Ombudsmen - Role

The following are some of the examples of the types of complaints for which Insurance Ombudsmen may be approached:

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 relation to the claims. 

Delay in settlement of claims. 

Non-issue of any insurance document to customers after receipt of premium.

There are some limitations in the types of complaints that are usually encouraged by Ombudsmen. The decision of the ombudsman is binding on the insurance companies but not on the insured persons, who may approach the courts, if dissatisfied.

There is also a governing body for Ombudsmen called the Governing Body of Insurance Council (GBIC), which has been set-up under the Redressal of Public Grievances Rules 1998, to look after the functioning of Insurance Ombudsman established all over India (URL: http://ombudsmanindia.org)

GBIC consists of a representative, usually a Chairman or a Managing Director from each of the insurance companies and one or more persons as Insurance Ombudsman.

Address of Governing Body of Insurance Council (GBIC):

Office of Governing Body of Insurance Council,
3rd Floor, Jeevan Seva Annexe, (Above MTNL),
S. V. Road, Santacruz (W),
Mumbai - 400 054.