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Thursday 29 October 2015

Insurance ombudsman an easy way to settle claims

Like in the case of other ombudsmen, a negligible number of the insured (policy-holders) are aware that a public authority called the Insurance Ombudsman exists in India, according to G. Rajeswara Rao, Insurance Ombudsman for Andhra Pradesh and Telangana and Yanam.

The level of awareness is so low that the ombudsman receives only a few thousands of complaints against the lakhs of claims repudiated every year, he said. The number of such claims rejected by 24 life and 28 non-life insurers in India last year was about four lakh. As the number of petitions submitted to the ombudsman is insignificant, awareness is being spread in different ways.

In 2014-15, 1,274 cases were settled involving an award amount of Rs. 13 crore within three months. In the current year, 595 cases were disposed of in as many months with a total financial award of Rs. 1.55 crore, he said.

Addressing the media here on Wednesday, Mr. Rajeswara Rao said aggrieved individuals who took policies like life insurance, Mediclaim, accident insurance and property insurance in their personal capacities could approach the ombudsman but the amount under dispute should not exceed Rs. 20 lakh.

Before lodging complaints with the ombudsman, the policy-holders should approach the grievance redressing committees of insurers.

The awards given by ombudsman were binding on the insurers but the aggrieved persons could go to a consumer court or other forum if he or she finds the awards unacceptable.

The policy-holders have to approach the ombudsman within a year of repudiation of their claims. Mr. Rajeswara Rao said 17 such insurance ombudsmen were functioning in the country and the Hyderabad centre that has jurisdiction over A.P, T.S and Yanam was adjudged the best last year.

In the first six months of 2015-16, the ombudsman passed 57 awards including 16 against Life Insurance Corporation of India and 10 against Reliance Life Insurance Co. Ltd. Complaints could be made in written form or mailed.

Source: The Hindu

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