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The Insurance Regulatory and Development Authority of India cautions all insurers against non-compliance with awards passed by the Insurance Ombudsman and non-submission of required statements. Insurers must comply with awards within thirty days of receipt or file appeals within sixty days under the Insurance Ombudsman Rules, 2017. Many insurers fail to comply with the awards, omit reasons for pendency in statements, or fail to submit statements entirely. The Authority views these violations seriously because delays undermine the grievance redressal framework and cause hardships to policyholders.
What you must do
Key dates
Who is affected
Thresholds
If you do not comply
Ask about this circular
[Image omitted. See the official document.]
Ref: IRDAI/CAD/CIR/MISC/038/03/2019
Date: 05-03-2019
To
All the CEOs/CMDs of Insurance Companies
Sub: Non-Compliance of awards passed by Ombudsman.
Attention is drawn to Authority's Circular No. IRDAI/CAD/CIR/MISC/063/03/2016 dated 01-04-2016 vide which all Insurers were directed to submit data pertaining to compliance of awards passed against them by Insurance Ombudsman.
Upon perusal of the data received from all Insurers for the period April, 2018 to December, 2018, the following observations are made:
Upon calling for reasons for non-compliance from the Insurers, few Insurers are submitting that they have complied with the award post timelines stipulated under the above mentioned rules. Non- compliance of these awards within the timelines prescribed would severely undermine the grievance redressal framework laid down and cause undue hardships to the policyholder.
In view of the above, all Insurers are hereby cautioned that non submission of statements prescribed under above mentioned circular and non-compliance of awards by Insurers within the timelines prescribed under Insurance Ombudsman rules, 2017 will be viewed very seriously.
[Image omitted. See the official document.]
TS Naik General manager, Consumer Affairs Department.
सर्वे नं. 115/1, फाइनेंशियल डिस्ट्रिक्ट, नानकरामगुडा, हैदराबाद-500 032, भारत | Survey No. 115/1, Financial District, Nanakramguda, Hyderabad-500 032, India (: +91-40-2020 4000 वेबसाइद : www.irdai.gov.in (): +91-40-2020 4000 Website : www.irdai.gov.in
