Insurance Ombudsman in India

About Governing Body of Insurance Council

The Governing Body of Insurance Council (GBIC) has been established  under Redressal of Public Grievances Rules 1998, to set-up and facilitate the Institution of Insurance Ombudsman in India.

The Governing Body of Insurance Council consists of one representative each from all insurance companies; the representative is required to be either the  Chairman or Managing Director or a Director of the company represented.

The Redressal of Public Grievances Rules 1998 (RPG Rules – 1998) contain provisions in respect of appointment and office term, etc for Insurance Ombudsman and also include stipulations in respect of staffing and administration of Ombudsman Centre, powers of Ombudsman, manner of lodging complaint and disposal of complaint by Ombudsman either by way of Recommendation or Award. Miscellaneous Provisions of the notification relate to constitution of Advisory Committee, submission of annual report, etc.

Insurance Ombudsmen are appointed by the Governing Body and are empowered to entertain complaints on the following aspects in respect of personal line insurances:

  • Any partial or total repudiation of claims by an insurer.
  • Any dispute in regard to premium paid or payable in terms of the policy.
  • Any dispute on the legal construction of the policies in so far as such disputes relate to claims.
  • Delay in settlement of claims.
  • Non-issue of any insurance document to customers after receipt of premium.

Highlights of Institution of Insurance Ombudsman

  • 12 Ombudsman Centres, covering the country, established in Ahmedabad, Bhopal, Bhubaneswar, Chandigarh, Chennai, Delhi, Guwahati, Hyderabad, Kochi, Kolkata, Lucknow and Mumbai.
  • Centres became fully operational during the financial year 1999-2000.
  • In the last thirteen years i.e. 01.04.2000 to 31.03.2012, the institution has dealt with 13721 complaints and has given relief of 134.14 Crores to aggrieved claimants.
  • Procedure is quick and free of cost.
  • Apart from regular hearings at the Centres, Insurance Ombudsmen hold outstation hearings within their territorial jurisdiction for the convenience of complainants.
  • With a current complaint disposal rate of 74.70% as on 31.03.2012, the institution has given a good account of itself as an alternate Grievance Redressal Machinery in Insurance Sector.

visit eMediclaim for List of 12 Ombudsman Centres in India.

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