a period of three months and such decision shall be binding on the insurance companies and its intermediaries or insurance brokers as the case may be.
Where the grievance is not resolved in favour of the policyholder or partially resolved in favour of the policyholder, the insurer has to inform the complainant of the option to take up the matter before insurance ombudsman giving details of the name and address of the ombudsman of competent jurisdiction.
It should get resolved fast.
It’s taking long time say 7 to 7 months to resolve one complaint
Out of 17 ombudsman how the head of ombudsman is selected.
To my knowledge 4 retired IAS. 4 retired judges 4 retired insurance professionals. When the work is same why the skill set is decided on city wise and profession wise.
As long as the Ombudsman is selected by the Insurance Companies themselves there won’t be justice. Hopefully now with the added officers, there wl be some balance of justice.
Thank you IRDAI.
Well said. It happened in my case sir. Ombudsman heard just 6 minutes and concluded the session without going through the entire case details. Finally I became a victim. I had to take back my vehicle without any coverage
obdusman is a puppet of insurance companies
It is not so. Check statistics of awards, which will show you the correct picture.
YOU RAE RIGHT. ESPECIALLY BANAGLORE OMBUDSMAN WHO NEVER PENALISES INSURANCE COMANY AWARD WITH INTERST EVEN WHEN ISUSRANCE COMANY HAS FAULTED AND DELELAYED .
Instead of pulling up the Ombudsman why not pull up the officers who drawing salaries in lacs without output. They are just busy building up own own clientele or PR with the broker’s. They stop doing any work 20-22 months before retirement. In charges don’t go in the market to fetch business . Claim hubs are the burning example of it.
I think, they are overburdened. Need more offices keeping in mind the number of complaints that are being received and for their faster resolution by insurance ombudsman. Moreover, this office must be a fulltime office with best infrastructure. This will speed up the claims and will be able to give justice to the customers.
I do agree that Ombudsman is a puppet of the insurance companies. Award had been passed on 28/03/24 by Ombudsman Kolkata. Still refund not made. I sent two reminders to the Ombudsman but no response till date. Direction given being followed by me. But what about the Company? What actions left with IRDAI I like to see. I am again going to report the matter to the IRDAI. Let’s see what actions the Authority take?. Whether these organisation are for the benefit of Insurance Company or the Insured persons?
Private insurance companies are not going as per ombudsman awards, what is the remedy? Govt insurance companies are afraid of ombudsman awards and paying even if the claim is not payable
there is a statement above that the insurance ombudsman needs to dispose of a complaint within 3 months! How ridiculous!! I have filed a complaint on March 12, 2024 and it has not been registered yet . It will take one year after the registration of complaint for first hearing to take place.
We are just chugging along on bullock carts in the days of jet age, 😊😊
Many offices of Insurance ombudsman, now a days, do not give response on time. They are taking more then 8 months to one year to accept application and insurance company quickly rejecting and cancelling the policy.
As per IRDAI annual reports, over the last eight years, more than 1.2 crore health claims have been repudiated, with more than 21 lac claims repudiated in FY 2022–23. There is need a to have special ombudsman for health claims with domain knowledge who can adjudicate faster. But for that Ombudsman council will have to give up fancy for appointing retired IAS officers and GMs as ombudsmen.
STARNGE THING IS EVERY OMBUSMAN OFFICE BEHAVES LIKE A JUDCIARY COURT, NO ONE CAN MEET BIMA LOKPAL EXCEPT ON HEARING DAY.
EVEN YOU CAN HAVE APPOINTMENT WITH PMO AND Chief SECRATERIES BUT NOT WITH BIMA LOKPAL. ALL OF THEM MUST KNOW THEY DO NOT HAVE ANY JUCIAL OR PARA JUDICIAL POWERS AND THEY CANNOT ACT AS JUDCIAL BODIES.
FURTHER OMBUSMAN CAN RESOLVE MANY ISSUES WITHOUT EVEN HEARING. HE CAN PASS AWARD BASED ON THE MERITS AND AS PER TERMS AND CONDITIONS WITHOUT WASTING TIME WHEN HE IS SURE OF THE CASE WHICH IS BEYOND DOUBT. THIS WILL HELP THE LESS EDUCATED POLICY HOLDERS, VILLAGE, RURAL POPULATION THOSE WHO ARE NOT FAMILIAR WITH ENGLISH, SENIORS THOSE INSUREDS STILL SUFFERING WITH DISEASE.
THE FURTEHR HARASSMANT OF PROCEDUERS AND PROCESS SHOULD BE AVIODED TO AN AGREEVIED POLICY HOLDER. A LOT MANY IMPROVEMENTS CAN BE DONE. BANGALORE OMBUDSMAN CAN NOT BE REACHED OVER PHONE AS IT IS MEANT FOR ONLY OUTGOING. THEY ARE NOT IN PRACTICE OF GIVING ANY ACKOWLEDGEMENT FOR ANY DOCUMENTS RECEIVED AT THEIR END PERSONALLY. PEACULIAR.
ALL OF US HAVE TO DEAL WITH THEIR ATTITUDE AND NOT ISSUE. THEY NEED TO BE SYMAPTHATIC AND FRIENDLY TOWARDS SENIORS, AND AGREEVIED POLICY HOLDERS WHO HAS APPROACHED THEM AS THE LAST RESORT BEFORE APPROACHING A LEAGL SOLUTION WHICH THEY MUST KNOW.