How do I make a complaint to the Insurance Ombudsman?
The ombudsman takes complaints from individuals, sole proprietors and micro enterprises. The policyholder files, or the policyholder's legal heirs, nominee or assignee. The complaint goes to the ombudsman whose territory covers the insurer's branch or office or your place of residence.
You must have complained to the insurer in writing first. Then one of three things has to be true: the insurer rejected the complaint, its reply left you unhappy, or a month passed with no reply. File within one year of that point. The ombudsman may condone a late complaint after hearing the insurer.
The complaint is free. You can make it online on the Council for Insurance Ombudsmen's website, by email or in person. Attach your complaint to the insurer, your KYC, the insurer's rejection letter and your policy copy. The council's FAQ says there is no provision to engage a lawyer.
The ombudsman can award up to ₹50 lakh including expenses, and the rules ask for an award within three months of receiving everything from you. The insurer must comply within 30 days of the award. The claim-rejected tool works out when the ombudsman opens for your complaint and the last day to file.
If this is where you are
The insurer rejected my claim or did not reply, and I want to complain to the Insurance Ombudsman without getting the form wrong.
Insurance Ombudsman complaint on Annexure VI-A
Your complaint on Annexure VI-A filled from your facts, the mediation consent page, the list of documents to file and your last date.
₹499₹799
Launch price until 30 November
Common questions
Can my company complain to the ombudsman?
The ombudsman takes complaints from individuals, sole proprietors and micro enterprises only. An entity outside those groups goes to a consumer commission.
What if my claim is above ₹50 lakh?
The ombudsman can award up to ₹50 lakh. A larger claim goes to a consumer commission.
Can I go to a consumer commission and the ombudsman for the same claim?
The ombudsman will not take a matter on which proceedings are pending before a court, consumer forum or arbitrator, or one already decided there. Going to a consumer commission first closes the ombudsman route on the same subject.
Who files if the policyholder has died?
The policyholder's legal heirs, nominee or assignee can file (rule 14(1)).
Want this handled for you? Tell us where you stand and we prepare the papers and take you through the filing.