Blog, Insurance Claim

IRDA Bima Complaint Process As per IRDA website

Grievance Redressal Mechanism

Who we are

The Policyholders Protection and Grievance Redressal Department of IRDAI oversees compliance of Insurers with Protection of Policyholders’ Interests Regulations and also empowers Consumers by educating them on Grievance redressal mechanisms. The Department facilitates an environment where the Insured avails himself of proper procedures and redressal mechanisms put in place by Insurers and the Regulations to address complaints and grievances of policyholders efficiently and with speed. IRDAI has established Integrated Grievances Management System (Bima Bharosa) in the year 2010 through which IRDAI monitors disposal of Policyholder Grievances across the industry. Policyholder can also complaint online through Bima Bharosa and view the status of his/her complaint online.

In all cases of Escalated complaints, a provision is made for the complainant to post his feedback after the Insurer has given the final resolution.

How to make a complaint

If you are not satisfied with the services of your insurance company, you may

1

Walk into any office of the Insurer and lodge a complaint Or Approach the Grievance Redressal Officer(GRO) of the Insurance company (Please refer the below document containing E-mail Ids of GROs of all the Insurance companies)

2Give your complaint in writing along with the necessary supporting documents

3

Take a written acknowledgement of your complaint with the date. The insurance company should resolve your complaint in any case not later than two weeks of receipt of complaint.

In case if it is not resolved within two weeks or if you are not satisfied with their resolution you may approach the Grievance Redressal Cell of the Policyholder’s Protection & Grievance Redressal Department of IRDAI through the following means:

  1. Register complaint directly in of IRDAI’s online portal – Bima Bharosa System-https://bimabharosa.irdai.gov.in/  
  2. Send the complaint through Email to  complaints@irdai.gov.in
  3. Call Toll Free Number  155255 (or) 1800 4254 732

Apart from the above options, if it is felt necessary by the complainant to send the communication in physical form, the same may be sent to IRDAI addressed to:

General Manager

Policyholder’s Protection & Grievance Redressal Department- Grievance Redressal Cell,

Insurance Regulatory and Development Authority of India(IRDAI),

Sy.No.115/1,Financial District, Nanakramguda,

Gachibowli, Hyderabad-500032

Only complaints from the insured or the claimants shall be entertained. The Cell shall not entertain complaints written on behalf of policyholders by advocates or agents or by any third parties.

Complainants are requested to submit complete details of the complaint as required in the complaint registration form. Please see below to download the Complaint Registration Form. Without the required information called for in the Complaint Registration Form, IRDAI will not be in a position to register the complaint.

Once the complaint is registered in to Bima Bharosa System, then details of complaint are passed on to respective insurance companies. Policy holder receives the confirmation email after registering the complaint along with IRDAI token no which helps in tracking of the complaint through Bima Bharosa System.

Grievance process in BIMA BHAROSA

banner

1) In case the complaint is not attended to within 15 days of registration of complaint in Bima Bharosa or the Resolution provided by Insurer is not satisfactory, you may approach the Insurance Ombudsman as per the procedure laid down under Insurance Ombudsman Rules, 2017.

2) Insurance Ombudsman is a quasi judicial body which provides a cost effective and impartial grievance redressal mechanism, (for more information about Insurance Ombudsman Rules and Procedures etc. please visit: http://www.cioins.co.in/

FREQUENTLY ASKED QUESTIONS

How can we help you

1. What should you do in case you have a grievance against Insurance Company or its Intermediary/Agent?

Approach the Grievance Redressal Officer of its branch or any other office that you deal with. Click here for mail ids of Grievance Redressal Officers, GRO, of all insurance companies

Give your complaint in writing along with the necessary support documents

Take a written acknowledgement of your complaint with the date.

The insurance company should resolve your complaint within 15 days of its receipt.

2. What should you do in case the resolution provided by grievance redressal officer of insurance company is unsatisfactory/ no resolution is provided within prescribed timeline?

In case if it is not resolved within 2 weeks or if you are unhappy with their resolution you can approach the Grievance Redressal Cell of the Policyholders Protection and Grievance Redressal Department of IRDAI:

Call Toll Free Number 155255 (or)

Send an e-mail to complaints@irdai.gov.in

Make use of IRDAI’s online portal – Bima Bharosa:

Register and monitor your complaint on Bima Bharosa Portal – at https://bimabharosa.irdai.gov.in/

Send a letter to IRDAI with your complaint:

Click here to download Complaint Registration Form

Fill and send the Complaint Registration Form along with any letter or enclosures, if felt necessary, by post or courier to:

General Manager

Policyholders Protection and Grievance Redressal Department- Grievance Redressal Cell,

Insurance Regulatory and Development Authority of India(IRDAI),

Sy.No.115/1,Financial District, Nanakramguda,

Gachibowli, Hyderabad-500032

3. What happens when I lodge a complaint on Bima Bharosa Portal – https://bimabharosa.irdai.gov.in/?

A complaint registered through Bima Bharosa will flow to the insurer’s system as well as the IRDAI repository. A Token Number is generated on successful registration of complaint in Bima Bharosa Portal and the complaint can be tracked using the Token Number. Updating of status of the complaint in insurer system will be mirrored in the Bima Bharosa Portal and the details of the update can be viewed in the Bima Bharosa Portal under the complainant login. The final resolution provided by the insurer will be available in the complainant login of Bima Bharosa Portal.

4. How do I track my grievance?

The status of the complaint is displayed after successful logging in to the Bima Bharosa Portal by the complainant.

5. What are the various scenarios of Bima Bharosa complaint

Best Case Scenario: New → Acknowledged → Pending → Attended To → Closed

If TAT crossed: New → Acknowledged →Pending → Escalated → Reopened → Attended To →Closed

If Resolution is not acceptable by POLICY HOLDER: New →Acknowledged →Pending →Attended To →Escalated →Reopened → Attended To →Closed

6. How do I contact the Grievance Redressal of Insurance Companies?

The company wise contact details Grievance Redressal Officers (GROs) and the grievance redressal

procedure of insurance companies are made available in IRDAI’s website i.e., https://www.irdai.gov.in/

The direct URL/link is provided below to directly access the GRO details:

https://irdai.gov.in/list-of-gros

7. How do I contact the Insurance Ombudsman?

The contact details of Insurance Ombudsman Centres are made available in the website of Council for

Insurance Ombudsman (CIO) at https://www.cioins.co.in/.

The direct URL for the same is https://www.cioins.co.in/Ombudsman.

Leave a Reply