Attention isdrawn to Authority’s Circular No. IRDAI/CAD/CIR/MISC/063/03/2016 dated01-04-2016 vide which all Insurers were directed to submit data pertaining tocompliance of awards passed against them by Insurance Ombudsman.

Upon perusalof the data received from all Insurers for the period April, 2018 to December,2018, the following observations are made:

a)   While Insurance OmbudsmanRules, 2017 mandate Insurers to comply with the awards passed by InsuranceOmbudsman within a period of 30 days of receipt of award, many Insurers are neithercomplying with the awards nor filing appeals within 60 days of receipt ofawards in accordance with provisions of circular referred above.

b)   While submittingthe statement, reasons for pendency for each award have to be mentionedseparately. However, many Insurers are not mentioning the same.

c)   Few Insurers arenot even submitting statements prescribed under above mentioned circular todesignated person.

Upon callingfor reasons for non-compliance from the Insurers, few Insurers are submittingthat they have complied with the award post timelines stipulated under theabove mentioned rules. Non-compliance of these awards within the timelinesprescribed would severely undermine the grievance redressal framework laid downand cause undue hardships to the policyholder.

In view ofthe above, all Insurers are hereby cautioned that non submission of statementsprescribed under above mentioned circular and non-compliance of awards byInsurers within the timelines prescribed under Insurance Ombudsman rules, 2017will be viewed very seriously.

TS Naik
General manager,
Consumer Affairs Department.