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How To Register A Complaint Against Health Insurance Claim

Published On Apr 11, 2021 5:30 AM By KANIKA WADHWA

The Insurance Regulatory and Development Authority of India (IRDAI) enables customers/policy holders to sue an insurance company in order to assist them in resolving certain issues. This government agency will assist you in all facets of the problem and help you overcome it as quickly as possible.

How To Register A Complaint Against Health Insurance Claim

How To File A Complaint Regarding A  Health Insurance Claim?

When suing your insurer with IRDAI, keep the following points in mind. There are many ways to file a complaint with the IRDAI.

1. Send A Letter To The Insurance Company

Foremost, file a report with the insurance company. Send a written note, along with supporting documentation, to the branch's Grievance Redressal Officer (GRO). Alternatively, you can file a complaint with any other office with which you interact. Also, make sure you get a written acknowledgement from the GRO about your complaint. The officer's contact information can be found on the policy sheet you received when you bought health insurance. Alternatively, you can visit the IRDAI website to obtain information on all insurance companies. Also, be aware of the free-look era.

2. Contact the IRDAI's Consumer Affairs Department

All insurance companys are required to respond to complaints within 15 days of receiving them. If the company ignores and does not react, or if you are unhappy with the insurer's behaviour, you can file a complaint with the IRDAI's Consumer Affairs Department:

  • Dial the toll-free number 155255 or 1800 4254 732 to reach the IRDAI's consumer affairs department's Grievance Redressal Cell.
  • Alternatively, you can send an email to complaints@irda.gov.in.
  • Alternatively, if any vial post or courier, you should fill out the Complaint Registration Form with other letters.

The form and address can be found on the official website.

3. System for Integrated Grievance Management

An Integrated Grievance Management System has been introduced by the IRDAI (IGMS). If you are unable to file a complaint with the Insurance Company's Grievance Redress Channel, you can file a complaint with IGMS. This system will give you a way to file complaints with the insurance company and keep track of them. To file a complaint and keep track of it, go to igms.irda.gov.in and fill out the form. A token reference number will be assigned to you until you are able to file your complaint.

4. The Office of the Insurance Ombudsman

If you are still disappointed, you have the option of contacting the insurance company or filing a legal suit against them in a civil court. It is a quick-moving judicial body that handles cases with a value of up to Rs. 20 lakh. The insurance Ombudsman retains the right to compensate the party that has been wronged.

If you are dissatisfied with your insurer, you have several options for filing a complaint. It's important to remember that you should first file a report with your health insurer before approaching IRDAI. You may even change the complaint in the middle of the process using the IGMS framework.

Disclaimer: This article is issued in the general public interest and meant for general information purposes only. Readers are advised not to rely on the contents of the article as conclusive in nature and should research further or consult an expert in this regard.

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